MOCC-ERY

Last week, the Federation of State Massage Therapy Boards presented their long-awaited proposal for a new national continuing education approval program. They are calling it Maintenance of Core Competencies – or MOCC for short. As I indicated in my previous post, this proposal not only failed to deliver on the original promises made by FSMTB, it has turned the entire professional landscape on its ear by recommending that most continuing education should be voluntary, not mandatory for license renewal.

Under this “MOCC-ERY” of a plan, the only mandatory components of continuing education would be those FSMTB deems to be relevant to “public safety”. If that’s not bad enough, FSMTB is proposing to take control over the design and delivery of these courses. Except it isn’t continuing education … it’s proving that you still know the things you should have learned in entry-level massage training as it pertains to protection of the public.

As a licensed therapist, do you want to be taken back to subjects like Ethics 101, principles of hygiene and sanitation, and the naming of unsafe massage practices – EVERY TIME YOU HAVE TO RENEW YOUR LICENSE? I’ve been teaching professional ethics for 14 years, and frankly, I find this proposal to be an insult to my intelligence.

I was very gratified today to receive the press release from AMTA denouncing the plan. In part, important communication states:

“AMTA reviewed the proposal and has many concerns with the approach of the FSMTB, the proposal itself, its inconsistencies and the lack of support provided for their view. Some of our specific areas of concern are:

  • –Overall, the impact of this proposal is to lower standards for massage therapy practice. It would shift the focus of professional development from building on the entry level education massage therapists receive to that of maintaining very minimal requirements of public protection.
  • –The proposal contradicts its stated intent, previous FSMTB statements on the need for continuing professional education and the mission of FSMTB.
  • –The proposal would take away the freedom of choice of massage therapists to determine their own practice focus and to choose the continuing education providers they prefer to meet their own professional needs by creating a “one-size-fits-all” approach for license renewal.
  • –The proposal provides no empirical data to support the efficacy, efficiency or necessity for a transition to this model.”

AMTA goes on to list 20 objections in their press release.

Although ABMP as an organization has not yet made an official statement, ABMP President Les Sweeney came out in support of the MOCC Proposal in his recent blog. In addition to being a member of AMTA, I am also a member of ABMP. I think highly of Les and the rest of the management there, but this is one of those times when we’ll have to agree to disagree. Les does state that he supports the role of the NCBTMB in the arena of continuing education; but he personally thinks CE should be voluntary. That is a major policy statement coming from the top guy at the largest professional membership association in our field.

The thing that is most outrageous and unacceptable about the MOCC Proposal is not the “public protection” course material that could be mandatory for therapists. It is the fact that leaders of four of our major stakeholder organizations in the field came together behind closed doors and decided that the majority of continuing education should no longer be mandatory.

It looks like there may have been major flaws in the process that led to this consensus document. Was the work of the eight-member Task Force shared with the full leadership of AMTA, ABMP, AFMTE and FSMTB with sufficient time to review and comment on this plan before it was published? Something doesn’t line up when AMTA comes out with a total smackdown of the plan, while their Immediate Past President was part of the team that was responsible for its development. Does that seem odd to you?

What we do know is that the decision making process took place in a vacuum, and there was no opportunity for public comment. Yes, the disclaimer says that “The MOCC is just a proposal and we’re seeking your feedback”, but input should have been sought from a broad range of constituents in the field before such a proposal was even made.

Continuing education classes that actually teach you anything new, under their plan, will become optional. Only the classes from the Federation, which they plan to make available on their website, will be required for license renewal. My opinion is that instead of being satisfied that the MBLEx has taken most of the exam revenue away from the NCBTMB, they would now like to take the continuing education dollars away, too. This plan will not only take dollars away from the NCBTMB, but also away from continuing education providers. (Disclosure: I am an NCBTMB Approved Provider of Continuing Education.)

The Task Force intentionally excluded representatives from the NCBTMB, and that’s another point that disturbs me. The Federation should be working in collaboration with NCBTMB. I was present at the AFMTE 2011 Annual Conference during FSMTB Executive Director Debra Persinger’s initial presentation about the Federation’s intent to create a CE approval program. NCBTMB Chair Alexa Zaledonis was in the audience at this session, and she publicly stated that her organization was willing to cooperate with FSMTB. It’s a shame to me that in light of their 20 years of experience in administering CE provider approvals, they are being left out of this loop. I’m gratified to see they’re not waiting around for an invitation, but instead, have gotten on with the business of making their own improvements.

