The Cannibalization of Care: A Forensic Autopsy of the Massage Therapy Profession (a Google Gemini Deep research project.

Executive Summary: The Systemic Failure of the “Wellness” Industrial Complex

The massage therapy profession, outwardly projected as a sanctuary of holistic healing and benevolent care, is in reality a predatory economic engine built upon the systematic exhaustion of human capital. It is an industry that functions by consuming the bodies and financial futures of its workforce, churning through compassionate individuals with a mechanical ruthlessness that belies its soft-focus marketing. This report delivers an unvarnished, exhaustive analysis of a sector in critical decay—a profession characterized by legalized wage theft, pervasive physical injury, rampant pseudoscience, institutionalized sexual violence, and a regulatory framework so fractured it fails to distinguish between legitimate healthcare and organized crime.

We are witnessing the slow-motion collapse of a trade that has failed to professionalize, failed to protect its workers, and failed to secure its standing in the modern healthcare hierarchy. Far from the “booming” career path promised by deceptive trade school marketing, the reality for the median practitioner is a grim cycle of physical deterioration, financial instability, and professional marginalization. The industry stands at a precipice, squeezed between the loss of consumer trust due to systemic abuse scandals and the rising tide of automation that threatens to render the human manual therapist economically obsolete.

This document dissects the anatomy of this failure. It examines the “churn and burn” labor models of the franchise giants, the deceptive financial structures of the gig economy, the predatory nature of for-profit education, and the existential threat posed by the inescapable association with illicit sex trafficking. It concludes with a forecast of a future where the “human touch” is not a premium commodity, but a liability eliminated by the ruthless efficiency of robotics and artificial intelligence.

I. The Economic Meat Grinder: Wage Theft, Precarity, and the Franchise Model

The foundational economic rot of the massage therapy profession lies in its unique and exploitative compensation structure. In no other licensed healthcare field is the professional so explicitly devalued as in the massage industry, where the “service hour” reigns supreme over the “clock hour.”

The “Service Hour” vs. “Clock Hour” Scam

The industry standard for compensation constitutes a sophisticated form of wage suppression. While the Bureau of Labor Statistics (BLS) reports a median annual wage of approximately $57,950 ¹, this figure is a statistical mirage that masks the granular reality of how massage therapists are paid. The vast majority of therapists, particularly those employed by the franchise chains that dominate the market, are compensated on a “piece-rate” basis. They are paid only for the time their hands are physically touching a client—typically a 50-minute “hour.”

This structure creates a bifurcation of labor time that explicitly devalues the essential administrative and clinical aspects of the job. A therapist is legally required to perform intake interviews, review medical histories, chart client progress (SOAP notes), turn over the treatment room (changing linens, sanitizing surfaces), and consult with the client post-session. In a standard healthcare model, a nurse or physical therapist is paid for their entire shift, regardless of patient volume. In the massage franchise model, these critical tasks are often uncompensated or compensated at a pitiable minimum wage “admin rate” that drags the effective hourly wage down significantly.²

The economic implications are devastating. A therapist scheduled for an eight-hour shift might only be booked for three hours of hands-on work. During the five hours of “downtime,” they are often required to remain on-site, effectively held captive by the employer without meaningful compensation. They subsidize the business’s operational risk with their own time. If customers do not show up, the therapist does not eat. This transfer of market risk from the capital owner to the laborer is a hallmark of the industry’s exploitative nature.

Table 1: Comparative Analysis of Labor Valuation in Allied Health vs. Massage Franchise

Metric	Registered Nurse / PT Assistant	Massage Therapist (Franchise/Chain)	Economic Implication for Therapist
Compensation Basis	Hourly (Clock time) or Salary	Piece-rate (Service/Hands-on time)	Extreme income volatility; uncompensated mandatory presence.
Administrative Tasks	Included in base pay	Unpaid or Minimum Wage	Devaluation of clinical documentation; incentive to rush or skip safety protocols.
Downtime / No-Shows	Paid at full rate	Unpaid or minimal “sit pay”	Employee bears the full cost of low consumer demand.
Benefits Eligibility	Standard for full-time (>30 hrs)	Rare; “Full time” often redefined	Lack of health insurance, paid leave, or retirement matching despite physical toll.
Overtime Calculation	Standard 1.5x over 40 hours	Often manipulated via “service hour” math	Difficulty achieving overtime pay despite long on-site hours.

