Safety Brief: Workplace Safety Risks in Registered Massage Therapy

Safety Brief: Workplace Safety Risks in Registered Massage Therapy

Structural Implications of Current Working Arrangements in British Columbia

Executive Summary

Registered Massage Therapists (RMTs) in British Columbia face recognized risks of workplace violence, harassment, and unsafe patient interactions. The predominant model of independent contractor-based clinic arrangements creates ambiguity in responsibility for workplace safety, limiting access to protections, reporting mechanisms, and consistent safety standards.
A review of multiple clinic agreements suggests a consistent pattern: clinics often control scheduling, fees, patient access, billing systems, and operational processes, while practitioners remain classified as independent contractors. In most industries, when an organization controls these core elements of work, the worker is more likely to be treated as an employee rather than an independent business.

This classification gap may limit access to workplace safety protections, reporting pathways, and accountability mechanisms. In a profession where national and provincial survey data has identified high rates of harassment and boundary violations, this raises important questions about whether current working arrangements adequately protect practitioners, patients, and the public interest.

Context: Workplace Risk in the Profession

Survey data from organizations such as the Canadian Massage Therapist Alliance and Registered Massage Therapists' Association of Ontario indicate a high prevalence of workplace harassment and boundary violations reported by practitioners.

These findings suggest that workplace risk is not isolated. However, the consistency of reporting pathways, protections, and support mechanisms available to practitioners remains unclear.

Structural features of working arrangements, including classification ambiguity and restricted mobility, may influence reporting behavior and limit visibility into these risks.
RMTs commonly practice within clinic environments under independent contractor agreements. As outlined in the accompanying Contract Pattern Summary, these arrangements typically involve:

• Clinic control over scheduling, fees, and patient access

• Integration into clinic policies, systems, and operations

• Restrictions on mobility and patient relationships

• Centralized billing and administrative control

While these roles are formally classified as independent contracting, the degree of operational control and integration introduces uncertainty regarding accountability for workplace safety.

Why This Matters

1. Unclear Responsibility for Safety

In traditional employment models, employers are responsible for maintaining safe working environments. In contractor-based models, this responsibility is often undefined or diffuse, despite clinics maintaining control over the physical environment and patient flow.

In most industries, when an organization controls the working environment, it is also responsible for safety within that environment. Where control and responsibility are not aligned, gaps in accountability may arise.

2. Limited Ability to Refuse or Exit Unsafe Situations

RMTs may face barriers to:

• Declining high-risk patients

• Terminating treatment when safety concerns arise

• Leaving clinic environments without financial or professional consequence

In most independent contractor models, workers retain the ability to determine who they work with and under what conditions. When that flexibility is limited, it may increase exposure to unsafe interactions and reduce the ability to respond to risk in real time.

3. Barriers to Reporting Workplace Violence

Anecdotal reports from practitioners suggest:

• Hesitation to report incidents due to fear of losing clinic access or referrals

• Lack of formal reporting structures within clinic settings

• Uncertainty regarding whether concerns should be directed to clinics, regulators, or occupational safety bodies

In most structured workplaces, reporting pathways are clearly defined and supported by policy. Where these pathways are unclear or absent, incidents may go unreported, limiting visibility into workplace risk.

4. Gaps in Access to Occupational Health Protections

Independent contractor classification may limit:

• Access to structured workplace safety protocols

• Clear pathways for incident documentation and follow-up

• Engagement with occupational health systems such as WorkSafeBC

In most industries, access to occupational health protections is tied to employment status. Where classification does not align with how work is performed, access to these systems may be inconsistent.

5. Implications for Patient Safety and Public Trust

Environments that are unsafe for practitioners may:

• Compromise clinical decision-making

• Affect continuity of care

• Undermine confidence in regulated healthcare settings

In healthcare settings, practitioner safety and patient safety are closely linked. Where working conditions are unstable or unclear, both may be affected.

Key Observation

Current working arrangements in the RMT profession may not align clearly with established expectations for workplace safety accountability, particularly in environments where clinics exercise operational control without corresponding responsibility for worker protection.

Position

Workplace safety in the RMT profession requires clearer alignment between working arrangements, legal classification, and accountability for safe practice environments.

Recommendations

1. Clarify Responsibility for Workplace Safety in Clinic Settings

Define the obligations of clinic owners/operators in maintaining safe environments, particularly where control over operations and patient flow is established.

2. Review Alignment Between Worker Classification and Safety Protections

Assess whether current independent contractor models adequately support access to workplace safety protections and reporting mechanisms.

3. Establish Clear, Accessible Reporting Pathways

Develop profession-specific guidance outlining:

• Where and how RMTs can report workplace violence

• Protections against retaliation

• Roles of regulators and occupational safety bodies

4. Strengthen Coordination Between Regulatory and Safety Systems

Improve alignment between:

• College of Complementary Health Professionals of British Columbia

• WorkSafeBC

To ensure consistent expectations for workplace safety across clinical settings.

5. Develop Practice-Specific Workplace Safety Guidelines

Establish clear standards addressing:

• Patient screening and risk identification

• Termination of treatment in unsafe situations

• Documentation and follow-up of incidents

Conclusion

Workplace safety risks in the RMT profession are not solely individual or situational, but are influenced by the structure of current working arrangements. Addressing these risks requires a coordinated approach that clarifies accountability, strengthens protections, and aligns professional practice environments with established safety expectations.

Jennifer Slauenwhite, RMT

Related articles: Appendix A: Contract Analysis