In May 2011, NCBTMB convened a meeting of the Massage Approved Provider Panel, which was intended to improve and enhance their current CE approval program. Most of the stakeholder organizations in the field were represented there, including FSMTB. Based on feedback from the participants, NCBTMB will begin reviewing and approving CE courses as well as CE providers this summer.

Personally, I did learn what I needed to know about protection of the public while I was in massage school. I am one of those people who enjoy attending continuing education courses. I don’t want it to be mandated to me that I have to take a no-fail test—which isn’t really a test if you can’t fail it, is it, of things that I already know—to meet my license renewal requirements. I don’t think that serves me, as a massage therapist, and I can’t see how it’s going to serve the public. The Federation seems to think this will wipe out complaints of unethical or unsafe behavior. I don’t believe that for one minute. Anyone who is going to act unethically is going to do it, no matter how many classes they take or whom they take them from. Unsafe behavior needs to be addressed in entry-level massage school. I would much prefer to see the FSMTB come up with a model program of public safety education for schools, instead of requiring therapists who have been practicing for years to take a ridiculous no-fail test.

Times are changing, as Les said in his blog, and our organizations are changing with them. It remains to be seen whether it’s for the better or the worse. I have supported the FSMTB in the past, because I believe the state boards coming together in an effort to solve common problems is a good thing. I still believe that’s a good thing. Unfortunately, I do not believe that this is an example of the kind work they should be doing, or the way they should be doing it. You can let them know how you feel about it here.

26 thoughts on “MOCC-ERY

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  2. Holly Foster

    Now that the NCBTMB has made their big announcement regarding the changes to their organization, I don’t quite see how this will really affect you as a CE provider. If NCBTMB does follow through, they should begin delivering real elevation of the profession by providing BOARD CERTIFIED examinations that actually mean more than the silly certificate of completion that we now get and many use to say “See here! I’m CERTIFIED in _____.” Even though they didn’t learn diddly squat in the 8-24 hours of class.

    I find it ridiculous to sit in such classes where there is nothing to build upon. They’re generally 1 and dones. They don’t truly provide you with an education, much less a framework for real therapeutic outcomes with your clients once you’re back in your practice.

    We have to take ethics courses every year or two for renewal. What’s so different about this? The topic of ethics doesn’t change all that much over the course of time. But it’s still mandatory for me to take that to receive my license renewal. What’s the big deal about safety, hygiene, etc.? Of course it’s redundant and a bore, but it’s what the board of massage states is the purpose for legislating massage anyway — to protect the public.

    Personally, I’d much rather take substantive training in modalities that interest me. I’d pay to do substantive training that will allow me to sit for a board exam, and then be able to call myself an LMBT, Board Certified in ______ much in the same way that a physician can. The current CE mandate really doesn’t elevate the profession in this regard now does it?

    I think that most massage therapists are like us Laura. We love to learn, and experience. If that’s the case, then we’ll still learn and experience through continuing education courses of our choosing. They just won’t be mandated by our state board of massage.

    Now, do I think that FSMTB got it right first time out of the shoot? No way. However, I don’t think they’re as far off the mark as you (and others) would like to think.

  3. Rebecca Adams

    I have to say I think that Holly Foster has some valid points. I don’t see a problem with voluntary continuing education. It’s just like public safety and core competence. If we want to learn, we will. If we want to be ethical, we will. So pick one horse or the other, and stop trying to straddle them both.
    Personally, I don’t think I would be at all insulted by being asked to demonstrate that I still remember how to protect public safety. I don’t have that big of an ego, I guess. Things like that just don’t get under my skin. And I would love to take continuing ed and pass an exam that would show me Board Certified in something! This is my passion, my path – massage school was supposed to get me to a point that I could BEGIN!!!!! And like Holly, I grit my teeth when someone takes 16 hours of instruction from someone who has studied for YEARS, and then gets a certificate of credit hours for LICENSURE RENEWAL, and then goes and tells everybody they are CERTIFIED in a modality…
    We want to be taken seriously by the rest of the communities out there?
    Then perhaps we should get serious…
    It should take more than 16-24 of instruction to be seriously competent in anything. Vodder Technique? 100 hours. Esalen? 100 hours. Lomi Lomi? If you do it Gloria Coppola’s way, you’ll spend 40 hours here with her, then 10 days in Hawaii with both her and some elders before she will let you call yourself a Lomi Practioner. John Barnes requires a series of Myofascial Release seminars. One weekend of Medical Massage won’t get you ‘Certified’ either..
    To be able to take a weekend’s worth of something, and come away with one or two things to add to your work is wonderful. So yes, I tell people I utilize Esalen and Lomi techniques. But I sure don’t call myself certified in it. Would I like to take a series and sit for an exam, either written or practical, that was Board approved and issued? You bet I would.
    And frankly, I don’t think there is any such thing as too much ethics. Or public safety. Because it creates an arena of responsibility. NO EXCUSES.. And pardon me, but over time, a refresher doesn’t hurt anybody, because you CAN get your facts crossed, as I was so quickly corrected by Laura earlier this week when I thought NC required 550 hours of instruction. So, it doesn’t hurt anybody to have their memory refreshed. I’m certainly not above it, and I’ve had a couple of IQ tests that I scored pretty good on..
    So, I’m sure, like Holly, they don’t have it right yet. I’m also sure that they’ve got some good ideas, and I hope they keep working on it..