Legal challenges, such as the Vann v. Massage Envy Franchising case, highlight the corporate strategy of distancing the “franchisor” from these labor practices.⁴ By claiming that each location is independently owned, the corporate parent shields itself from liability for wage and hour violations, while simultaneously enforcing strict operational manuals that dictate the very conditions leading to the violations. The franchisee, often squeezed by high royalty fees, squeezes the therapist in turn.

The Franchise Industrial Complex: Commoditization and Burnout

The proliferation of chains like Massage Envy, Hand & Stone, and Elements Massage has industrialized therapeutic touch. These entities operate on a volume-based model that treats the massage therapist not as a clinician, but as a replaceable unit of production on an assembly line. The business model relies on selling low-cost memberships to consumers, which artificially depresses the market rate for massage services across the entire profession.²

To sustain the low introductory rates and membership discounts, franchises must maximize the output of their labor force. Booking protocols frequently demand back-to-back sessions with only 5 to 10 minutes of turnover time between clients.² In that brief window, a therapist must discharge the previous client, strip the table, sanitize the room, dress the table, review the next client’s file, and mentally reset. This relentless pace is biomechanically unsustainable.

The economic logic of the franchise is clear: it is cheaper to burn out a new graduate in two years and recruit a replacement than it is to structure a schedule that allows for career longevity. The high turnover rate is not a bug; it is a feature of the system. The “churn and burn” model relies on a constant influx of optimistic, debt-laden graduates from massage schools who are desperate for immediate employment and lack the client base to start a private practice.

Forum discussions among therapists reveal the depth of the despair. Workers describe being pressured to upsell retail products and “enhancements” (like aromatherapy or foot scrubs) during the treatment to eke out a meager commission, transforming the therapeutic encounter into a sales pitch.⁵ This commercialization erodes the therapist’s professional identity and ethical boundaries.

The Gig Economy Trap: The “Uberization” of Bodywork

The emergence of on-demand apps like Soothe and Zeel was heralded as a liberation from the franchise grind, promising therapists autonomy and higher wages. In reality, these platforms have further eroded the economic standing of the profession, creating a digital race to the bottom that strips away the safety of a controlled environment.

While these apps advertise hourly rates that appear higher than franchise wages (e.g., $75-$95 per hour), a forensic accounting of the costs reveals a different story.⁷ The therapist assumes 100% of the overhead:

• Transportation: Gas, vehicle depreciation, and parking costs are borne by the worker.
• Equipment: The therapist must purchase and transport their own massage table (weighing 30-40 lbs), linens, oils, and music.
• Unpaid Travel Time: A “one-hour” appointment often involves an hour of round-trip driving and 30 minutes of setup/breakdown time.
• Self-Employment Tax: The 1099 classification adds a significant tax burden (15.3% SE tax) compared to W-2 employment.

When these costs are factored in, the “premium” pay of the gig economy often nets out to near-minimum wage levels, with the added physical burden of hauling heavy equipment into strangers’ homes. Moreover, the algorithmic management of these platforms creates a coercive environment. Therapists who decline bookings due to safety concerns, distance, or fatigue are penalized by the algorithm, receiving fewer future offers or being “shadow-banned” from the platform.⁸

The safety risks of the gig economy are acute. Unlike a clinic or spa, where a front desk staff acts as a buffer and security presence, the mobile therapist is entering a private residence alone. Reports of sexual harassment and assault are prevalent, yet the platforms often prioritize customer retention over therapist safety. The “Trust & Safety” teams described by these companies often serve primarily to limit corporate liability rather than protect the worker.⁹ The reality is that the gig economy has turned the massage therapist into a delivery driver, but the cargo is their own body, and the destination is often unsafe.

Geographic Disparities and Cost of Living

The economic viability of the profession is further strained by geographic disparities. While wages are higher in states like Washington and Oregon, the cost of living in these areas erodes the purchasing power of the therapist.¹⁰ In lower-cost areas, the market is often saturated with low-wage franchise locations, suppressing earning potential.

Data shows extreme variance in earnings potential based on location, with a therapist in Portland potentially earning $71,000 while a counterpart in Orlando earns $53,000.¹⁰ However, when adjusted for the soaring costs of housing and healthcare—which most therapists must purchase on the open market due to lack of employer benefits—the “livable wage” evaporates. The profession is becoming economically viable only for those with a partner who provides health insurance and financial stability, effectively relegating massage therapy to a “second income” status rather than a primary career.

