Posted on

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.

 

Posted on

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!

Posted on

Expanding Our Scope, Protecting Our Future

There have been numerous attempts to come up with a good working definition of  massage therapy. While I certainly appreciate the effort that has gone into them, in my opinion, most have fallen short in one way or another. Part of the problem is that massage therapists are independent-minded and are harder to organize than a bunch of cats. If you look at the 44 state massage laws that currently exist, you’ll find 44 different versions of what is called a scope of practice definition. Add to that the newest definitions found in the MTBOK and the ELAP, and we’ve got a murky mess that makes it nearly impossible to achieve portability of licensure. In fairness to the creators of both of those documents, which were collaborative efforts with support from all of the professional massage organizations, they were put out for public comment, which really didn’t amount to a ripple in the general scheme of things. My attitude is, if you didn’t take time to comment, then don’t gripe about the results.

We arrived here because there was no common template that was used during the rush to get state massage license laws passed over the past 15 years. Licensure standards are much more consistent in other healthcare professions because each one has been working from something called a Model Practice Act (MPA). I’m wondering… where can we get one of those?

Well, after nearly a decade after it came onto the landscape, the Federation of State Massage Therapy Boards has finally come up with their own MPA. They’re wrapping up the open comment period on the first public draft of this document, which has been posted to the their website. Much of it is run-of-the-mill legislative kind of language, but some sections really need further work. I’ve sent them my comments, and I hope you have too.

What I’m most concerned about in the FSMTB Model Practice Act is the scope of practice definition. As presented, it could restrict what massage therapists are allowed to do in their practices in the future. That’s a giant problem. If we define ourselves in a narrow way, other healthcare providers and business interests will ensure that we stay in our own little box.

Fortunately, I just heard from my North Carolina colleague Rick Rosen on this subject. He has developed what I think is a much more appropriate definition that strengthens and clarifies the diverse range of massage therapy practice in a way that expands possibilities, rather than shrinks them. By the way, Rosen was one of the co-founders of FSMTB, and was also the founding chairman of our state licensing board in NC, where he contributed to the writing of its laws and rules. Here’s what he said in his comments to the MPA Task Force:

“I am concerned that the definition set forth in Section 103 of the MPA is potentially limiting, as it characterizes the work performed by licensees as only that which relates to the manual application of techniques to the soft tissues of the body. Massage therapists are much more than pressure-delivery technicians. For example, they interact with clients in varied ways and provide assessment, treatment planning, and make recommendations for changes in a client’s ergonomic usage and movement patterns that can reduce chronic muscle tension. In addition, massage therapists can work with body awareness to assist clients in reducing stress and developing a healthier sense of self.”

“During the start-up phase of FSMTB in 2005, we looked carefully at the structure of board federations in other health care professions. I remembered from that research that most health care professions had robust and extensive scope definitions, as compared with the relatively one-dimensional definitions found in state massage practice acts.
With that in mind, I accessed the current model practice acts from the fields of nursing, physical therapy and occupational therapy. Using these templates as a guide, I developed a new definition that is broadly inclusive of the range of treatment models in our field, and establishes an expanded scope that more accurately represents the major areas of application in clinical practice.”

With that said, I’m sharing the full text of Rosen’s proposal for a new scope of practice definition:

PRACTICE OF MASSAGE THERAPY. A healthcare service of the healing arts provided to clients by a person who is licensed pursuant to this Act.

(1) The practice includes:

(a) Assessment of the functional and structural characteristics of the myofascial network and related systems of the body through tactile, visual and verbal methods;

(b) Treatment of the myofascial network and related systems of the body using manual methods, or by mechanical or electrical devices or tools that emulate or enhance the action of human hands;

(c) Active or passive movement of the body within the normal anatomical range of movement;

(d) Application of lubricants and other topical agents to the skin;

(e) Use of hydrotherapy and other adjunctive methods to produce therapeutic effects;

(f) Client education to facilitate body awareness and self-care;

(g) Treatment planning, communicating or collaborating with massage therapists and other licensed healthcare providers, and engaging in research, teaching and administration.