  4. Sandy Grover Mason

    Well, I applaud the idea of getting Board Certified in certain modalities, for all the reasons stated above. And if NCBTMB wants to spearhead that, that’s fine. But there are many, many CE courses I have taken (and taught), which do not claim to “certify” anyone, but pass on very useful, hands-on information. This blog was about the proposal by FSMTB to do what seems to me to be lowering expectations for the profession rather than raising them, and about yanking the valuable (as well as bogus) CE options which are out there altogether.

    I just don’t see how an online, “no-fail” written exam is going to ensure public safety. It seems a mockery to me – they want to ensure that every 2 years we are still at the level we were when we were first licensed? I may be misinformed, but this seems like a joke. I don’t know any MT who wants to aspire to the level he/she was upon graduation/licensure.

    Of course I am biased – it will affect me as a CE provider. People will have to really have the whim to learn, rather than by mandate need the measly 4-6 CE’s I offer for my courses. Ok, so I have to earn the right to have students pay for my class. I can see that.

    But I disagree that the ‘average MT” wants to learn. In my experience, there are a few (usually about 20-30%) in my class who are avid learners, and most of them accumulate more CE’s than they really need, because they love to learn. But most of them are there because they waited too long, it was nearby or it was really affordable. Most of us are just lazier than Holly. The CE requirement as it currently stands seems to me to be an incentive to further your education, and most of us need that incentive to get off our butts and go out and take classes – it’s all to easy to procrastinate and stagnate.

    Also, I know of no other licensed health profession which does not require Con Ed (heck even my husband, a Geologist, has to have it). It is the nature of dealing with the gravity of affecting human bodies; of dealing with human pathologies, and the rapid pace of new discoveries, technologies, theories, modalities, which (in my opinion) mandates that we keep in step with the times and abreast of the newest information. Not to mention it’s a great forum for communication with the leaders in the field, and an opportunity to spark conversations – especially for those who are not members of a professional organization such as AMTA or ABMP. I can’t back down from feeling that REQUIRING massage therapists to keep abreast of this information is vital to the progression of our profession being recognized fully by the medical community.

    Finally – I have to agree with Holly that there are many classes out there which offer little or no real benefit. This is why NCBTMB is re-vamping the Approved Provider process, and it’s legitimate to do so. But I can attest that many attendees of my Paranasal Sinus Drainage class have thanked me later and told me they integrated the moves I taught them into most of their massages now, with positive results. I am not a Board Certified Paranasal Sinus Drainage Practitioner… but I did invent the moves, master the theories behind it, and consider myself an expert in it. And the moves, when a practitioner becomes proficient, take less than 10 minutes to perform. Does this really require an exam for someone to put on their card that they can do it?

    This has happened for me in many CE classes, especially from the more experienced teachers: I always take something away from them that I either learn from or add to my repertoire. If it’s even one, very cool move, I consider the hours worth it. As for Ethics… sorry, but I’ve never been a proponent of on-line courses unless in a web-seminar forum, and there just doesn’t seem to me to be the same educational value to taking an on-line test, which you then self-correct as there is to getting a bunch of your fellow MT’s in groups, bantering in a lively conversation about real-life situations.

    To me, the newly proposed NCBTMB standards seem like (theoretically) a good idea, whereas the FSMTB’s proposal does not appear to be furthering any educational standards… it really has the feel of regression. IMHO. Which is really interesting, because it was not long ago I might have felt the reverse of each of these organizations. Not that it has to be a contest, but… well, it IS interesting.

