Deal, or No Deal?

In my last blog, The Good, the Bad and the Ugly, I reported that the only good thing that came out of the recent FSMTB Annual Meeting was the announcement that NCBTMB and FSMTB had reached an agreement on licensing exams, which promised to spell the end of the long “exam wars”. FSMTB trumpeted this news in their October 3rd press release, which stated:

“FSMTB and the NCBTMB have worked cooperatively to reach an agreement that the NCBTMB will no longer provide examinations for licensure purposes and will now focus exclusively on delivering quality certification programs. This supports the common goal of the FSMTB, Associated Bodywork and Massage Professionals (ABMP), American Massage Therapy Association (AMTA) and the Alliance for Massage Therapy Education (AFMTE), for the Massage & Bodywork Licensing Examination (MBLEx) to be utilized as the sole licensure exam for the profession, thus facilitating licensure portability for therapists.”

Too bad that we really can’t celebrate this news because the so-called “agreement” did not include the Approved Continuing Education Provider Program operated by NCBTMB (which 27 state massage boards use in one way or another). Like rubbing salt in the wound, the FSMTB turned right around and passed a resolution to create their very own CE approval program–as if NCBTMB didn’t exist.

It actually gets worse. I received word that at last week’s Florida Board of Massage Therapy meeting in Orlando, it was stated publicly that there was really only a “letter of intention” between the two organizations that was signed before the FSMTB Annual Meeting, and that the details of this letter would be worked out later in a formal agreement.

Now I’m no attorney, but a letter of intention is NOT the same thing as a legally-binding agreement. It’s more like putting a small deposit down on a house to get the process started, with the purchase contract and the mortgage money to come later. A lot can happen between those two steps.

So I’m confused here… is there a deal, or is it no deal? For the FSMTB to send out a national press release with the subject line “FSMTB AND NCBTMB REACH AGREEMENT” when no final document appears to have been signed, raises all kinds of red flags and ethical questions.

We never needed two competing licensing exams, and we sure as blazes don’t need two competing national CE approval programs. Looks like it’s time for the heads of these two organizations to get back to the negotiating table and work out the rest of this deal, for the benefit of the CE community and the profession as a whole.  And don’t come out until you get it settled!

The Good, the Bad, and the Ugly

With apologies to Clint Eastwood, I’m using the title of his classic Western to talk about three major announcements from the Federation of State Massage Therapy Boards, and what they mean to the rest of the profession. This all came down at the recent FSMTB Annual Meeting, held in Tucson on October 3-4.

The Good: FSMTB and NCBTMB reach an agreement on licensing exams.
Woo hoo! Praise the Lord and pass me the MBLEx! After six years of costly and damaging “exam wars” between the two organizations, NCB was unable to keep its market share of the entry-level testing business. As FSMTB’s exam revenue grew each year, NCB’s declined. NCB finally saw the handwriting on the wall and agreed to stop offering its national certification exams for state licensure as of November 1, 2014 – in exchange for an unspecified amount of money.

This is a huge benefit for the profession, as we can finally move towards having a single licensing exam that is under the direct oversight of state massage boards. (Only Hawaii and New York are still hanging on to their own state exams.) It means less confusion for students and massage schools, and a boon to portability of licensure in the future. This has been a long and painful struggle between FSMTB and NCB, and I for one am thrilled to see it come to a peaceful end.

The Bad: FSMTB adopts CE standards and license renewal recommendations.
Two years ago, FSMTB proposed a radical shift to the continuing education landscape, as outlined in their Maintenance of Core Competency proposal. The MOCC was slammed by organizations, schools, CE providers and individual therapists alike – and yet, the worst of it has made its way into FSMTB’s new continuing education and license renewal standards.

This is a classic case of “If it ain’t broke, then don’t try to fix it.” Overall, our existing CE system works reasonably well, so the last thing we need is yet another organization coming in with an agenda to transform and/or grab control of it. Last year, we suffered through an attempt by NCB to do just that. After a massive grassroots effort, NCB toned down most of the unacceptable changes they were trying to force on providers and sponsors of continuing education. They’ve been behaving themselves since then, and their CE approval processes have been operating more smoothly, although personally some of the classes they have approved are still an issue with me. I’d like to see some sort of designation for those of us who don’t practice or teach pseudoscience and don’t want to be lumped in the same category as those who do.

Now we have the FSMTB trying to flex its muscles. It’s like we just got King Kong calmed down, and now we have to do the same with Godzilla!

At the recent FSMTB Annual Meeting, state board reps passed a resolution from their CE Task Force to “implement a program that provides reliable, unbiased and appropriate vetting of continuing education providers and the classes offered to the consuming public.” That sounds high and mighty, but there is no reference to NCB and their existing national Approved CE Provider program in the resolution, and there was no mention of NCB when this resolution and the license renewal standards were presented to the Delegate Assembly for consideration. Did they think that no one would notice this sin of omission?
The LAST thing we need is another CE approval program! FSMTB could have easily solved their delegation of authority issue by entering into a partnership agreement with NCB to use their existing program. This should have gotten rolled into the exam deal between the two organizations, so that CE approvals could be consolidated.