(2) Primary areas of application for massage therapy include:

(a) Wellness/Stress Reduction: treatment that supports the general health and well-being of the client, facilitates the relaxation response, addresses patterns of chronic tension related to stress, reduces pain and discomfort, promotes a more positive sense of self;

(b) Corrective/Rehabilitative: treatment that addresses specific symptoms or conditions, provides rehabilitation from the effects of injury, trauma or surgery

(c) Performance Optimization: treatment that improves the performance of specific activities or occupations, facilitates postural alignment and more efficient ergonomic patterns of use;

(d) Palliative: treatment for clients in recovery from illness or in the end stage of life that focuses on providing psychosocial support and relief from discomfort;

(e) Integrative: treatment that promotes awareness of the connections within the physical, cognitive and emotional aspects of the client, as well as treatment in conjunction with other licensed medical or mental health providers in a coordinated plan of care.

(3) The practice does not include:

(a) The diagnosis of illness or disease;

(b) Medical procedures, high-velocity low-amplitude chiropractic adjustive procedures, or prescription of medicines.

(d) The use of modalities for which a license to practice medicine, chiropractic, nursing, physical therapy, occupational therapy, acupuncture or podiatry is required by law; or

(d) Sexual activity of any kind.

I think Rosen has nailed it here. Without going beyond what we should do, this is more inclusive and a much more accurate description of what we do actually do. This more inclusive definition could save us headaches down the road if we are challenged by other professions for infringing on their scope of practice.

Today, June 15, is the last day for public comment on the MPA. Please pass this around… this should be the start of some interesting and important discussion. There’s nothing less than the future of the massage therapy profession at stake, so we have to get this piece right! Don’t sit on your hands. Take the time to comment, and if you don’t, then you are giving up any right to complain about it after the fact.

Posted on

I Need a Little Help from My Friends

Actually, I am asking for help for one of MY friends. She may be one of your friends, too, either in person or you may know her from social media, or her radio show, or the book she’s recently written. Her name is Shawnda Strongfaith Kettles.

I met Shawnda several years ago, when she won a mentoring contest I was holding. I had received many entries for the contest. If memory serves, I chose the ten that spoke the loudest to me, blacked out all the identifying information, and gave them to my staff members to vote on the final selection. She won unanimously. She had been homeless for a while. She had three daughters to take care of. She had gone to massage school, became a licensed therapist, and picked herself up from a bad situation. Her positive attitude in the face of all this just struck me as amazing. Champ and I went down to GA to meet her in person. 415918_347384488608777_1108678625_oShawnda has been working full-time as a massage therapist for the past couple of years, and keeping herself very busy. She is a great writer…she writes poetry, and short stories. She has been hosting poetry slams, making radio appearances, encouraging other poets and writers to share their stuff, taking care of her very accomplished daughters, all three of whom are at the top of their classes in school, being active in her church, and then one recent day, her life changed in an instant. I will cut and paste from her FB page, posted April 29:

April 10, I went blind for 5 days…completely. On April 14, the day my book was released, I became extremely lethargic and my body felt heavy. I walked myself to my bed at 3:30 p.m. and haven’t taken a step since then. On April 15, I woke up paralyzed from my right arm down, my left arm being the only extremity that was moving. Two days later, I got the use of my right arm back, but haven’t gotten my use of my legs. Thursday, April 24, I was admitted in the hospital and was diagnosed with NMO (Neuromyelitis Optica)…an uncommon disease in the MS family. It primarily affects the spinal cord up to the optic nerve. I have infection in my spine that may leave me permanently paralyzed from the waist down. As of right now, I have NO feeling in my legs and can’t feel touch. Day by day, I can feel changes in my body in terms of touch and sensation. I am slowly losing control of my bladder and bowel functions. In case you don’t know what that means, I can’t tell at times if I have to go to the bathroom or even take myself to the bathroom. I am 36 years old and I have to have someone to take me to the bathroom and at times clean me up. There are days that my jaw muscles aren’t strong enough to chew my own food, or my body doesn’t have enough energy to feed myself, so I have to be fed. Do you know how humbling that is? Do you know what kind of perspective that puts your life in?

Shawnda spent a couple of weeks in the hospital, and then was released home with a wheelchair and home visits from the physical therapist. She has been able to slightly move her right toes. She still has no feeling at all on the left side. Due to a very strong course of steroids, the infection in her spine did subside. However, the doctors have warned her that this form of MS is rare and that her paralysis may last for the rest of her life.

966183_851470814866806_6718987686827674630_oIn spite of that, her spirit and positive attitude is just humbling to me. She laughs every day. She encourages other people every day. She shares her testimony every day. She is a testimony every day. I can’t imagine I would have half the sense of humor and grace that she has if this happened to me.

