Tag Archives: LauraAllenMT

Report from the AMTA National Convention

I arrived in Ft. Worth on Wednesday in time to attend the House of Delegates preliminary meeting, which was quite exciting. I was only an alternate this year so I did not get to participate in several spirited debates, one concerning the ACA, and another concerning delegates who arrive late for the meeting (they don’t get seated–something I am in total agreement with.) I spent the evening at the Lippincott author’s dinner, something I always look forward to. Authors and educators Ralph Stephens, Ruth Werner and her husband Curt, Pat Archer, Celia Bucci, Joe Muscolino, Diana Thompson, LWW Publisher Angus McDonald, Acquisitions Editor Jonathon Joyce, my wonderful editor Linda Francis were all present, and I’m probably forgetting someone! We dined at Reata, which served great Tex-Mex food, and the service was top notch.

Thursday morning, the opening ceremony was great. Doc Hendley was the keynote speaker. He is the founder of Wine to Water, and a fellow North Carolinian. He received a standing ovation and had some people in tears, including me. His life’s work is providing clean water to people all over the world who do without it, and it really makes you realize how much we all take for granted. President Winona Bontrager recognized long-standing members and handed out awards, including giving the President’s Award to Rick Rosen, co-owner of the Body Therapy Institute in Siler City, NC, and recognizing him for 30 years of service. Rick has contributed so much to this profession, I’ve actually written a previous blog about him. Congratulations to him for well-deserved recognition.

I had another chance to catch up with Joe Muscolino on Thursday when we shared a table at Starbucks. He is such a smart man who has been around this business for a long time. I’m hoping to attend his dissection class one of these days. Back to the House of Delegates on Thursday evening, where three position statements were considered.

Thursday night, the North Carolina Chapter went out to dinner together. Great to catch up with everybody. I walked back to the hotel with Joel Tull and we got slightly lost…which was okay…we took a good walk! Joel is a sweetheart and a gentleman, and he told me an Irish joke, which I won’t repeat here, but it was great to visit with him.

Friday I visited the Massamio booth for my appointment with Michael Reynolds. His task was to whip me into shape at using HootSuite, and he gave me some great advice. He and Allissa Haines were busy, busy, busy educating people about social media marketing. I hate I didn’t have more time to visit with both of them. That was the case with a lot of folks that I loved to see but just didn’t get to hang out with much.

Bruce Baltz saved me from a total meltdown by giving me a foot massage at the Bon Vital booth….shame on me for wearing a pair of flats all week, my feet were killing me! Note to self, don’t do that again!

On Friday I attended a presentation on the parasympathetic nervous system by Dr. Sandra Smith, Dr. Drew Riffe and Dr. Christopher Moyer. This was one of the research track classes and I was thrilled to see the room packed. The same thing happened on Saturday when Dr. Moyer taught a class on the effects of massage therapy on anxiety and depression. He’s a great teacher, and again, it was so wonderful to see the room filled with people who are interested in learning about and advancing massage therapy research.

Friday night I attended the reception for the Massage Therapy Foundation. I’m still trying to take it all in. AMTA’s annual donation to the MTF was $450,000. The Florida Chapter of AMTA made a $20,000 donation. The MA Chapter made a $10,000 donation. Massage Envy made a $10,000 donation. Then Massage Envy VP CG Funk made the offer that she would match up to $500 if someone passed the hat. Richard Wedegartner passed his cowboy hat around and in ten minutes collected over $800. He said next year he would wear a bigger hat. Biotone made a $15,000 donation, and Massage Warehouse made a $10,000 donation. Performance Health made a $2500 donation in honor of Diana Thompson, whom they honored for her many efforts on behalf on the profession. Outgoing President Ruth Werner also honored Diana, and I could not think of a more deserving person. I was really blown away by the generosity and dedication to massage therapy research that was on display. Thank you to every donor, whether your donation is big or small, it all helps!