It’s hard to believe, but the resolution was passed without any details on how FSMTB actually plans to vet CE providers and classes. Why should we trust that FSMTB can do this in an effective manner? They’ve been offering the MBLEx for six years now, and they still don’t have an online practice exam and exam study guide for massage students. The very worst of it is that FSMTB’s plan for CE and license renewal centers on “public safety”, while minimizing the role of CE for “professional development”. The problem is that there is no evidence that we have a widespread “public safety” crisis in our profession, so there’s no factual basis for what FSMTB is trying to do. (There are a lot of specific flaws in the CE standards and license renewal recommendations FSMTB has adopted. I’ll detail those in a future blog.)

What I can see from all this is a major threat to the existing CE provider and sponsor system in our field. FSMTB’s proposal is so completely out-of-synch with how CE is organized and delivered, and FSMTB stands to consolidate even more money and power if this model is adopted by state massage boards. We’re just coming out of a period where NCB tried to dominate the field. Now FSMTB is acting like they’ve picked up the NCB playbook and are trying to run with it.

The Ugly: FSMTB publishes the Model Massage Therapy Practice Act (MPA).
As I wrote about in my previous blog, the MPA was released after three years of behind-the-scenes work and two rounds of public comment. Most of its content is the kind of standard stuff found in all templates for occupational licensure. However, FSMTB really blew it in a number of key areas, and the final version contains both technical errors and some awful policy decisions. As FSMTB’s leaders had final say, the responsibility for correcting these fatal flaws rests on them.

Judging from how few comments were made on the three blogs I posted about the MPA, it looks like it doesn’t register as all that important. Wake up people! A model practice act is one of the bedrock components of a profession. It contains the Scope of Practice definition and other essential elements that influence both education and practice. If you haven’t taken time to read our new MPA, I urge you to get familiar with it and keep up the pressure on FSMTB to fix it. Remember that it doesn’t become law unless it’s adopted by a state legislature.

Let’s celebrate the Good, and get to work on the Bad and the Ugly!

Final Draft of Model Practice Act Released

The Model Practice Act was released in its final draft this week, after more than three years of work on it and two periods of public comment. The introduction does state that it will be an evolving document as changing times and circumstances dictate, but as of now, it still has many of the school owners on my social media pages up in arms.

The language requiring accreditation from previous drafts (Section 103(B) ) was modified to say “Approved Massage Therapy Education Program means a school or educational program that meets the criteria established in rule by the Board, at a minimum includes 625 Clock Hours, and is both authorized in the jurisdiction in which it is located and that reflects a curriculum acceptable to an accrediting body recognized by the U.S. Department of Education…” While the requirement has been downgraded to a suggestion, the comment section makes it clear that the eventual goal is required accreditation for one and all.

Personally, I have some mixed feelings on this. Accreditation is a process of quality control–to a point. (Disclosure: I am a peer reviewer for COMTA). Obtaining accreditation is not cheap, it’s rigorous and it’s time-consuming. It sends the message that you have voluntarily gone over and above what the state requires. Other health care professions require it. And therein lies the clincher.

There are no other health professions that I am aware of accrediting programs that teach psuedoscience, and many massage school programs, including those accredited by COMTA and other accrediting bodies–and in the case of community colleges, even the regional accrediting bodies–do. So what does that really mean? Is it really a hallmark of excellence when we accredit things that have no basis in fact, just because it’s tradition, and been around for a long time, even though it’s been shot down by science?

I am not a school owner, but if I was, I wouldn’t be hitting the panic button just yet. The FSMTB has no power of legislation and they can’t lobby. In order for accreditation to become the law of the land, that’s what will have to happen: it will have to become the law of the land, literally, through legislative changes. There may be some FSMTB member states who are gung-ho to see it happen, but remember, state boards can’t lobby, either. That is the domain of the professional associations. In my state, our AMTA chapter has paid a lobbyist for many years. Since the chapter fees are now optional, I have heard that he volunteered to continue working at a lesser fee, but I bet some of the state chapters have lost their lobbyist altogether, if they had one to start with. The wheels of government don’t turn that quickly unless they’re greased.

The MPA is a template for the states. It isn’t the law and it may never be. For the few unregulated states, should they finally get out of the Dark Ages and decide to regulate, this will be very time-saving for them. It isn’t perfect; nothing is. Obviously a lot of work went into it. Only time will tell what effect it is really going to have.

To the Edge and Back

I’ve been quiet for the past few weeks because I’ve been ill. On August 17, I wasn’t feeling too well, not really full-blown sick, but on the puny side, and I told my husband Champ I wanted him to cover our office the next day and let me stay home. I felt a little worse on Tuesday, and stayed home again. I had terrible diarrhea all night and was constantly thirsty. On Wednesday morning, I woke up in a state of extreme illness and confusion. Champ asked me if I knew the signs of a stroke. Of course I do, but I looked at him blankly and said “no.” He asked if I knew who he was. That was another “no.” He asked if I knew who I was. When I answered “no” to that, he took me to the ER.

After a few blood tests, x-rays and the like, a doctor came in and informed me I was being admitted with a severe urinary tract infection, which I had not had any of the usual symptoms of, and that it had gone systemic. I also had pneumonia in both lungs–something I just went though in March of 2013. They admitted me to the hospital and started pumping me full of antibiotics. The diarrhea lasted four more days to the point where I was reduced to wearing a diaper in the hospital. That’s a rather humbling experience. A friend of ours who is a pharmacist told Champ that another day or two without the antibiotics and IV fluids, and I would have died.