Georgia Regents University/Medical College of GA is a teaching hospital and they covered the cost of Shawnda’s initial treatment because this is such a rare case, they wanted to study it. She will be receiving disability payments from Social Security. However, with three teenage daughters in school, I don’t know how far that will go.

A fund has been set up for Shawnda. If you feel led to help someone, you can click on this link to donate. Or buy a copy of her book. Every little bit helps. There may come a day when your life may change in the blink of an eye, and you’ll need someone’s help. Just pay it forward. Share this post if you will. Thank you very much.

Posted on

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.

 

 

Posted on

Getting Rich or Getting By?

I conducted one of my scientific FB polls this week. For the benefit of those of you who may not be on my FB page, it was about how much money massage therapists are making. I obtained 53 usable responses. Here they are. Of those 53:

7 work in a spa
2 work in a “luxury” spa
14 work in a chiro office
18 work in a massage office
3 work at Massage Envy
4 work in an MD’s office
2 work in a hospital
1 works in a nursing home
1 works in a salon

14 are classified as ICs, but 4 of those said they know they are misclassified and should be employees

39 are classified as employees, but only 11 of those people get paid anything when they are not performing massage.

5 of the ICS say they get paid when they are not doing massage, ranging from minimum wage to $9 an hour.

5 of those 39 people say they have benefits, ranging from CEs to full benefits such as insurance and vacation time

18 reported that they are paid on commission, which ranged from 30% to 80%, and an average of 53%

2 people who said they were ICs said they pay a flat rent for the use of a massage room; 1 of those pays $10 per massage, the other pays $25 per massage

28 people reported being paid by the hour, with hourly pay ranging from $7.40-85.00 an hour. The average was 23.41 per hour.

Of those 28 who are paid hourly:

3 report that they make $10 an hour or less
5 report that they make $11-15 an hour
8 report that they make $16-20 an hour
6 report that they make $21-25 an hour
3 report that they make $26-30 an hour
Then the data jumped to $50, with 3 people reporting that they make $50 or more per hour

30 people said they receive tips
23 people said they do not receive tips

21 of the 53 people work more than one job to make ends meet

$$-wise, it appears that the MD’s office and the hospital are the best places to work, with higher pay and more benefits.

I tossed the answers of sole proprietors and contractors who only told what they charge and didn’t account for their net earnings. Sandy Fritz addressed that issue in her blog this week.

When I published the results on my FB page, there was lots of chiming in about the low pay rates, and a few comments about people spending $40,000 to go to massage school and ending up working for a pittance. So I started investigating the cost of schools. In my state of NC, you can get a good education for less than $10,000. In fact, at some long-established schools, including one that’s COMTA accredited (which is not cheap to obtain), you can attend for less than $6000. Of course, that varies all over the country, but it seems like the majority of smaller schools are trying to keep their programs as affordable as possible. School owners from across the country chimed in, as did MTs telling what they had paid to go to school, and I don’t recall anyone going as high as $40,000. Massage school looks like a bargain education, for the most part.

Many of the comments on the results of the payment poll were negative, with the usual accusations toward the franchises for lowering the bar, and criticisms of other employers paying too little and expecting too much. One thing that I have noticed is that very little of that criticism comes from people who are actually employers. The majority of it is from people who have never been on the employer side of the equation.

When I opened my business ten years ago, I prided myself on paying above average. I wanted to do that in order to attract quality therapists and not have staffing problems. That worked pretty well for a long time, and I certainly wasn’t getting rich; I was getting by. I live in a very small town that is very economically depressed. The place where I live has not recovered from the recession, and in fact, in many ways it’s actually gotten worse. They claim the unemployment rate in our town is 12%, but that’s not realistic because it doesn’t include the many people have maxed out their unemployment benefits and all the self-employed people who have lost their businesses and can’t get in that line. Our homeless shelter is full every night. Soup kitchens and food giveaways are keeping a lot of people from going hungry.

A little bit of industry has started to trickle back in, but instead of the big cotton mills that employed several thousand people each, the businesses that are coming in are small companies that employ maybe 25  people. It’s not really making a big dent in the cycle of poverty and foreclosure that is going on here. People I know who have worked hard all their lives have lost their homes and their businesses. It isn’t a pretty picture, and I’m not exaggerating, or dressing it up. It’s the cold, hard facts. If you go on a tour here, you’ll see all the empty factories sitting here and all the empty small-business storefronts in our towns. You can’t begin to document the fallout on small business. The three really nice restaurants in our county–the kind of expensive place you’d go to on your anniversary or another special occasion–have all closed. Anything that is considered a luxury is not doing so well. People have cut down on massage. They’ve cut down on going to the nail salon, the hairdresser, the movies, and other forms of entertainment and eating out.