Friday after the reception I spent some time catching up with Ariana Vincent. Ariana is dynamite in a small package! We actually roomed together Friday night and had a great chat.

After my class on Saturday I made a quick visit through the exhibit hall before heading to the airport. I missed the closing panel presentation on the ACA. According to Ariana, who took notes, the four panelists spoke knowledgeably about the health and legal ramifications. Therapists are encouraged to investigate thoroughly before jumping into the insurance waters, and reminded that you must be HIPAA compliant in order to accept insurance. The therapists in unregulated states will not be allowed to participate in insurance filing under the ACA. I’m sure there’s more but that’s the gist of it.

All in all, I had a great time. I always do! There is just something awesome about being with a couple of thousand people who do what you do! The Texas Chapter did a great job as hosts and we all appreciate it. Already looking forward to next year in Denver!

An Alternative to CE Regulation (just in the nick of time)

As I’ve written about on this blog, the NCBTMB has been trying to roll out an “upgraded” scheme to regulate the entire world of continuing education. After all, their stated mission is “To define and advance the highest standards in the massage and bodywork profession.” (Doesn’t that give them free rein to tell the rest of us what to do?) Apparently, NCB wasn’t satisfied with just approving CE providers – now they want to require the thousands of CE courses to pass through their hands as well. Go back to my posts from November 18, December 28 and January 8 to read about the many problems that are likely to come up if NCB’s new Board Approved Continuing Education Provider Program comes to pass.

If this wasn’t bad enough, along comes the FSMTB who have announced they are jumping into the CE approval game with their own new approval process. They’re calling for volunteers to serve on three different committees that will build and operate a whole deal that will be separate from what NCB is planning.

We already have too many different CE approval hoops for providers to jump through. It’s just plain crazy for FSMTB to be looking at putting another national approval scheme on the map. The feedback I get is that many CE providers are already struggling with the challenges of the economy and the burdens of CE regulation. If nothing changes, things are about to go from bad to worse in the CE community.

Fortunately, some people outside of these two silos have had their thinking caps on. My NC colleague Rick Rosen has just put out a major white paper on this subject, which will give you everything you need to know to understand this issue (and then some). Most importantly, he has come up with a very interesting and practical alternative to the formal regulation of CE, to be called the National Continuing Education Registry.

In this paper, Rosen poses four big questions that challenge the basic assumptions that have driven our regulation of CE. He says these must be addressed before NCB and FSMTB do anything else with their approval schemes.

He provides a lot of useful background information along with detailed answers to these questions. All of that serves as a lead-in to an overview of the National Continuing Education Registry. It is designed to be an online listing service that will replace all existing national and state CE approval processes:

  • CE providers will be screened by a designated entity to determine that: 1) the provider is a legitimate business entity, and 2) where required, the provider has a valid state-issued massage therapy license, registration or certification. Providers will sign a participation agreement that includes adherence to a code of ethics.
  • Each CE course will be screened to determine that it is within established subject matter standards that are broadly relevant to the professional practice of massage therapy.
  • The Registry may be utilized by state massage regulatory agencies as the means to determine whether a CE course is acceptable for renewal of a licensee’s credentials to practice. In a similar way, NCBTMB (or other certification agencies in the future) could utilize this service to determine whether a course taken by a certificant meets the criteria for recertification.
  • This service will give massage therapists a basic level of assurance that listed courses will be accepted for license renewal and/or recertification, and that the course is offered by a credible individual or institutional provider.

The overall structure of the Registry is similar in ways to the Multiple Listing Service concept in real estate. It will be based on a voluntary participation of CE providers, who agree to conduct their business according to a code of ethics. Like shopping for a house, therapists will have to perform their due diligence to find the courses and providers that meet their learning needs. There are no guarantees, but a provider’s reputation for integrity will be a great asset.

So instead of making CE regulation more burdensome, complex and costly, he is offering a way to simplify, streamline and consolidate the whole process. That sounds damn good to me!