I was released after a week in the hospital, which included two days in the ICU. My mom came to take care of me. She is 75 and I could never in a million years have had a better mother than what she has been to me. I turned 55 while I was sick. She was wiping my butt just like I was baby, so was Champ, and for all intents and purposes, I was one. She made me some homemade soup the day after I came home. I ate a half a bowl (it was delicious vegetable soup). About an hour later, my stomach got very bloated and hard. I was vomiting, and the next morning, I told Champ I thought I had better go to the ER.

Low and behold, another x-ray revealed that I was full of gall stones. They admitted me again and  took out my gall bladder early the next morning. After another week in the hospital, I came home again last Thursday.

My hormones and electrolytes were screwy in the hospital, and I had to go to the doctor for a checkup yesterday. I also spent last night at the Sleep Center–not a restful place at all. I haven’t gotten those results yet, but I had been placed on a BiPap in the hospital because I was retaining too much carbon dioxide. They woke me up in the middle of the night and put me on a CPAP. I expect I’ll hear all about it later today.

On my birthday, all I could say was “55 and still alive.”

I have been overwhelmed at the outpouring of love and compassion from everybody. FB friends I have never even met sent me cards and gifts. Several people sent me money in amounts from $5 to $500, which just made me cry in gratitude and disbelief at the kindness. People sent flowers and fruit baskets. Local people have delivered food to my house. Restaurant owners have refused to take any money when Champ went to get takeout.

Since I’m known for pissing people off with some of my commentaries, I might as well not pass up this opportunity to say thank God for Obamacare. Last year, when I was stricken with pneumonia the first time, we had given up our health insurance. It had gone to over $600 a month. Champ was not working much, our business was struggling in our local economy, which is still very depressed, and we simply couldn’t pay for it anymore. It was either give that up or give up eating. We also had a $5000 deductible. My hospital bill was over $10,000, which I am still working to pay off. On January 1, I got us signed up for Obamacare. We are now insured with a $500 deductible, not $5000, and we are paying $235 a month. My prescriptions have cost me $5 each. The nebulizer I had to get to take breathing treatments at home four times a day was free. Before anyone jumps on taxpayers subsidizing that, let me say that I got my first job at the age of 13, and I have worked every day of my life since, so I have paid my share in taxes and I continue to do so. It feels good to me not to have to worry that I am going to lose my home or my business over healthcare expenses. So there. I appreciate it whether anyone else does or not.

Champ’s social security kicks in this month, so we can breathe a little easier on that front, as well. I am taking a few weeks off from work to gain my strength back. I am sapped. I have seen some of my FB friends spreading the suggestion that people buy my books in order to help my finances, and I really appreciate that more than I can say, along with everything else people have done for me during this time. So in a fit of shameless self-promotion, I will list them here in case you are led to purchase one.

The first one is one I finished last year while I was in the hospital with the first round of pneumonia. It’s about death and dying and the wonderful Nina McIntosh, author of The Educated Heart. I watched Nina get her affairs in order while she was suffering from ALS. When I was in the hospital, I had the thought that I might not be leaving there alive, and that I needed to get my own affairs in order. We all do, while we’re able to, instead of leaving it for our grief-stricken family to do. The last part of the book walks you through that. It’s called The Days Still Left.

My most recent book is Excuse me, exactly how does that work? Hocus Pocus in Holistic Health Care. I didn’t question anything I was taught in massage school, and I should have. Part memoir, partly an examination of some of the things that are heavily marketed to massage therapists, who then turn around and market to the unknowing public. Yes, it will step on a few toes, but my hope is that it makes people THINK.

Massage is my second career. In my first life, I cooked for the public for more than 20 years. My little cook book is full of great Southern recipes and funny stories that happened to me in the restaurant business. Nothin’ Fancy, Good Food and a Few Funny Stories.

In 2012, The Massage Nerd, aka Ryan Hoyme, and I collaborated on the Manual for Massage Therapy Educators. This is NOT meant to be a textbook. We were both unceremoniously foisted onto our first class of massage students, and this is just the practical advice of the things we wish we had known when we started out and what we’ve learned along the way.

The Plain and Simple Guide to Therapeutic Massage & Bodywork Examinations 2nd ed.   Get ready to pass the MBLEx or NCBTMB exams. The inside cover has a scratch-off password to a website filled with practice questions and learning games.  Great teacher ancillaries, too. I am very proud to say this book is sold in hundreds of massage schools.

One Year to a Successful Massage Therapy Practice is full of low-cost and no-cost ways to get your practice off the ground or revitalize an older one.

I’m proud of this book because I didn’t try to sell it to LWW; they asked me to write it, and I was happy to oblige. The inside cover has a password for a website with dozens of useful forms. It covers everything from your business plan to retirement and in between.             A Massage Therapist’s guide to Business also has great instructor ancillaries.

That’s it, although I do have a few more in the works. Thank you for your support.

Model Practice Act Causing an Uproar

Disclosure: I am a peer reviewer for COMTA.

I have complained a lot about massage therapists sitting on their hands, not having any interest or involvement in governance, and not caring or being informed about what is going on until it’s too late to do anything about it. I can’t make that complaint about massage school owners in the past couple of weeks. I’ve never seen such a hue and cry over any other issue.