Over the years that I’ve been in business, expenses have gone up. I haven’t raised the price of massage in a couple of years because of the financial condition most of our county is in, and I feel it would be a nail in the coffin of my business if I raised it right now. The level of pay I used to offer people has gone down, which was a hard decision for me and one that I hated to make, but it is still superior to what anyone else in this area pays. As the owner, I also have to make a living. It isn’t going to serve me, or my staff members, if I can’t pay the bills and have to go out of business.

The accusations that employers are getting rich while the massage therapists are getting substandard pay is getting old. If that’s happening, it must be the minority, because I am not getting rich, and of the several hundred massage therapy business owners who are also employers that I am personally acquainted with, I can’t name any who are. They are either struggling, or they are making a decent living, but they aren’t millionaires and in all likelihood are never going to be one. The business owner is the one taking the risks. The business owner is the one paying the rent or mortgage, the utilities, the phone and Internet, the advertising, the laundry, the cleaning, the office supplies and janitorial supplies, the bank service charges, the credit card fees, the accounting services, the sales and use tax fees, and if they are utilizing employees instead of contractors or renters, they’re matching Social Security and Medicare contributions and depending on the size of the operation, paying other benefits as well. Franchise owners are criticized all the time, but they also invest a lot of money up front and it takes them years to get it back.

There used to be a middle ground between getting rich and getting by, and that was called the middle class (which is reportedly shrinking on a national level). I think that’s what we have in massage. We have a few people who are making minimum wage. We have a few people who are making big bucks, and the rest are somewhere in the middle.

As for those who are criticizing business owners and claiming that we’re the rich while you’re the poor, I encourage you to put yourself in our places. Go ahead, take a leap, open a business, get a bunch of people you are responsible for, and take responsibility for all the overhead. When the economy is booming, you may be booming along with it. And when the economy sucks, you may be in the same position all owners have been in when that’s the case–trying to cut down expenses without making service suffer and trying to make sure everyone keep their jobs, while still managing to make enough money to keep the doors open and meet your own personal obligations.

Obviously, the economy is booming in some places, and some people are doing very well. To them I say congratulations.

To the estimated 70% of MTs who are leaving the profession after less than two years on the job, I say I hate that you were set up with unrealistic expectations.

To my fellow business owners, I say that sometimes you’re the windshield, sometimes you’re the bug. I’ve enjoyed my role in keeping people gainfully employed and providing a pleasant place to work, and I have always tried to show my appreciation for that in pay and in other ways.

To all those who have criticized employers that have never actually been one, I say you don’t have the slightest idea what you are talking about. If you ever become one, and you can manage to give your therapists top pay, while surviving severe economic downturns without laying people off or letting them go, having disgruntled staff members, personally paying all the bills and bearing all the other responsibilities, then you can criticize to your hearts content.

 

Posted on

Weekend Update

A lot has happened this past week. First of all, the massage world lost a wonderful person with the passing of Dan Barrow. He was the long-time moderator in the AMTA House of Delegates, among his many other accomplishments, and was just one of the nicest people I’ve ever met. He will be missed. My sympathies go out to his lovely wife Virgina and his family and friends. You can read his complete obituary here.

One good thing happened this week. Steph Lasch was arrested at the Minneapolis-St.Paul airport after she had boarded a plane bound for Beijing, China, with her husband and her son. This has been a long road for a lot of massage therapists. In case you don’t know the background, you can read it here.

Since last fall, I have been communicating regularly with the Lino Lakes Police Department to keep up with what has been happening in her case. I had provided them with numerous pages of FB conversations and other print items where she claimed to be a certified public accountant, a certified fraud investigator, a third-year law student, a tax expert, a marketing expert, and everything except the president of the United States.The dozens of massage therapists who reported her to that department, and also to the FBI, the Attorney General, the Better Business Bureau, and everywhere else they could turn to will hopefully get some justice now. People may never get their money back, but it is my big hope that her actions do not go unpunished.