II. Physical Destruction: The Body as a Depreciating Asset

Massage therapy is one of the few professions where the practitioner’s body is the primary tool of the trade, and that tool is subjected to catastrophic rates of depreciation. The physical toll of the profession is not merely a side effect; it is a statistical inevitability built into the mechanics of the work.

The Epidemic of Repetitive Strain Injury (RSI)

Research indicates that an overwhelming majority of massage therapists experience work-related pain (WRP) or Repetitive Strain Injury (RSI). Studies place the prevalence of WRP among therapists at approximately 85%, a staggering figure that would prompt OSHA intervention in almost any other industrial sector.¹¹ The most common sites of injury are the tools most essential to the trade: the hands, wrists, and thumbs.

The mechanics of deep tissue and therapeutic massage require the generation of force that frequently exceeds the physiological tolerance of human connective tissue. When performed for the 20 to 30 hours of “hands-on” time per week required to earn a living wage in the low-pay franchise sector, the result is Cumulative Trauma Disorder (CTD).

Table 2: Injury Prevalence and Mechanism in Massage Therapists

Body Region	Reported Pain/Injury Rate	Biomechanical Cause	Career Impact
Hand/Wrist	65.5%	Compressive force; repetitive flexion/extension; carpal tunnel compression	Inability to perform standard strokes; loss of fine motor control; career-ending without surgery.
Fingers/Thumb	60.3%	Point pressure application (trigger point work); hyperextension of CMC joint	Osteoarthritis; “Thumb blowout”; permanent loss of grip strength.
Shoulder	55.0%	Leverage generation; poor body mechanics during deep pressure	Rotator cuff tears; bicipital tendonitis; frozen shoulder.
Lower Back	50.1%	Leaning/posture over table; forceful rotation	Debilitating chronic pain; herniated discs; sciatica.
Neck	49.2%	Head posture during sessions (looking down); upper trap strain	Cervical strain; tension headaches; nerve impingement.

Source Data: ¹¹

The Finite Career Lifespan

The high rate of injury creates a cruel paradox: to make a livable income, a therapist must work more hours; yet, working more hours exponentially increases the likelihood of a career-ending injury. This results in an incredibly short average career lifespan. While the BLS projects 15% growth for the profession ¹, this is largely a function of replacement needs—filling the void left by the legions of therapists who physically break down and exit the field within 3 to 5 years of graduation.¹³

The industry’s “growth” is essentially a measure of its turnover. It is a metabolic rate of consumption. The “burnout” rate is reported at 49%, but this clinical term masks the physical reality: bodies are breaking. Therapists are not just “tired”; they are suffering from tenosynovitis, bursitis, and nerve damage.¹²

The Lack of a Safety Net

There is virtually no safety net for these workers. Because many are classified as independent contractors (1099) or work “part-time” hours (20-25 hours a week is considered physically full-time for massage, but legally part-time for benefits), they lack disability insurance or workers’ compensation coverage.

When a massage therapist blows out a thumb CMC joint or herniates a lumbar disc, their income drops to zero immediately. They rarely have paid sick leave to recover. This forces many to work through the injury, exacerbating the damage until it becomes permanent. The profession effectively eats its young, relying on a constant stream of healthy, naive bodies to feed the consumer demand for low-cost bodywork.

III. Educational Predation: The Diploma Mill Pipeline

The supply of fresh labor required to sustain the franchise and gig economy models is generated by a for-profit education sector that often engages in predatory practices, selling a dream of “healing” and “autonomy” that rarely materializes.

The Debt-to-Income Disparity

Tuition for massage therapy programs typically ranges from $10,000 to over $20,000 at private institutions.¹⁵ For a median income of $57,000 (and significantly lower for entry-level franchise work), the return on investment (ROI) is mathematically poor. Students often graduate with significant federal loan debt, only to find that the “high demand” for therapists consists largely of low-wage positions that barely cover their loan payments.¹⁷

The marketing materials for these schools often cite the “highest potential” earnings or “business ownership” opportunities, glossing over the reality that building a private practice takes years of unpaid equity and marketing—years that the new graduate, burdened by debt, does not have. They are funneled directly into the franchise mills to service their debt.

