The way I understand and practice them, medical massage and wellness massage are two entirely different services.

 

Medical massage is medical care delivered to a patient under the direction of a prescribing health care provider and typically paid for by a third party.

 

 

The table below is my attempt to clarify and elaborate on the differences between these practices (another table illustrates how clinical massage and ralaxation massage fit in). This is an early draft of a work in progress. If you have comments, criticisms, or suggestions please e-mail me.

 

	Medical Massage	Wellness Massage
commercial context	health care system	personal service industry
customer relationship	patient	client
dominant paradigm	scientific, problem-solving	intuitive, nurturing
reason for treatment	medical necessity	client request
focus	functional outcomes	client satisfaction
termination of care	maximum medical improvement (usually)	when client's needs are met or change
primary massage treatment techniques	clinical massage techniques like myofascial treatments, deep tissue massage, Cyriax cross-fiber friction, neuromuscular "point of pain" technique, and muscle energy technique	relaxation massage techniques like Swedish, deep tissue, circulatory massage, and craniosacral
pricing	rates set by UCR and RVU	rates set by the consumer marketplace
billing services	yes (discount for payment at time of service)	no (all payments due at time of service)
payment	can take 30-90 days or longer	due at time of service
tipping	never/rarely	often
therapist accountable to	patients IRS/state/local taxes state/city licensing authorities certification boards referring providers other HCPs involved with case insurance companies health care networks attorneys courts independent medical examiners auditors	clients IRS/state/local taxes state/city licensing authorities certification boards
	Medical Massage	Wellness Massage
time spent on documentation, coordination, and communication	10-30 minutes per session	30-60 minutes or less per session
training	advanced 1200-hour massage certification course plus advanced training in orthopedic assessment & treatment protocols pathologies and contraindications medical terminology pharmacology documentation communication skills	basic 500-hour massage certification course
experience	need clinical and professional experience and/or an internship	can start practicing right after graduating from massage school
receiver's emotional state/level of proactiveness	didn't ask to be injured, may be depressed, anxious, or otherwise distressed by both the injury/accident and/or ensuing work, life, and health complications	proactively seeking care, typically healthy and active
physical demands on practitioner	can be heavy - orthodpedic assessments, mobilizations, myofascial treatments, cross-fiber frictioning, and other injury-treatment techniques can be hard on your body	may be lighter - Swedish and some other techniques are less demanding, but deep tissue massage can be hard on your body
emotional demands on practitioner	can be heavy - patients can be disengaged, distraught, or otherwise unengaged or difficult to engage	typically light and/or manageable
client education	may be OK (therapist should ask the prescribing referrer about this), but shouldn't contradict what the rest of the medical team is saying	OK within scope of practice ("drink plenty of water," "do that stretch I showed you," "put an ice pack on it," etc.)
marketing model	business-to-business networking with referring providers, health care networks, etc.; many legal and ethical considerations regarding referral relationships, etc.	consumer marketing (much like a tax preparer, hair dresser, real estate agent, etc.); gift certificates, referral discounts, and other consumer marketing practices are OK
	Medical Massage	Wellness Massage