Although she never got any of my money personally, I had appeared, along with three other women, as a blogger (about professional ethics, at her request) on a massage coaching website she had going on. She had announced far and wide that I was her mentor, and I felt compelled to just keep trying to spread the word about the avenues people could use to complain on account of that. The police report actually focuses on the money she defrauded massage clients of at her business location, and not the dozens of therapists she stole from. In any case, she’s currently in jail. I’d love to attend her trial. You can read about it here. My last piece of advice to her was to get her act together for the sake of her child. I contacted the LLPD again this evening and they told me that her son was handed over to her husband; they were on the plane with Steph but her husband was not charged with anything.

Champ and I attended the NC AMTA Convention in Statesville this weekend. We had a good time visiting with people we don’t see often enough and both of us enjoyed our continuing education. Champ took an ethics class with Felicia Brown and I took a class in teaching and classroom management from Dr. James Zarick. One of the best classes I have ever attended. Desiree Sawyer was elected as our new chapter president. I spent this morning visiting with Mike Hinkle, founder of the World Massage Festival. I am honored to be the keynote speaker at this year’s Festival in Las Vegas. I guess I’ll just try to make as few people mad as possible!

I spoke up at the business meeting about AMTA national office decision to do away with chapter fees. I want it to go on the record that I think this is the worst move this organization has ever made. In my opinion only, this move was designed to make AMTA’s membership fee more competitive with ABMP. The fact is, ABMP has a different business model than AMTA. ABMP does not have state chapters to support. They don’t have hundreds of volunteers. Personally, I think they’re a fine organization with fine people at the top, and they just operate differently. I think AMTA needs to quit worrying about ABMP and focus on doing the best for the massage profession. This is impacting chapter budgets, and while they have rolled out some additional benefits for the chapters, I don’t think it offsets what they’re losing. I’ve seen the budgets from three different states in the last few weeks and it is having an impact, and not a good one. I think they will regret this move in the long run. I’d like to see a massive letter-writing campaign to the Board of Directors describing the negative impact this will have on the chapters’ ability to provide top-notch education experiences on a state level and on chapter donations to the Massage Therapy Foundation. Please do that here.

I’ve had an emotional week myself. I implemented some changes at my business, which never happens without a few growing pains, and the death of an old friend whose funeral I had to miss in order to attend the convention have made me a little whacked out this week. Then hearing the news about Dan Barrow, followed by the news about Steph Lasch, and it has seemed like a roller coaster. The world just keeps turning.

Peace and Prosperity.


Posted on

CAMTC: Under the Gun, ABMP Says “Declare Victory and Move On”

I’ve spent the past day or so reviewing the CAMTC Sunset Review Report…at over 200 pages, it’s a narrative of the who, what, where, when, and why of the organization, which is now in its fifth year.

California operates differently from the other regulated states. The CAMTC is not officially a state regulatory board. It is a non-profit organization, offering voluntary certification. It is just my opinion that this is a big improvement over the previous state of affairs there, when there was nothing at all, other than each municipality regulating as they chose, which more often that not meant that legitimate massage therapists were classified along with sex workers and treated the same way. I’ve heard horror stories from therapists who have in the past been made to take a test for STDs, along with paying money to each individual town in which one was practicing. Someone doing outcalls may have been looking at a separate license and another financial burden in many different places. The CAMTC aimed to put a stop to this by getting it into the statutes that if you had the CAMTC certification, you were allowed to skip all the local hoops. It was a very hard battle.

During the Sunset hearing process last week, ABMP Chairman Bob Benson testified. Benson served the CAMTC Board for four years, including a term as the initial Vice Chair. He attended 51 of the 52 meetings held during his tenure. His complete testimony may be read here. Benson’s opening remarks referenced the Vietnam war, in speaking to the present state of affairs at the CAMTC, and he urged the organization to “Declare victory and move on.” I have heard from several veterans who were very upset about that analogy and feel that Benson’s remarks showed a great disrespect for the people who served in Vietnam and a cheapening of those who lost their lives there. I have met Benson personally on several occasions and I don’t think he would intentionally insult veterans, but I have to agree it was not the best choice for comparison.

Beyond that opening faux pas, Benson brings up the following points about the weaknesses he perceives in the CAMTC. One is that CEO Ahmos Netanel is wearing too many hats. There is no controller or operations officer or chief financial officer; Netanel is doing all three jobs, apparently. There’s no doubt he’s a busy man; I run into him myself at national meetings.