Accreditation Fraud and Educational Failure

The sector is rife with fraud and instability. High-profile collapses of institutions like the Cortiva Institute and the scandals involving the selling of transcripts (diploma mills) undermine the credibility of the entire licensure process.¹⁹

Investigations have revealed shocking malfeasance:

• Transcript Selling: In Florida, schools were found selling transcripts for thousands of dollars to individuals who never attended a single class, allowing untrained individuals to obtain state licensure.²¹
• Falsified Records: Schools like South Bay Massage College and Lincoln Institute were caught falsifying attendance records and “coaching” students to pass the MBLEx (licensing exam) through memorization rather than actual learning.²³
• Accreditation Loss: The revocation of accreditation for schools like Myotherapy Massage College highlights the failure of these institutions to maintain even basic financial or educational standards.²⁵

This fraud devalues the license of every legitimate therapist. It floods the market with unqualified practitioners who drive down wages and increase the risk of consumer harm.

The “150% Rule” and the Fight to Overcharge

The desperation of the industry to maintain its student revenue stream is evident in the legal battles over the Department of Education’s “150% Rule.” Professional associations like the American Massage Therapy Association (AMTA) have sued to protect the ability of schools to charge for program hours that exceed state licensure requirements by 50%.²⁶

For example, if a state requires 500 hours for a license, schools want to charge federal financial aid for 750 hours. They argue this is for “advanced training,” but critics argue it is simply a mechanism to maximize Title IV revenue from students who are taking out federal loans. The industry is fighting for the right to burden students with more debt for education that is not legally required to work. It is a brazen defense of revenue generation over student welfare.

Curriculum Deficiencies: Teaching Pseudoscience

The curriculum in many of these institutions is also subject to severe criticism for its lack of scientific rigor. Time that could be spent on advanced anatomy, pathology, or evidence-based pain science is often diverted to “energy work,” reflexology, polarity therapy, and other pseudoscientific modalities.²⁸

By teaching students that they can “move energy” or “release toxins,” schools are setting graduates up for failure in the integrated healthcare market. They are graduating mystics in a market that demands clinicians. This educational failure is a primary driver of the profession’s inability to gain respect from the medical community.

IV. The Illicit Shadow: Trafficking, Stigma, and Reputational Rot

Perhaps the most devastating indictment of the massage therapy profession is its inability to disentangle itself from the commercial sex trade. The industry is fundamentally compromised by the widespread prevalence of Illicit Massage Businesses (IMBs), which operate under the guise of therapeutic establishments while facilitating human trafficking and prostitution.

The Scale of the Problem

Estimates suggest there are over 9,000 illicit massage businesses operating in the United States.²¹ This is not a fringe issue; it is a massive, parallel industry. In many jurisdictions, these establishments operate openly in strip malls, possessing valid business licenses and even employing individuals with state-issued massage licenses (often obtained through the fraudulent schools mentioned above).

The existence of this parallel industry creates a catastrophic reputation problem for legitimate therapists. The public often lacks the sophistication to distinguish between a legitimate clinic and an IMB, leading to a pervasive stigma.

Impact on Legitimate Therapists

Surveys and anecdotal reports indicate that legitimate massage therapists regularly face sexual harassment and solicitation from clients who conflate the profession with sex work.¹⁴ This is not a “misunderstanding”; it is a direct result of the industry’s failure to police its own boundaries.

Female therapists, who make up the vast majority of the workforce (approx. 80-88%), are disproportionately targeted. They must endure “creepers,” inappropriate requests, and the constant psychological burden of screening clients for safety. This hostile work environment contributes significantly to the burnout rate.

Regulatory Failure and Complicity

State boards and local municipalities have proven inept at distinguishing between legitimate therapy and organized crime. The “fragmented local regulatory structure” allows IMBs to exploit jurisdictional gaps.³⁰

• The Utah Report: A scathing report from Utah’s Office of Professional Licensure Review found that IMBs continue to receive licenses that legitimize their operations. The regulatory bodies lack the resources or the will to effectively police the thousands of establishments.³⁰
• Performative Credentialing: Professional associations rely on “credentialing” and “board certification” as a solution, but trafficking networks easily circumvent these barriers. The “Rubmap” phenomenon—review sites where sex buyers rate IMBs—demonstrates that the illicit market is organized, efficient, and operating with near impunity.²⁹

The result is a profession where legitimate practitioners must constantly defend their legitimacy, endure sexual harassment as a “hazard of the trade,” and compete economically with businesses that utilize forced labor to undercut market prices.