If you care about this issue, I highly recommend that you read Rosen’s paper to get the complete picture, and then contact the leaders of NCB and FSMTB and urge them to set aside their own approval programs in favor of this National Continuing Education Registry. The power of grassroots lobbying is the only tool we have to get the small group of people who lead these two organizations to wake up and smell the coffee on this vital issue.

You can download the white paper from this link:
http://tinyurl.com/NCER-Proposal-FEB2013

There are few people who understand how all the pieces fit together in the massage therapy profession. As someone who was a co-founder of both FSMTB and AFMTE, served as a state massage board chair, and is a school director, CE provider and CE sponsor, Rosen takes the long view in looking at the problems in our profession. Frankly, I don’t know where he finds the time to research and write these papers, but I’m sure grateful that someone cares enough to do it! I urge everyone to share this with their networks.

 

I’m in Pain

Yes, I’m in pain. Believe it or not, it pains me to write negatively about the National Certification Board for Therapeutic Massage & Bodywork. I am personally acquainted with many of the people who work there, from the CEO, Mike Williams, on down, to Board members, staff members and volunteers. I count some of them among my friends. I know for a fact that they are dedicated and hard-working people.

I’ve been NCTMB since 2000 and an approved provider of CE since 2002. I’ve seen the ups and the downs of the organization: the days of great service, and the days of bad service. I’ve seen the leaders who had the best interests of the profession at  heart–and one or two who were on a personal mission to bring down the organization with their wild spending and lack of professional ethics. And I’ve seen–and even been a party to–some of their missteps. A couple of years ago when they announced an advanced certification exam, I signed right on. I even appeared in an advertising campaign for it, along with quite a few other well-known massage therapists, educators, and even some illustrious physicians. The failure of that project, I believe, was because it was a general thing, and not a specialty certification–which the profession has been requesting for quite some time.

CEO Mike Williams responded to my Wish List blog last week. I met Williams at the AFMTE meeting a couple of months ago and spent a very enjoyable couple of hours talking with him one-on-one. I hear (from other folks, he wasn’t bragging) that he has a proven track record of helping floundering organizations get back on track. He even joked to me that he had learned everything he needed to know about the NCB from reading my blog.

You can’t please all of the people all of the time, and I know that just from the comments I receive on this blog. However, distress at their latest action seems to be shared by more than a few people. The NCBTMB sent out an application for a new assigned school code to massage schools this week. Now, the organization has required a school code since the beginning; it’s just a number that students must include on their application to sit for one of the NCB exams, and it is supposed to demonstrate that the school is legitimate. That’s good in theory; and I think the original intent was to keep schools and/or individuals from falsifying diplomas and transcripts.

A number of school owners went up in arms this week when they received the application. True, it is just seven pages long, and that’s way less than what is required for a state board school approval or COMTA accreditation…but therein lines the issue: except for the schools in the few unregulated states, these schools have already been approved by their state boards, and in some cases, one or more accrediting bodies as well.

One school owner on my FB page said “We are opting out. The list of required paperwork is oppressive. Our school is now sending them all off to the Mblex. It’s moves like this that, in my opinion, will seal the deal of completely making the NCBTMB irrelevant. We had a school code with them, we maintain state approval which can be verified easily on the state website. The additional hassle which this organization seems to thrive on is over my tolerance level.”

Another sore point is the human trafficking angle. Now, I don’t think anyone is in favor of human trafficking except the people who are making a living off of it. As background, there has been legislation introduced in a few states requiring massage establishments to post notices about human trafficking–something that isn’t required in a convenience store (in other words, they’re picking on us again, supposedly because massage is a business in which it’s a big problem). On their 2010 990 filing, the NCB reported giving a $5000 donation to the Polaris Project, which fights human trafficking. They also started publishing brochures about human trafficking and selling them (at 2.50 for 25 of them, I don’t think they’re getting a big revenue stream off of that).