  5. Elise Wolf

    We here at OMERI agree 100% with the AMTA’s response and Laura. I applaud Laura for, although not in a major way, pointing out the financial conflict of interest in the proposal: FSMTB creates the requirements, and then requires that THEIR own course (which won’t be free) is what is needed to fulfill the requirement? Wow! Like Laura says, it does seem that the financial rewards of taking state licensure away from NCB was not enough. Now in one fell swoop they make their own CE requirements that only they can fill….and how many on the task force will have a financial stake in what/whose content goes into the course (no one gives up content for free), and the process of administration?

    And while some massage therapists have the financial options of paying for multiple courses and tests every two years, many or most do not. So, there will be no choice for these folks – pay for the mandatory courses and test and don’t do further CE.

    Another screaming problem with this proposal and one which is the underlying subtext is what it says overall about massage therapists. If massage therapists NEED to take courses in entry level material every two years, then clearly they NEED to do that. Which of course means that they are not competent to remember the material, thus someone must come around and help them remember it. Unlike other professions where the person is considered competent to practice on a basic level in their profession, massage therapists, according to FSMTB, are not. This subtext cannot be removed from the proposal, it is at the heart of it. It is the most insulting and derogatory statement about the people in this profession I think I have ever seen in 15 years of being involved in the profession.

    I am not a massage therapist, I simply interface with these professionals through my work. I believe strongly that the direction of the profession should be focused on ADDING to the the core competencies not making professional’s regurgitate this material over and over again ever two years. And, quite frankly, I do not see the need that FSMTB does.

    Instead, we see people who are quite competent. Most would take way more classes if they could afford to then what is required. However, dollars and timelines direct their educational goals by necessity. For others, without requirements of CE, they would happily go through their lives doing what they have been doing. I agree with the idea that CE should not be voluntary for the purpose of public benefit (and most professions believe this to be true).

    The profession of massage has a real choice in the current era. If it wants to be a legitimate healthcare profession then the education of those in the profession should go beyond massage 101. The requirements of the professional boards are the litmus test as to who the profession wants to be.

    (Note: these comments reflect the opinions of Elise Wolf, not Whitney Lowe).

  6. Emmanuel

    AMTA opposed the FSMTB and the MBLEx before it supported them. And it supported the NCE before it opposed it. I hope they will see the light and support the MOCC proposal, especially now that NCBTMB has announced plans that should alleviate some of the concerns here.

    FSMTB’s proposal is brilliant. Brilliant along the lines of Apple’s “think different” campaign.

    The proposed mechanism is simple, efficient, and helps the states keep their promise of protecting the public by ensuring that competencies are met. It creates room for the profession – through its organizations- to self-regulate and elevate standards; that’s one of the definitions of being a profession, isn’t it?

    NCBTMB’s announcement could not be timelier because it shows how this could work. the states protecting the public, professional organizations elevating standards.

    Things are looking up for the profession.

  7. Kathy

    I find the FSMTB proposal right on target. The point of regulation is public safety not elevation of a profession. There isn’t any empirical data which proves mandatory CEU’s work to elevate the profession though they have managed to create a thriving cottage industry for those involved in providing the classes as well as those “certifying” them.

    I find the following statement by the AMTA ridiculous.

    “–The proposal would take away the freedom of choice of massage therapists to determine their own practice focus and to choose the continuing education providers they prefer to meet their own professional needs by creating a “one-size-fits-all” approach for license renewal.”

    In actuality the FSMTB proposal brings freedom of choice to every massage therapist and allows each individual to choose when and what they study according to their own timeline/needs rather than have it forced upon them to maintain a license.

    As one who practiced before mandatory CEU’s became the rage of licensing boards I and many many others within our profession engaged in seeking continuing education on our own because we wanted to learn new techniques and increase our knowledge. Yes, there are MT’s out there that won’t grow beyond what they learned from their massage school training but it is apparent by Ms. Grover-Mason’s acknowledgment that those people exist now even with the mandated CEU’s. Removing the mandate will place people in her class that really want to learn what she’s teaching. A win-win-win for the students, their clients AND the teacher.

    I see this as an overall positive step for massage therapists.