Benson also points out other problems: the unwieldy size of the Board–20 people (although currently there are only 19); the fact that there is no central office, which leads to communication and control challenges; a lack of adequate information on the website and delays in getting things posted; 5 years in operation and as of yet no customer satisfaction surveys; a lack of data on how much the CAMTC is paying their management company; a lack of salary standards, and unsatisfactory performance metrics for the dissemination about applicants and certificate holders.He also actually refers to their plan to start approving establishments and massage schools as “delusional.”

Benson isn’t one to complain without offering a solution, so his suggestions are the transition of this organization into a formal state regulatory board, as the other regulated states have; to substitute mandatory licensing for voluntary certification; to use 2015 as a transitional year; and to honor CAMTC certificates and allow holders to convert them to a state license on their expiration date without jumping through any further hoops.

I contacted Ahmos Netanel and gave him the opportunity to respond to Benson’s comments. His reply below is verbatim:

In his comments during the March 10, 2014 legislative Joint Oversight Hearing: Sunset Review of CAMTC, Bob Benson, acting as the voice of ABMP (Associated Bodywork & Massage Professionals), advocates for dismantling the current statewide certification program and instituting a state board for regulating massage therapy under the Department of Consumer Affairs (DCA). Bob Benson is certainly dedicated to the massage profession; however, he is a minority voice.  In fact, no CAMTC Board member has ever expressed a position similar to his.

The CAMTC Board has accomplished a great deal.  Yes, as with any new organization, there is room for improvement.  However, in a very short time, by any standard, we have put a statewide infrastructure in place to work closely with police and local government, and there is no doubt that consumers can have confidence that a CAMTC certified professional is educated to safely provide care. 

CAMTC has done more than simply oversee the certification of qualified massage therapy professionals. CAMTC has initiated work with local authorities, local elected officials, professional organizations, other stakeholders and the Legislature to modify its enabling law to correct issues and oversights. Presently, the Sunset review process implemented by the Legislature allows for the substantive amendments needed to control illegal massage parlors.  In doing so, we want to be respectful of the work being done by legitimate massage providers and not return to the era of onerous patchwork enforcement— the kind of control that simply assumes massage is adult entertainment.

CAMTC also investigates and un-approves schools as part of ensuring that certification candidates met strict educational requirements.  Ironically, the state bureau which regulates private post-secondary schools, now BPPE, was allowed to sunset between July 2007 and January 2009.  The lack of an official school oversight body during that time had a significant negative impact on the massage industry and the safety of the public.  Stepping in since 2010, CAMTC, with only minimal resources, has been able to un-approve 47 massage schools that were not meeting minimum standards for massage education and we hope to do more beginning in 2015.

In the ongoing and important effort to eradicate illegal massage parlors, CAMTC is asking the Legislature for the authority to provide statewide registration and investigation of massage establishments.  Many local jurisdictions lack the resources to effectively stem the tide of these illicit businesses and CAMTC is up to the challenge. 

The problems raised by the police chiefs and the cities are our problems, too.  Their complaints and concerns are issues we are addressing with great success in many parts of California.  For example, our training programs have been attended by more than 100 local agencies. And many cities – impressed by our organization – now require CAMTC certification. 

The proliferation of illegal massage parlors is bigger than massage therapy alone, but we are an integral part of the solution.  We propose:

  • Raising educational standards
  • Establishing a registration program for establishments
  • Expending local government control over the use of massage as a subterfuge for prostitution

A state board under DCA has merit. It also has significant drawbacks, including starting a new entity from scratch. It is likely that a new state board would take anywhere from 2 to 5 years to become fully operational.  The cost in terms of time and state resources is not warranted when CAMTC is already in place and functioning successfully. 

Further, a state board simply cannot function as efficiently as a private entity like CAMTC.  Consider, as was discussed on March 10th in the Joint Oversight hearing for the DCA, that the current time for disciplinary actions by DCA boards is 540 days, despite the target of 180 days.  Just scheduling a hearing with the Office of Administrative Hearings takes approximately 200 days (testimony by the Legislative Analyst’s Office). Furthermore, the cost to discipline or revoke a state license is over ten times greater than what it costs CAMTC  to discipline or revoke a certificate holder.  CAMTC provides a high level of due process to certificate holders at a lower cost and in fraction of the time that it takes a state board to do the same.

Whatever the merits of moving to a state board under the DCA, it is not going to happen by magic nor will it happen overnight.  It will be a long, costly process. And dismantling CAMTC won’t benefit California consumers or those individuals practicing massage therapy in California.  Rather, it will leave a gaping chasm for both.  