On the application that came out this week, school owners are being asked to sign a pledge about not participating in human trafficking, and doing whatever they can to stop human trafficking. I got calls from a few people that were upset about that; they stated to me that the NCBTMB was overstepping its boundaries and giving a false impression of having regulatory or law enforcement authority. Personally, I think any entity donating money to the Polaris Project and doing their part to fight human trafficking is admirable, but as someone on my FB page pointed out, is there really any school actually participating in such a thing that wouldn’t just sign the pledge anyway? It’s like asking people if they use illegal drugs on a job application. No one is going to write down that they have a cocaine habit, are they?

On the NCBTMB website, there are a couple of dozen schools listed as having their school code suspended, revoked, or denied. The reasons are not given, so one doesn’t know whether they were found to be participating in human trafficking, running a diploma mill, or what.

In his response on my blog, CEO Mike Williams talked about the forthcoming improvements from the NCB. Let me say, as much as it pains me: different singer, same song. I must make it clear that I have wanted this organization to survive, and thrive, but I am very concerned. And as Angela Palmier pointed out in her comments, people laughed when there was talk of another entity creating a licensing exam. In the meantime, the MBLEx has proceeded to saturate the market and it will just continue to get bigger and bigger–even if the NCBTMB steps in to challenge the states’ right to choose, like they did last week in Tennessee. They did actually prevail there, but at what cost? The Board members were upset, the GR rep from AMTA was upset, and in the end, the decision for the Board to acquiesce was based on their desire not to see their other impending legislation get scrapped in the crossfire.

In addition to the FSMTB sticking their toe in the water to test the profession’s reaction to their CE plan, I’ve recently been contacted by several people about starting (yet another) CE approval body. It wouldn’t happen overnight, but there’s no reason to think it can’t be done. For that matter, there is nothing to prohibit another entity from starting another certification agency….just like there are numerous accrediting agencies besides COMTA. It could happen.

I don’t doubt that the NCB has good intentions–but as we all know, good intentions are sometimes misguided. Placing an additional and very unnecessary burden on school  owners is misguided and the perception is that it’s one more example of duplicated efforts in this profession. Challenging state boards is misguided. The NCB needs all the public support they can get, and that isn’t winning them any friends. It is creating ill will, period. Hanging on to entry-level licensing instead of focusing on  becoming the one true certification agency is misguided. That’s my story and I’m sticking to it.

 

It’s All About Me

It’s all about me, so here’s my wishlist for the profession. It’s difficult to place these in order of importance, because some of them depend on each other, and in my little corner of massage, they’re all important. It’s election time–aren’t we all just about sick of hearing about it–candidates mudslinging and making campaign promises? If I was the President of Massage Land, here’s what I’d do:

The Federation of State Massage Therapy Boards would sit down at the table with the National Certification Boardand hammer out an agreement to a) help ease the NCBTMB out of the entry-level test market, b) contract with them to collaboratively administer continuing education instead of trying to take it over and c) forget their MOCC-ERY plan.

The NCBTMB would a) graciously accept that it’s time for them to get out of the entry-level test market, b) focus on cleaning up the CE approval program, and c) get it together with their new plan of raising standards of certification.

Both of these entities would cease and desist in sending out Job Task Analysis Surveys that are flawed from the get-go….they both supposedly pay psychometricians to help them out with these things, and still they are falling way short of the mark in ascertaining what they really need to ascertain. Stop worrying about how many times a week we give a massage, and stop ignoring the relaxation benefits of massage as if they don’t exist.

There will continue to be Leadership Summits. They will stick to the agreed-upon agenda at their meetings and not allow major surprises  to slide in from any of the organizations, and they will practice complete transparency and stop sending out press releases that contain no more information than an invitation to a baby shower.

Every one who is involved in massage therapy education will join the Alliance for Massage Therapy Education.

The profession will come to a consensus on what constitutes required core competencies for entry-level education, while still giving school owners the autonomy and individuality to rise over and above that.