V. Systemic Sexual Misconduct and Consumer Safety

While the industry struggles with the external threat of IMBs, it faces an equally horrifying internal crisis: the rampant sexual assault of clients by licensed, background-checked therapists within major franchises. The “safe” spaces of the industry have been exposed as hunting grounds for predators.

The Massage Envy Scandal

The revelation that over 180 women filed sexual assault lawsuits against Massage Envy franchises exposed a culture of corporate negligence and cover-ups.³² This was not a case of a few “bad apples”; it was a systemic failure of the franchise model.

Detailed reports and lawsuits ³⁴ outline a playbook used by franchises to manage “incidents”:

1. Ignored Complaints: Franchise owners frequently disregarded initial reports of inappropriate touching to avoid losing revenue or staff during a labor shortage.
2. Lack of Reporting: There was often no mandate to report allegations to police or state boards. A therapist fired from one location for misconduct could simply move to another franchise (e.g., Hand & Stone, Elements Massage) and reoffend because their license remained active.³⁴
3. The “Zero Tolerance” Lie: Policies touted in marketing materials were often ignored in practice. The “Commitment to Safety” was a PR shield, not an operational reality.

The Legal Shield: Franchise Liability Avoidance

The franchise structure is weaponized to evade liability. In lawsuits, the parent company (Massage Envy Franchising, LLC) consistently argues that because each location is independently owned, corporate headquarters bears no responsibility for the assaults committed by therapists.⁴ They claim to be merely a “branding” company, not a healthcare provider.

This legal maneuvering leaves victims with little recourse, as individual franchise owners often lack the capital to pay significant damages. Furthermore, customers are often forced into arbitration agreements buried in the fine print of their membership contracts, which keeps allegations out of the public court record and silences victims.³⁶ This secrecy allows the predator problem to persist, hidden from public view.

Specific Cases of Horror

The snippets reveal a litany of specific atrocities that highlight the danger:

• Kirkwood, Missouri: A therapist charged with sodomy and abuse of a postpartum client.³⁴
• College Station, Texas: A therapist arrested for digital penetration of a client.³⁴
• Chicago, Illinois: Two men assaulted at the same spa, weeks apart, proving the facility failed to act on the first report.³⁸

These are not anomalies; they are the result of a system that prioritizes profit over protection. The background checks are superficial, the training on boundaries is often an online module, and the oversight is non-existent.

VI. The Crisis of Legitimacy: Pseudoscience vs. Medicine

For decades, the massage therapy profession has attempted to position itself as a legitimate branch of healthcare. However, it remains mired in pseudoscience, anti-intellectualism, and a “turf war” with physical therapy that it is definitively losing.

The “Woo” Factor: Alienating Science

A significant portion of massage education and practice is based on debunked biological mechanisms. The pervasive claim that massage “flushes toxins” (specifically lactic acid) is physiologically false—massage actually impedes lactic acid removal by mechanically restricting blood flow during compression—yet it remains a staple of therapist-client communication.³⁹

Concepts like “energy blockages,” “craniosacral rhythms,” and “releasing fascia” (which requires force far beyond human capability to mechanically alter) are widely taught and practiced despite a lack of high-quality evidence.³⁹ When therapists speak of “grounding energy” or “detoxifying the liver” through foot massage, they render themselves ineligible for serious integration into hospital systems or insurance reimbursement models. They relegate the profession to the realm of “spa services” and “pampering” rather than evidence-based healthcare.²⁸

The Physical Therapy Turf War

Physical Therapists (PTs) and Doctors of Physical Therapy (DPTs) are increasingly encroaching on the manual therapy space, and they are winning. PTs offer evidence-based manual interventions (mobilization, manipulation) backed by doctoral-level education and, crucially, insurance reimbursement.⁴²

In this comparison, massage therapy loses on every front:

• Scope of Practice: PTs can diagnose and prescribe; LMTs cannot. PTs treat pathology; LMTs treat “wellness.”
• Efficacy: PT manual therapy is integrated into a functional rehabilitation plan with active movement; massage is often passive and palliative.⁴⁴
• Economic Viability: PTs have a stable career ladder with benefits; LMTs have a ceiling capped by their physical endurance.