Legitimate massage providers create jobs, promote a healthy lifestyle, and enhance communities.  We cannot go back to the antiquated and oppressive patchwork regulation of the past.  It won’t solve the problem of illicit massage parlors or correct any of the other issues about which cities are concerned.  Only working together – CAMTC alongside cities – can we protect both the public and legitimate massage providers. 

CAMTC is proud of its successes and we look forward to working with the police chiefs, the local communities and Bob himself to do great things for the massage therapy profession and the public.

Respectfully,

Ahmos Netanel

Chief Executive Officer

California Massage Therapy Council

I do not wish to minimize any of the accomplishments and hard work of the CAMTC. I applaud what they have done. However, I’m in agreement with Benson on this one; I’d prefer to see them with mandatory licensing instead of voluntary certification. It won’t be the answer to every problem; it never is. But I do urge them to make the transition, and hopefully, that can be accomplished without the gaping chasm Netanel mentioned.

 

 

 

Posted on

Massage Regulation: What is the Point?

Seems like almost daily, on one of my networks, someone will post the question of “what good is massage regulation really doing?” They often throw up points like “prostitution still exists,” and of course it does and it always will. Other complaints are about how much money the state revenue department, or the licensing board, or the Federation, or the testing company is making.Then we’ve got the complaints about taking CE to satisfy the law, and how that’s just a money-making racket. As a CE provider, believe me when I say I’m not getting rich off of it, and very few are. But back to the question, what is the point?

The point of licensing in any profession is basically quality assurance for the public, for their own safety and protection. To get a license, you’re supposed to have x number of hours of education. You’re supposed to pass an exam proving entry-level knowledge . In most places, you’re supposed to get the continuing education in order to keep it. You’re supposed to agree to abide by a code of ethics and uphold standards of professional behavior. You’re supposed to first do no harm. You’re supposed to act in the best interests of the client.

There are now only a couple of states that are the last holdouts with no regulations in the works or already in effect…anyone may call themselves a massage therapist or any other derivative indicating massage, whether they actually know anything or not.

In reality, it’s hard to find out exactly how many members of the public have been harmed by massage therapy. The insurance companies and professional associations don’t like to release that information. Many of the state massage board websites do have license verification online, and some do list disciplinary actions, but in most cases that will only show up if you already know the name of the therapist that has been found guilty of some infraction. It must be said that not every single person who has been found guilty by a board is really guilty…there were times during my own five years of board service that I did not believe the accused person was guilty, but the majority voted that they were. It must be also be said that some therapists who are in fact guilty never ever get reported and thus keep preying on the public. There just aren’t any guarantees, just like with any other walk of life or profession. There are people in every profession that are dishonest or predatory, and massage therapy is no different.

All things considered, I think licensing has been a valuable thing, and personally, I’d like to see it in every single state. Yes, there are still people who will practice illegally. There are still prostitutes who will hide behind massage. But I think on the whole, licensing has brought a healthy amount of awareness and credibility to massage therapy.

I’m not resentful of having to get a criminal record check to get a massage license. If we were being singled out I’d be upset, but every other health care provider in our state has to do it. I’m not resentful of having to take continuing education….I love learning and I actually look forward to taking CE. However, I do think there comes a point in time when that should be optional. Realistically, should someone who has been practicing for 20 years need to attend an ethics class the same as someone who has only been practicing for a year and may not have even faced any kind of ethical dilemma yet?

I’m not happy with the present state of the CE environment, anyway. I think a person who is taking science-based classes or classes designed for public protection deserves more credit than people taking fantasy-based classes. With the long list of inappropriate classes that are currently approved, I really don’t see how attending a class in shape-shifting is doing anything to protect the public.

Some state boards are self-supporting. Some are at least partially subsidized by the state. Some try to educate the public. Some don’t. Some pursue illegal massage more than others. Nothing’s perfect.

The point, to me, is that the majority of us, by paying for that license and jumping through the hoops, are proving that we have at a minimum, the entry-level knowledge to practice massage safely. The majority of us have taken the education, and passed the exam, and meet our CE requirements. The majority of us are practicing ethically. The majority of us are trying to keep massage and sex separated. The majority of us abide by the rules. The majority of us are just here to take care of our clients and do the best we can. There will always be some bad apples, but I think requiring licensing has weeded out a lot that might otherwise be here. Just my opinion.