All unregulated states will get state-wide regulation and all localities will honor those and not place ridiculous additional burdens on licensed therapists.

All massage schools will be required to teach research literacy to their students, and will only hire instructors who are capable of doing so.

The NCBTMB will stop approving woo-woo courses for CE credit, and all entry-level massage schools will stop teaching it. I don’t care if you study Interplanetary Voodoo with the Archangels, but you don’t deserve any credit for doing that.

Our professional associations will conduct annual surveys that have NOTHING to do with a Job Task Analysis–the sole purpose of it will be “Tell us what you think we are doing wrong and give us your suggestions for how we could do it better.”

The Alliance for Massage Therapy Education will develop a program to offer instructor training to the masses that will be accessible and affordable–perhaps online.

Board members of all representing organizations will recognize their responsibility to not blindly follow the leader; to avoid not only conflicts of interest, but the appearance of conflicts of interest; will not put up with any cover-your-ass type behavior within their organizations; will hold their hired leadership accountable, and will have enough gumption to get rid of them if and when such behavior occurs.

All massage schools would seek COMTAapproval. If your school can’t afford that or doesn’t qualify because of not meeting the hour requirement, may I say that their standards are on their website for all the world to see for free, and you could still go about the self-study process and getting things up to snuff, even if you don’t formally seek the accreditation.

All school owners would be bound to have their school bonded, so that no school goes bankrupt and leaves students in the lurch in the middle of their program.

All schools would be required to post their pass rates on the licensing and certification exams on their websites and in their catalogs.

No school owner will be allowed to say to a potential student “Don’t worry, your criminal record won’t keep you from getting a license.” It should be mandatory for it to be disclosed that they may not receive a license. The state of Texas has a non-binding review, where for $50 a person seeking a career in any licensed profession can submit their criminal record for review prior to spending their time and money on pursuing education. Every state should do the same.

There should be a national exam for instructors to prove they are competent in teaching methodology and a subject matter expert in whatever area they intend to teach.

Each state should require a jurisprudence exam. Your licensees can’t adhere to the law unless they know what it is, and the percentage of applicants who actually read your practice act in its entirety is probably less than 5%–I’m basing that on asking that question in all the classes I teach. Hardly anyone reads them, but if they had to pass a test on it, they would.

The Massage Therapy Body of Knowledge would be about massage.If you want to have an energy work body of knowledge, create that.

Everyone involved in the profession would give financial support to the Massage Therapy Foundation. Give $100. Give $5. Give $1. Give whatever you can afford to give, just do it.

 

I could probably go on for days, but I have other chores to get to today. I invite my readers to add what they will. What’s on YOUR wishlist? What’s on mine that you object to, and why?

 

 

If at first you don’t succeed….

Try, try again. That’s what the regulatory board in my home state of North Carolina is recommending when it comes to getting the Federation of State Massage Therapy Boards to do something about the confusing status of continuing education approvals.

Two years ago, the NC Board of Massage & Bodywork Therapy introduced a resolution at the Annual Meeting of the FSMTB (which was held in Puerto Rico). This document instructed the Federation’s Board of Directors to “begin the process of developing a new national approval program for continuing education providers and courses.” The organization’s leadership responded positively to the resolution, and announced to the profession in the Spring of 2011 the launch of a comprehensive project to do just that. They also invited AFMTE, AMTA and ABMP to work with them to provide input that would help shape the project.

In spite of this clearly stated intention to develop a “centralized quality assurance process for all courses taken by massage and bodywork therapists for the renewal of State licensure or State certification” (quoted verbatim from the FSMTB press release dated 3/29/11), the outcome of this process missed the mark by a country mile. The MOCC Proposal, which stands for Maintenance of Core Competencies, failed to deliver what the state boards asked for, and what FSMTB promised.