The attempt by massage organizations to create “Board Certification” (NCBTMB) to elevate the profession has largely failed. It is viewed by many in the field as a “money grab” that offers no tangible increase in wages, referrals, or respect from the medical community. The “BCTMB” credential is unknown to the public and ignored by the medical establishment.⁴⁶

VII. The Future: Obsolescence, Automation, and Economic Ruin

Looking toward 2025 and beyond, the future of the massage therapy profession is bleak. The convergence of automation technology, artificial intelligence, and economic headwinds threatens to render the human massage therapist an obsolete luxury item for the mass market.

The Rise of Robotics: The “Aescape” Era

The introduction of robotic massage systems, such as Aescape, signals the beginning of the end for entry-level human labor in this sector. These systems offer consistency, do not suffer from burnout or RSI, do not sexually assault clients, and can operate 24/7 without labor law violations.⁴⁸

While industry apologists argue that “robots can’t replace the human touch,” the economics argue otherwise. For the consumer seeking simple pain relief or relaxation, a robot that costs significantly less per session, requires no tip, and guarantees a consistent experience will be an attractive alternative to a human therapist who is variable in quality, potentially injured, or emotionally exhausted.⁵⁰

Table 3: Human Therapist vs. Robotic Systems (The Replacement Logic)

Feature	Human Therapist	Robotic System (e.g., Aescape)
Consistency	Highly Variable (Mood, Fatigue)	100% Consistent (Programmable)
Availability	Limited by fatigue/schedule	24/7 Availability
Safety	Risk of sexual misconduct/assault	Zero risk of misconduct
Cost to Consumer	High (Wage + Tip + Overhead)	Lower (Capital depreciation only)
Employment Liability	High (Wages, HR, Lawsuits)	Low (Maintenance contracts)
Scalability	Linear (1 therapist = 1 client)	Exponential (1 tech manages 10 bots)

Major chains like Equinox are already integrating these systems.⁵⁰ As the technology matures, it will cannibalize the “maintenance” and “relaxation” segments of the market—the bread and butter of the franchise industry.

AI and the “Uberization” of Management

Artificial Intelligence is already actively displacing administrative roles within the industry, but its impact on the gig economy will be more profound. AI-driven scheduling and “predictive” pricing will further commoditize the therapist, treating them as interchangeable units of labor to be deployed with maximum efficiency and minimum pay.⁴⁹

The “Superagency” concept suggests that AI will manage the workflow, reducing the therapist to a pair of hands directed by an algorithm. This removes the last vestiges of professional autonomy, turning the therapist into a task-rabbit for the wellness algorithm.

The Recessionary Guillotine

As the global economy faces inflationary pressures and potential recession, massage therapy—viewed largely as a discretionary luxury expense due to its lack of medical integration—is the first item cut from household budgets. The “Lipstick Effect” may save small beauty purchases, but a $100+ massage service is a prime target for consumer austerity.⁵² The Global Wellness Institute reports growth in the “wellness economy,” but this growth is driven by technology, real estate, and products—not by the wages of service providers.⁵³ The pie is getting bigger, but the therapist’s slice is disappearing.

Conclusion: A Profession in Need of a Eulogy

The massage therapy profession as it currently exists is a structural failure. It is an industry that devours the physical health of its workers, exploits their financial naivety through predatory education and franchise arrangements, and exposes consumers to unacceptable risks of sexual violence and pseudoscience.

It is a profession that has failed to launch. It remains trapped in a limbo between healthcare and sex work, unable to claim the legitimacy of the former or escape the stigma of the latter.

The “future” of the profession is likely a stark bifurcation:

1. The Elite Niche: A tiny cadre of highly educated, medical-adjacent manual therapists who work within clinical settings, charge high rates, and serve a wealthy clientele.
2. The Automated Mass Market: A vast sector of robotic services and AI-managed wellness pods that handle the bulk of relaxation and recovery work, eliminating the need for human labor.

The middle class of the profession—the franchise worker, the independent spa therapist, the mobile gig worker—is facing extinction. They are being squeezed out by the physical unsustainability of the work and the ruthless efficiency of technological replacement. To recommend this career path to a young person today, without “kid gloves” or varnished truths, is to recommend a path of certain physical pain, probable financial instability, and inevitable professional obsolescence. The massage therapy profession is not dying; it is being automated, regulated, and exhausted out of existence.