The Model Practice Act is on its second period of public comments, and I’m pretty sure the FSMTB is hearing from a lot of upset people. I had a few issues with the first draft, and I hear it got about 1300 comments. I’m willing to bet this one will get twice that, caused by a one-word change in the following definition, found in Section 103(B):

Approved Massage Therapy Education Program means a school or educational program that meets the criteria established in rule by the Board, at a minimum includes 625 clock hours and is both authorized in the jurisdiction in which it is located and is accredited by an accrediting body recognized by the US Department of Education. Education received outside of the United States must be substantially equivalent to the criteria of this Act and must be recognized by the jurisdiction in which it is located.

In the first MPA draft, this requirement for schools was stated as state authorization AND/OR accreditation. The removal of just one word here makes a world of difference, which has set the massage education community into a tizzy.

My Facebook is buzzing with comments from school owners, teachers, and other interested parties. Overwhelmingly, the feeling is that this is going to put a lot of schools out of business. There are also people that feel that we have about twice as many massage schools in the US as what are really needed, and that this has led to churning out too many graduates, which has led to a glut in the job market, and contributed to the proliferation of franchised massage (or maybe it’s because of franchised massage).

Rick Rosen is the co-owner of Body Therapy Institute in Siler City, NC, one of only two schools in our state that are accredited by COMTA, shared some of his comments on it with me:

There are two primary reasons this accreditation requirement is inappropriate and potentially damaging: First is the fact that about half of all massage schools in the U.S. are not accredited. In general, these are smaller proprietary institutions that only offer massage programs. It is doubtful that most of these schools could qualify for accreditation even if they wanted it, because of the lack of financial resources. Smaller schools that are undercapitalized are unlikely to be able to meet the financial ratio requirements of COMTA and the other accreditors, not to mention the initial and ongoing costs of accreditation.

These massage-only institutions embody the lineage of massage therapy and the healing arts, as contrasted with for-profit career colleges and publicly-funded community colleges where massage is one program among dozens (if not hundreds). Mandatory accreditation WILL cause many of these smaller schools to close, which would be a tremendous loss for our field.

Second, COMTA is the only specialized accreditor in the massage therapy field, and the only agency with competency-based curriculum standards. Institutional accreditation by the other six vocational accreditors and the seven regional higher education accreditors fails to provide a meaningful measure of quality assurance for the massage program itself.

Therefore, it makes no sense for FSMTB to include an institutional accreditation requirement in its Model Practice Act when such accreditation (in the case of non-COMTA-accredited schools) ignores the elements that are critical to producing a well-trained massage therapist. It is the integrity of the program’s curriculum, the competency of the instructors and the consistent application of admissions criteria that are the critical elements that make a sound massage therapy program — far more so than the financial and operational standards that comprise the bulk of institutional accreditation.

So, if roughly half the massage schools in the U.S. cannot qualify for accreditation, and the other half (minus the 67 schools and branch campuses that are under COMTA accreditation) are accredited under institutional standards that do not reliably produce skilled and employable massage therapists who last more than two years in practice — where does that leave us?

We need a regulatory structure for schools that can satisfy the minimum requirements of state massage statues for protection of the public, while preserving the ability of our smaller massage schools to exist. In addition, we need a mechanism to bring all massage programs under single set of programmatic standards to establish consistency of entry-level training that is impossible to achieve within the current system.

Rosen’s solution is for COMTA to add a non-accreditation level program approval to its scope, which would require the blessing of the USDE. In addition, all massage schools with institutional accreditation from other agencies would also need to seek programmatic accreditation from COMTA – a structure that is common in other regulated professions. The language in Section 103(B) of the MPA would then need to be changed to include programmatic accreditation OR approval by COMTA – along with approval or licensure by the educational authority in the jurisdiction in which the school operates.

There are a lot of other school owners out there that don’t feel any accreditation should be required at all, particularly owners of small schools who have long-standing, successful programs that have lasted for decades without accreditation. Accreditation is not cheap. It’s time-consuming to initially obtain, and time-consuming and expensive to renew. While I have heard many small school owners talk about the expense as a deterrent to getting accreditation, I’ve heard as many others say “I’m not going to have anyone telling me how I have to run my school.”

Sandy Fritz, who has owned a school (not accredited) for more than 30 years and is a well-known author and advocate for massage education, stated on her blog that accreditation was a good thing–and then it moved away from a process to determine excellence and became a hurdle to jump across to access the cash cow of financial aid.

Actually, institutional accreditation has always been about being a financial gateway rather than a hallmark of excellence. When COMTA came on the scene, it was the first accreditor to offer programmatic standards that were meaningful to massage education. Unfortunately, they’re also the smallest player on the accreditation field and have no real ability to affect the whole.

I can’t speak to the other accrediting agencies, for my experience as a peer reviewer for COMTA is that a school that seeks the accreditation is sending a powerful message: “I do more than the state requires me to do.” Accreditation involves an in-depth self-study, and documentation, documentation, documentation. If it isn’t in writing, it doesn’t exist. But that’s a good thing. It ensures that policies and procedures are in place that are for the good of the student, the good of the school, and the good of the profession.

COMTA has been criticized for including pseudoscience (energy work) amongst the things that are acceptable for curricula in accredited schools. Without have read the standards of the other accrediting agencies, my guess is that they do, as well. The NCBTMB condones it, the AMTA and ABMP both condone it, the FSMTB condones it, so COMTA is hardly the lone ranger. It just goes to show, once again, that massage therapy accreditation is not being held to the same standards as medical professions do with their accreditation, which is why we’re still a vocation and not a profession.