To remind you, the MOCC Proposal was based on a new (and unproven) concept of separating continuing education that relates to “public protection” from all other CE that is taken for “professional development”. MOCC recommended that only CE related to “public protection” be required by state boards for renewal of licensure, and everything else be put into the voluntary category, to be regulated by… well, the proposal didn’t even mention NCBTMB. If this all weren’t bad enough, FSMTB would become the exclusive provider of coursework needed to maintain “core competency” in the subjects related to “public protection”.

For more background on the MOCC issue, refer to my blog posts of 3/14/12 and 4/15/12. It’s also illuminating to read the press release AMTA issued on 4/23/12 which contained a complete repudiation of the Federation’s proposal.

In a friendly game of golf, you can take a “mulligan” every now and again–a “do-over”. My colleagues at the NC Board are giving the FSMTB leadership an opportunity to take a mulligan on this vitally important CE approval issue. They have recently submitted another resolution to be discussed by Member Boards at the upcoming FSMTB Annual Meeting in New Orleans on September 27-29. This resolution is much like the original from two years ago, and its appearance at this point in time indicates that the need for a single-source national CE approval program has not gone away.

The primary rationale is contained in this statement from the new resolution:
“Reliance upon the NCB Approved Provider program has been problematic for state boards because (a) NCB is a private, non-profit corporation that lacks oversight from and accountability to state regulatory boards; (b) its program has not adequately evaluated the quality or relevance of CE courses; (c) administration of this program has had notable service delivery problems over an extended period of time.”

That’s all true, but the opera ain’t over ’til the fat lady sings. The NCBTMB has the infrastructure already in place–and this will be nothing more than another case of duplicated efforts if the Federation steps in and tries to take it away without consideration of the NCB’s position in that marketplace. I think a collaboration would be more appropriate; by contracting with the NCB to administer CE approvals, FSMTB could establish the accountability structure that state boards must have with NCB, and FSMTB wouldn’t have to reinvent the wheel. They could just improve upon it.

Yesterday, I conducted one of my Scientific Facebook Polls, and asked the questions: How many MTs REALLY care what is happening with our professional organizations and what they are doing? How many people care about the MTBOK, the ELAP, the MOCC (don’t y’all love all these acronyms) or even know what they really are? How many people care about the legislation and regulation of massage? How many people care that there are initiatives to raise standards for teachers of massage therapy and for massage education in general? Do you care about all those things, or would you rather just be left alone to do massage?

I got 75 replies in a 24-hour period, and one thing is apparent: to the average massage therapist trying to make a living, many perceive our organizations to be all about politics and all about money. To some extent, that’s true…the one with the most money wins. The perception is also that they all have their own agendas. Actually, recently some of them seem to have the same agenda, but they’ve wasted time and money in duplicating efforts, or opposing each other’s efforts, and scrapping over turf wars. In a recent blog I urged the NCBTMB to take themselves out of the entry-level exam market and suggested that the FSMTB assists them financially in return for their doing so. Earlier this week, in a piece published in Massage Today, Ralph Stephens called on AMTA and ABMP to offer “substantial and ongoing financial support” to COMTA and AFMTE, to further their important efforts to improve the quality of massage therapy education.

FSMTB and the NCB have recently conducted new Job Task Analysis surveys, both of them seriously flawed, in my humble opinion. These surveys show a strong bias towards the clinical/medical side of massage therapy, and contain virtually nothing about the KSA’s related to delivering massage therapy as a primary means of facilitating well-being and integration. From my perspective, the latter is of equal or greater importance.

In addition, the FSMTB survey has a special add-on section to gather data for the Entry-Level Analysis Project (ELAP). This dual-purpose survey does ask lots of questions about specific medical conditions, but it contains nothing about the client/therapist relationship. The word “relax” does not appear anywhere, and the word “relaxation” shows up just once.

There’s also an over-focus on the huge number of modalities that are marketed in this field. Many of these listed are obscure and little-understood. It’s wrong to ask a therapist to define themselves by a single named modality. Practitioners typically use a broad range of methods with clients. The modality is not the treatment — it’s the totality of what a practitioner brings to the session.