  8. Janet

    Unfortunately, it’s all about money, and has absolutely nothing to do with the progression of massage therapy as a profession. Both (so called) organizations care little about the profession. I’ll do what’s necessary to remain licensed in states where I choose to practice, but I certainly don’t base any *true* CE choices (and I take 100+ hours a year) on the ‘suggestions’ of orgs I do not respect.

  9. Julie A.

    I think there are a few things that massage therapists are not getting. The federation will have a monopoly. Monopolies always raise their prices once the competition is out of the way. What are monopolies? Google “monopoly” and get ready to have your hair stand on end.

    Examples of monopolies? The phone company that providers your land line is a monopoly. Try reading your phone bill sometime. Utilities are monopolies. OPEC is another monopoly…has anyone seen the price of gasoline lately. What do you think you spend in a year?

    Sure I would like to have a monopoly just like the Federation wants to have one. I would like to be the only one who can offer massage in the whole county. Just like the Federation wants to be the only one. It’s too bad for the rest of you massage therapists. You will all be put out of work. Just like thousands of CEs providers will be put of work.

    Plus I want the government to force everyone to buy massage from me…just like the massage boards are going to force you to buy from the Federation. And of course, like all monopolies, I will raise my prices handsomely. There is no limit on what i can charge!

    I will have to raise them a lot higher then gas prices because you buy gas every week or two and I can only gouge you every year or two. But gouge you I will, because everything in the Federation’s proposal is designed to do just that.

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  13. Heather Fedor

    I know I’m a little late in the discussion but I’m dealing with a situation that involves both these Boards. I studied in Las Vegas and became nationally certified 7 years ago and ended up having to move back to my home state Ohio. Ohio doesn’t accept NCBTMB they only accept the MBLEx. Since I became a massage therapist, I have had some difficulty due to the downturn in the economy, which has caused at different times, the inability to keep up with all requirements. In 2007 I worked at a spa in one of the casinos and they provided us with table Thai massage CEU’s. I would never claim to be a certified Thai Therapist; however many of the techniques and the sequence I was taught has been incorporated or done as a modality. That was invaluable to me. In 2009 I ended up with 3 jobs at the same time which I ended up quitting 2 of them because it was wasting my time and I wasn’t making money. So I continued working at the 1 job I kept, but Vegas was hit hard and my license expired, so I had to quit for awhile. I ended up moving to Florida, lived there a year was about to get licensed there which caused me to quickly make up CEU’s (which by this time my national expired) to get my national back. Right as I was about to go through Florida’s licensing process I had to move back to Ohio. Now that I’m in Ohio, it is most difficult to do the job I trained for and spent so much money on (which I still owe) because I have to take the MBLEx. There are so many problems that I have with this.

    1. You can only take it at 6 month intervals and you have to go to Columbus to take it. I live up by Cleveland.

    2. It is by far inferior to the NCBTMB which offends me; I worked hard for that National. I’ve retained 60% of my education, which in my eyes is the pertinent and applicable part. That other 40% isn’t making me a bad therapist because I have difficulty accessing it in my brain. Besides I still know how to read and I have books and access to them.

    3. In the state of Ohio, you can do a 3 month course and become a massage practitioner who can only do relaxation massage. That offends me. I even heard something about an 8 hour course!

    4. They don’t require any CEU’s which I like them being mandatory because often life gets busy and it ends up getting put on the back burner. And obviously being in a state that doesn’t require CEU’s makes it difficult to find hands on continuing education. I have the kind of personality that requires a push. I love to learn but I’m not exactly a self starter in that area. I do better under pressure and mandatory CEU’s help me with that.

    With those points being highlighted I would like to say the standards and quality of massage therapists in the state of Ohio are much lower than the standards and quality I experienced in Las Vegas under the NCBTMB. I’ve received quite a few massages here and I’m currently working in a salon/spa as a receptionist and have gleaned some insight into this subject. I’m not afraid of taking tests, but this MBLEx situation just makes me really mad. It’s the principle of the matter. I don’t like being a pawn in their turf war and it’s hurting me financially. The FSMTB will allow anyone into this profession it seems and I take pride in my education, standards, ethics and hard work I’ve put into it, despite some of my setbacks. But yet they won’t let me work here unless I take their stupid test. I’m not down with this kind of regulation. I admire the states that accept both; it should be that way nation wide. People move and shouldn’t be unable to work when they do so, it’s crap if you ask me. Fortunately for the State of Ohio, I don’t have children and therefore am not seeking state assistance, but if I did you bet I would! (I don’t know if that is really true, but it could be lol)

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