The period of public comment ends on August 15. If you want your voice to be heard, you should seize the opportunity by clicking here.

 

Report from the World Massage Festival

Champ and I spent last week in Las Vegas at the World Massage Festival. This was our fifth year there, and the biggest and best one yet. Almost 700 people at this one…9 years ago when Mike Hinkle started the Festival, 20 people were in attendance.There were people from every state and 7 or 8 foreign countries. A whole contingent came from Trinidad.

The World Massage Festival is a unique event. Mike and Cindy bend over backwards to make the Festival affordable to everyone. Instead of a $189 hotel, we were in the Tuscany, an all-suite hotel, for the magnificent price of $59. And they are nice rooms! The staff at the Tuscany was very nice and helpful, the food was good, and in general it was just a good experience to stay there.

Over $50,000 in door prizes and scholarships were given away. I got to do a lot of the name-drawing and I had some real fun helping make people’s day with cash prizes, diamond jewelry, and other goodies.

On opening night, I was the keynote speaker. It was a humbling experience to look out at the room and see so many dedicated colleagues, many of whom have been doing massage for many more years than I have. During the awards ceremony, Irene Smith was honored with the Lifetime Achievement Award. I have to confess that I was not familiar with her work until Sunday night. She started the first project in the US to massage AIDS patients and has been doing Hospice work since the 1970s. Her entire career has been based on selfless giving. She is an example of the finest massage has to offer.

Since the beginning, one of the purposes of the Festival has been to recognize those who have made significant contributions to massage, through the Hall of Fame. Judi Calvert is always the host for this occasion and as usual did a beautiful job. I spent some time talking with several of this year’s inductees, all genuinely nice people who leave their ego at the door in spite of some of their amazing accomplishments. I spent an hour visiting with Mark Beck, who wrote the textbook I learned from in massage school, which was a real treat for me.

Lots of friends were in attendance at karaoke night, and we have got some talented singers in massage therapy. People had a blast singing and dancing.

Quality education, as always, was a highlight of the Festival. Champ took a class in Thai Massage from Mukti Michael Buck and really enjoyed it. I taught two classes, participated on a student panel, helped out with registration and karaoke night, and kept busy visiting with people. Glad to see Allissa Haines, Andrea Lipomi, Ryan Hoyme, Jake Flatt, Gina Smith, Thomas Liberto, Vivian Madison-Mahoney, Enid Whittaker, Michael McGillicuddy, Cherie Sohnen-Moe, Leena Guptha, and so many more. The WMF is always like a family reunion. I also got some great bodywork from Karen Kowal. Darcy Neibaur raised over $2000 in the Sweet Serenity booth to benefit the Greenville SC Shriner’s Children’s Hospital.

I also enjoyed having Sally Hacking and Mary O’Reilly of the FSMTB come into my student class and answer questions about the MBLEx for students.

Pualani Gillespie took Champ and I out for a fabulous dinner at Mario Batali’s restaurant, Carnevino, and we had a great visit with her.

Next year, the tenth anniversary, is going to be held in Michigan City, Indiana, and I expect it to be even better. I appreciate Mike and Cindy and everything they do. I hope to see you there!

FSMTB Releases Model Practice Act

The Federation of State Massage Therapy Boards released the Model Practice Act a few days ago, just after the third anniversary of the announcement they had formed a Task Force of 8 state board members to work on it. I just had the time to read it in its entirety today, and as a former state board member and former delegate to the Federation myself, I appreciate the huge amount of time and effort that went into it.

I didn’t find much that surprised me. Last week when this was first released, I saw some rumblings from educators and school owners about the requirement for massage therapy programs to be 625 hours. As the publication says, it is consistent with the 625-hour recommendation of the recently-released ELAP (Entry-Level Analysis Project) that was a collaborative effort supported by all of the national massage organizations. Since there are currently more than two dozen states that still have 500 hours as their entry-level requirement, that’s going to require some major changes. Many smaller schools would probably go out of business rather than comply with the change.

The document does not state the name of the NCBTMB or any other entity’s exam in the context of eliminating them, but the definition of “examination” is given as a standardized test or examination of entry-level massage and bodywork knowledge, skills, and abilities that is developed and administered by the Federation of State Massage Therapy Boards. That means the MBLEx, period. About 40 states are currently accepting both the MBLEx and the NCB’s licensing exams. There are also a couple of states that have their own exam–and require much more than 625 hours. I don’t see that those states will want to back up and adopt this.

The MPA does seem to support portability in a good way. There are provisions for therapists participating in planned out-of-state events, temporary assignments such as with traveling sports teams, etc.,and emergency response disaster teams without requiring jumping through hoops. It would also seek to make the title of each state’s act the _____Massage Therapy Practice Act, leaving the term “bodywork” and any other terminology out of it. Licensees would be designated “LMT” (Licensed Massage Therapist) uniformly across the states.

One thing that I was not crazy about was the protocol for choosing board members. The MPA states that 7 members are to be appointed by the governor. I would prefer to see that power spread around a little. I wouldn’t want to see governors of any political party appointing only the people for their own party, for example. In my state, the appointees are made by the governor, the speaker of the house, and the senate pro tem. I think that or something similar is a little better balance of power, personally; even if they do randomly turn out to all have the same party affiliation.