Posted on

Free Massage!

Do you ever feel like you have a sign on your forehead that says “Free Massage?” Every day on my social networks, I see massage therapists talking about being asked to do free massage. “Come and do free chair massage at our event and it will get your name out there….” never mind that you’ve been practicing for 15 years and your name is already out there. I recently saw on FB post where a chiropractor wanted someone to come to his office and do a week’s worth of free massage so he could get the client feedback and decide whether or not he would hire the person…I guess he thought she just wouldn’t need any rent money or groceries that week. If he’s located near a massage school that’s turning out graduates or an area that’s saturated with massage therapists, he could feasibly keep the “audition week” going for a long time–and quite probably billing insurance for the massage that he’s not even paying the therapist to perform.

At the massage school I attended, back in the day, we were required to perform 25 hours of community service…free massage on a deserving population. 15 years later, I still don’t mind performing free massage on a deserving population. I occasionally volunteer time to what I think is a worthy cause. I once gave weekly massage to someone for almost a year because he had spent nearly a year in the hospital, his medical bills were in the millions of dollars, and he just plain needed the work and couldn’t pay. One of my staff members has given a lot of massage at an abused women’s shelter. Another did deeply discounted work on someone who was seriously injured and didn’t have any insurance, and many of us have done that kind of thing at one time or another, for nothing other than the warm fuzzy feeling of having helped someone.

If there is an event going on that I think we need to have a presence at, I will pay staff members to do chair massage; I don’t expect people to work for free. We just can’t and/or won’t go everywhere we are asked to go. If the event is more than ten miles away from my office, I’m not really inclined to go there. There are plenty of massage therapists in our county, and if there’s a health fair that’s all the way at the other end of the county and plenty of practicing therapists between here and there, I’d rather let one of them have it.

I have recently been receiving invites to an event in Shelby, NC. That’s 25 miles away from here and I know at least half a dozen therapists that practice there, so I’m not going to go encroach on their territory. The last time the organizer called, I told him he was wasting time by continuing to call me about it and suggested he contact therapists from that area. I also turned one down that was relatively close, but on a holiday. When the woman called me, I said, “thank you, but our staff members want to spend the holiday with their own families that day.” Not only do they want us to do free massage, they also want us to pay them for a booth to do it in.

Sometimes MTs are distressed or hesitant about saying “no,” because “it’s at my mother-in-law’s church,” or “one of my clients asked me to do it, but it’s 30 miles away,” and that kind of thing. If you’re a new therapist, or an old one who’s feeling torn on this issue, then here’s the answer: “Thank you for thinking of me, but I already have clients booked for that day.” Or you can say “Thanks, but I don’t give my services away,” with no excuse. You don’t need an excuse.

If you have the time, and so much money you don’t have to worry about paying your bills, then feel free to give away all the massage you want to. Say yes to everyone who asks. You’ll probably get some business out of it, but keep these thoughts in mind: Some people will do anything just because it’s free, that they would never think of actually spending money on. Some people who are already consumers of massage and already have their own therapist of choice will sit down and get the massage, again, just because it’s free. And many times, people don’t place much value on something they get for free.

If you need an actual return on investment for your time, then you need to pick and choose what you’re going to participate in. Realistically, you stand a much better chance of getting business from an event that’s 5 miles away from your office than one that’s 25 miles away from your office. Some events, like an annual festival, attract a lot of people from out of town that are never going to become clients, but you’ll have to massage them along with any locals who might potentially become clients.

Your dentist isn’t going to do your root canal for free. Your doctor isn’t going to do your appendectomy or deliver your baby for free. The plumber, the electrician, the washing machine repairman isn’t coming to your home for free. You can’t walk into Walmart and load up on free goods, but for some reason, many people seem to expect that massage therapists are always available to give it away.

Here’s the reality check: most of us have overhead directly related to our work. It also costs money to get educated, to get licensed, and to keep up with continuing education requirements. It costs money to run our homes and our lives–just the same as it does for the people who are soliciting us to come and do free massage. We have mortgages, car payments, student loans, and debts to pay. We need food and utilities and medicine and school tuition and child care just like everyone else.

Doing free massage is sometimes a good marketing opportunity. It’s always providing a public service, and you should do it only when you genuinely want to. Don’t allow yourself to be talked into doing it when you don’t want to, and don’t allow yourself to feel guilty for turning anyone down.