I also wondered about the discrepancy in defining “clock hour” as 50 minutes of instruction and “contact hour” as 60 minutes of instruction. The NCBTMB has traditionally allowed 50 minutes of instruction as a contact hour for the purpose of continuing education.

The states are also still left with more autonomy than I expected. There’s plenty left in their hands, so to speak, with the usual statements about how the board may adopt, amend, and repeal rules. There is also a licensure by endorsement stipulation and a grandfathering accommodation.

There are only five states left without licensing. It would certainly be to their advantage to have this right out of the gate and avoid having to reinvent the wheel. As for the other 45 states that are already regulated, I don’t see that there will be a mad rush to adopt this, unless what they currently have isn’t working for some reason. We have to remember that the FSMTB is not a regulatory body in and of itself, but a coalition of regulated states. They can’t force the MPA on any state, nor are they trying to. It is a blueprint, a collection of suggestions for how to make the states more uniform in the regulation of massage. Too bad it didn’t exist a few decades ago before most of the states got on the bandwagon.

I don’t have any harsh criticisms of the document. Personally, I like the concept of raising the minimum requirement to 625 hours, but then again, I’m not a school owner that would be affected by such a thing. My final analysis: kudos to the people that worked on it. Things like this that are done by volunteers always come under a rash of criticism from people who disagree with the product.

 

 

AMTA: The Chapter Fee Fiasco

I just came from a wonderful weekend teaching at the MA Chapter of AMTA. What a great group of people. I was there four years ago for their 50th anniversary, and personally know many of the members there. It was fun to see them and meet some new ones.

A few weeks ago I was at the IL Chapter. In between, I attended the annual meeting of my own chapter in NC. At all three of these conferences, I attended the business meeting and heard the treasurer’s report.

This weekend in MA, National President-Elect Jeff Smoot, who was there to speak at the meeting, was put on the hot-seat by a member who questioned National’s move to make Chapter fees voluntary. The member actually asked outgoing Chapter President Mary White, and she deferred the question to Smoot. Smoot replied that good things were happening that would be announced in September, and that it had been a unanimous decision of the Board of Directors. He also stated that the chapter fees had originally been intended to help with legislation, and that now that 45 states are licensing, there was not the need for it that there once was. I am personally begging them to reconsider. Any practice act can come under the gun at any time. Our chapters need lobbyists and attorneys to protect our interests. We need our own local people that are familiar with the laws and known to the legislators in our own states.

AMTA is SUPPOSED TO BE a member-driven organization. I’ve been a member for more than 10 years. I love my state chapter. I have been impressed with every chapter I’ve ever been to. Every one of them is filled with enthusiastic people with a passion for massage and volunteerism.

What really ticks me off is that the members were not consulted on this decision, which was apparently made last year during the BOD meeting at the National Convention in DFW, behind closed doors. I had questioned the ethics of this decision earlier as being conducted in a manner that was less than transparent, and was told that AMTA’s attorneys sanctioned the secrecy because competitors were present in the open meeting. The Chapters were not immediately informed, either. Budgets that had already been prepared for the coming year had to be redone. And yes, it is having an impact, in spite of National’s claim that they are making this up to the chapters in other ways.

The MA Chapter is a prime example. They have for years donated $10,000 annually to the Massage Therapy Foundation. That had to be revised down to $1050 this year. There are other chapters that have been very generous to the Foundation. I fear they will not be able to afford that support now, and that the Chapter’s ability to provide great local education opportunities is going to suffer, too.

To add fuel to the fire, I received a copy of the following solicitation today that Massage Magazine Insurance Plus, an arm of the company owned by Joe Doyle, sent to all the state chapters:

Now that AMTA has discontinued the requirement to support state chapters with every membership, how will each state support their LMT’s and the industry at large? 

At Insurance Plus, we have an opportunity for you to continue to drive revenue for your state chapter while also providing incremental insurance coverage’s for stolen equipment and identify theft protection above what AMTA has offered to their members.  All at a savings of $75 off of AMTA’s membership fee.

At MASSAGE Magazine Insurance Plus, we are always looking for more ways to support the Massage industry either through school communications, print and digital publications as well as being a leader in liability coverage by providing significant coverage’s, at record low pricing.  We would like to take a portion of our cost ($20 for professional policies and $8 for student policies) and pass that along to your association for each policy that is directed by you and your site.

Insurance Plus has the highest rating in the industry, A++ underwritten by MedPro, a Berkshire Hathaway/Warren Buffett company.

I will give Joe Doyle credit for his brazen behavior in seizing the moment. He’s too smart to think AMTA wouldn’t immediately respond to that, which they did, with the following letter to all the chapters:

Dear Chapter Leaders:

By now, you probably have seen a solicitation from Massage Magazine Insurance Plus about partnering with the chapter. This solicitation is illegal and unauthorized. AMTA has consulted with legal counsel, and chapters should not respond in any way to the solicitation.  Beyond policy issues, there are other legal matters raised by the solicitation.  If you have any questions, please reply to this email.

Sincerely,
AMTA Chapter Relations

My guess is that might also get the magazine dis-invited to the National Convention, but you never know. Freedom of the press and all that.

I urge all AMTA members to continue to support your chapters. I further urge you to contact the Board of Directors and tell them you a) do not appreciate being left out of this decision and b) you do not support this move. You can do that here.

 

ELAP: Now that I’ve Read the Whole Thing…

I spent most of my spare time during the past week reading the Final Report and the Entry-Level Education Blueprint of the ELAP. Again, I will offer my appreciation for the collaboration of the Coalition and the team that actually performed the work on this. It was a big project and obviously, people took time away from their own pursuits to participate in it.

Now that I have read the whole thing in its entirety, I have a few observations on it. I quote from the Coalition statement:

We aspire to have this report influence several profession audiences:

• the Federation of State Massage Therapy Boards, which can use The Core as it builds guidelines for a model practice act;

My comment on that: The press release announcing that the FSMTB was going to create a Model Practice Act first appeared on April 1, 2011. In a letter I received dated Jan.31, 2014, FSMTB Executive Director Debra Persinger stated that the Task Force is currently completing the final revisions before releasing it for public comment.

It’s just my opinion that the ELAP will be a last-minute inclusion in that, if it does in fact get included.

• state licensing boards, which can use The Core in setting education requirements for licensees;

My comment on that: What is the Model Practice Act doing, if not that? It seems very possible that this is a duplication of efforts. While there are of course other things included in a practice act, one of them is spelling out the hours of required education. I don’t know any state board that goes much beyond setting the total number of required hours, and how that should be broken down in a general list of required subject matter. Not to mention changing a practice act requires legislative action.

the Alliance for Massage Therapy Education, which can refer to The Core in creating teacher training standards and curricula;

My comment on that: Aha! And therein lies the clincher and the biggest issue I have with it. Since I couldn’t say it any better myself, I am going to share the comment that Rick Rosen left on my FB page:

“The critical missing element that will prevent the ELAP Core Curriculum from being implemented on a wide scale is the lack of teacher training in our field.

I simply cannot fathom why the cash-rich organizations in our field (AMTA, ABMP, FSMTB) would spend significant sums of money on a curriculum development project, while they continue to turn their back on providing the financial support needed to carry forward the Alliance’s National Teacher Education Standards Project. Without this long-term investment in teacher development, educational outcomes and the quality of massage therapy services delivered will remain inconsistent at best.

My comment on Rosen’s comment: Nailed it on the head. And it would be another interesting research project to determine what the average training is of teachers in massage schools across the US.

I will repeat Rosen’s sentiments by saying I would like to see all the organizations give this kind of support to the Alliance for Massage Therapy Education and their National Teacher Standards Education Project. 

The Alliance is the youngest organization out there, and does not yet have the kind of cash reserves built up to move this project along at a better pace. The fact is these kinds of projects do require money in order to come to fruition. The Alliance membership is made up of educators and industry partners, and will never have the kind of membership numbers enjoyed by the other organizations by virtue of that fact. I can visualize the ELAP being very useful to the teacher training project–but they need the money to make it happen. I urge our other organizations and industry supporters to put your money into this project.

• the National Certification Board for Therapeutic Massage & Bodywork, which can use The Core as it identifies beginning vs. advanced knowledge and skills for its Board Certification credential;

My comment on that: The Board Certification exam is already out there and is still practically new. I don’t see any major revisions taking place on it any time soon. The NCBTMB is using their “old” certification exam for their entry-level licensing exams, and has been for years. As a certification exam and a licensing exam should require two different job task analysis surveys and one should not be interchangeable with the other, they are already in muddy water, and I don’t really see how this will clear it up. And, as is the case with the MBLEx, the exams that the NCB is using for entry-level licensing are geared to a 500-hour education requirement. Again, this would require major changes to that as well.

• professional membership organizations, which can use The Core in shaping membership criteria;

My comment on that: Pay the money, show proof that you are either a student or a licensee or a practitioner in an unregulated state, and boom! you’re a member. Within the past few months, myself and others made well-documented complaints about an unethical practitioner who was scamming fellow massage therapists and try as we might, we could not get her removed from the membership rolls of AMTA or the massage listing service. She has now finally been removed, after it was reported that she was also scamming her clients. Or she just didn’t pay her membership renewal fee. Either way, she’s no longer listed, but it took months to get any action on that front.

• the Commission on Massage Therapy Accreditation, which can use the Core in evaluating massage and bodywork curricula for programmatic accreditation;

My comment on that: COMTA has had their competencies spelled out for years. The basic difference I see is that ELAP is spelling out the number of hours to be spent in each subject matter area.

• other accrediting organizations, which can use The Core in shaping their accreditation criteria;

My comment on that: COMTA is the only accreditation organization devoted to massage therapy (and they now also include asthetic programs). The other accreditation programs I am aware of approve of all kinds of schools and programs and use the same evaluation criteria for a massage program as they would an engine repair program. I don’t realistically see it having impact on these types of accrediting agencies, although it would be nice if it did.

• school owners, administrators and faculty, who can use The Core to strengthen or validate curricula and to adopt consistent learning outcomes;

My comment on that: I wholeheartedly agree. I encourage all school owners, administrators and faculty to read this document…and I know the majority won’t take the time. I have seen the prevailing attitude of “I’m not going to let anyone tell me what to do at my school,” when I have tried to promote COMTA accreditation (disclosure: I have been a COMTA peer reviewer). It doesn’t matter if it would vastly improve their existing program. Stubbornness is hard to overcome.

• and potential massage therapy students, as they consider where to enroll.

My comment on that: I would be shocked to know that any potential student is ever going to read the 527- page document to help them choose a school. Just my opinion.

More of my unsolicited opinion: I am not critical of this document on the whole. I think it spells out a good foundational education for entry-level massage therapists as it was meant to do, and it requires 625 hours to do it in.

There are still 26 states here with a 500-hour minimum requirement. While it is very true that there are many schools that exceed their state’s hour requirement, there are also a large number of school owners that are determined they are not ever going to do more than the state requires. Neither do I see it having much effect, if at all, in states that already have higher requirements for education.

The ELAP report states that a 2012 survey showed schools are teaching an average of 697 hours. Still, if this were to be legally adopted, which I think is a long shot at best, it would undoubtedly put some schools in the position of “cooperate or close down,” which in the general scheme of things, might not be a bad thing, if their students are not truly well-prepared.

I am just of the opinion that being prepared to pass an entry-level examination, and being prepared for the real world of massage, are two very different things. It also isn’t about hours, per se, but about competencies–a statement, in fairness, made in the ELAP–but it does take a certain number of hours to teach those competencies, and this is what the work group decided on.

Bottom line: I like it, but I do think that in spite of the Coalition statement of support, that there has been some unnecessary duplication of efforts on some of their parts here, and that a good curriculum can only be effective with good, well-trained teachers. I’d like to see an equal amount of time, money, and effort spent on the National Teacher Standards Education Project. 

 

 

ELAP Final Report & Entry-Level Education Blueprint Released

The Entry-Level Analysis Project Final Report and the Entry-Level Education Blueprint were released today, and it’s a whopper…266 pages in the Report, and 527 pages in the blueprint. Obviously, I haven’t read that all this morning. I do want to take the time to express my appreciation for the collaboration among the Coalition (ABMP, AFMTE, AMTA, COMTA, FSMTB, MTF, and NCBTMB) and to Anne Williams of ABMP in particular, for spearheading the project. Both documents were co-authored by the ELAP workgroup, which included Pat Archer, Clint Chandler, Rick Garbowski, Tom Lochhaas, Jim O’Hara, Cynthia Ribeiro, and Anne Williams.

According to the Report, at the initial meeting of the Coalition in 2011, two pressing issues were identified: the inconsistent quality, depth, and focus of entry-level massage programs, and the lack of licensure portability from state to state.

The big recommendation is that 625 hours of education are needed just to give students the core basics that they need for entry-level competency. According to the report, currently 28 states only require 500 hours; 7 require between 570 and 600, and 10 states require more than 625 hours. In my opinion only, no matter how wonderful the Blueprint, those states that already have higher standards won’t be inclined to dumb it down for the rest. New York and Nebraska, for example, both have 1000-hour requirements. I don’t see portability happening there–ever–unless every other state decides to come up to that level. However, the Report does reference a 2012 study that states the average massage program in the US is 697 hours–so maybe even in the states with the 500-hour requirement, there is a tendency to do more than required–and that’s nice.

For those schools that are less than 625 hours, this recommendation would undoubtedly increase financial costs to the owner that would have to be passed along to the student.

The shocking news, to me, is the statement that 40-50% of graduates are leaving the field within two years of graduation! I would be interested to know exactly how those figures were arrived at.The Report cites unrealistic expectations about the physical demands of massage and compensation, and the evolving life circumstances of 20-somethings. I’m personally not sure how relevant the 20-somethings are; it’s been my own experience in the past 15 years that there are as many middle-aged people (whatever that is, nowadays) that take up massage as a second career as there are young people who jump in right out of high school.

The workgroup would like to encourage everyone to pay more attention to the core curriculum than the hours. According to the document, this can serve everyone:

  • The Federation can use it as a guideline for the Model Practice Act
  • The state boards can use it in setting hours for education
  • The AFMTE can use it in setting teacher standards
  • COMTA can use it in evaluating massage and bodywork criteria for accreditation
  • the NCBTMB can use it for identifying entry-level vs. advanced knowledge for Board Certification
  • Professional membership associations can use it in shaping membership criteria
  • School owners, administrators and faculty can use it in validating curricula and adopting consistent learning outcomes
  • Potential massage therapy students, as they are deciding where to enroll.

There is, within the document, the subtopics of Eastern bodywork, TCM, concepts of qi and all the accompaniments to that, with the caveat that schools may choose to integrate that according to their own philosophy. The focus is on the application of Shiatsu, tui na and Thai massage, which I will not argue the efficacy of, without personally buying into the theory behind them. I’m not going to have this argument here because it wears me out, and frankly, I’m outnumbered.

There is no doubt that a huge amount of work went into this project. Personally, I gave a lot of feedback on it during the calls for comments that happened some months ago, as did several other educators I know. I wasn’t crazy about this idea when it was initially introduced, and I was further distressed by the way the review and comment process was set up…I didn’t think it was good to have such a piecemeal approach to it, but in reality, I feel that the chance that many more people would have responded to the whole thing is probably relatively slim…it would have been just as long in any case. Anne Williams stated during one of the presentations on it that I attended last year that it isn’t perfect, but what is? I sincerely do commend everyone who gave of their time and effort on this huge undertaking. I plan to say more about it after I’ve read every page.