Finally, this Federation JTA is similar to the recent JTA from NCBTMB: another duplicated effort that still falls short of giving an accurate picture of what happens in the real world of massage therapy. You can count how many times a week we give a massage or take SOAP notes, but that’s not what it’s really about. It’s about our rapport with the client, and what kind of results we are able to produce, and what kind of trust we can inspire in our therapeutic relationships. The MTBOK generally missed the boat on this as well, although I have high hopes that the line-by-line analysis and re-mapping of the MTBOK that was conducted by AFMTE will give us a usable body of knowledge.

As a result of these large-scale projects, it’s likely that the kind of incomplete and disjointed training that is typical in our field will get further enshrined as the baseline for education. Skewed survey questions produce skewed data. Using that data to build a new standard for the entire field is not just wrong, it’s a crime against the lineage of massage therapy. Just look at what has happened to the other health care professions who have organized themselves around the mechanistic/reductionistic model. People are treated as parts, and no discipline ever looks at the whole person. Massage therapists still have the ability to treat holistically. Relaxation is being relegated to a lower-class status of therapeutic effect, when it’s one of the most valuable aspects we offer with this work.

This whole scenario illustrates one thing: the time has never been more ripe for getting our act together, and that isn’t going to happen while there’s all this push and pull and one-upmanship going on with the organizations. When the leaders of the seven primary stakeholder groups sat down at the table for the first time last September, the ELAP proposal appeared out of nowhere–it wasn’t even on the agenda and it got slid in anyway. I would like to see them sit down again, and take a serious look at these issues. Put ego and profit aside. Take a real look at the flaws in your information-gathering processes. If you want to see what massage therapists really think, sign on to my Facebook page and you might get a rude awakening at their opinions of you. You wouldn’t exist without us, and what we think does matter. A Job Task Analysis survey asks what we do--and frankly, it isn’t near as important as what we think. Consider that.

 

The Snake Oil Medicine Show

There’s nothing earth-shaking in the world of massage politics on my radar this week, so I’m just going to make a few observations. I know that I am about to step on more than a few toes here, but it must be said.

I’ve got a few thousand massage therapists in my social networks (FB, LinkedIn, Twitter, Google +). In the mornings, when I’m drinking my coffee, I visit those sites and scroll through to see what people are up to. I like to read that people are having success with their clients, enjoying their work, being active in their communities, growing their businesses, volunteering, and a lot of wonderful things that massage therapists do.

What I don’t like to see is what I call the Snake Oil Medicine Show. There’s a popular band here in NC by that name, so I’m stealing it for this blog. According to Wikipedia: The phrase snake oil is a derogatory term used to describe quackery, the promotion of fraudulent or unproven medical practices. The expression is also applied metaphorically to any product with questionable and/or unverifiable quality or benefit. By extension, the term “snake oil salesman” may be applied to someone who sells fraudulent goods, or who is a fraud himself.

There are a lot of products (and practices) out there that have no proven benefits at all, and many that have in fact been proven not to have any benefits. Massage therapists seem to be particularly gullible to falling into the trap of not only using them personally, but also promoting them and selling them to their clients. I don’t know the real reason behind this phenomenon, but I can guess at several: 1) The therapist is not interested in scientific evidence and buys into the hype on the product’s website. 2) The therapist is desperately looking for something to bring in additional income. 3) The therapist has a genuine desire to help people, and truly believes the wild claims made by whatever company is selling the product, and thinks that it’s a duty to share it with clients.

If you’ve been following me for any length of time, you know that I am interested in the evidence-informed practice of massage, and that I’ve been on a mission to bust the myths of massage. This problem goes beyond that; and if I tried to bust every unscrupulous product out there, I’d never have the time to write about anything else. There are a lot of “quackery” websites on the Internet that have done most of the work for me….if only people would read and believe. But the fact is, you can hit some people over the head with scientific evidence, and they’re not going to believe it.  They’re too attached to that “detox” machine, or that dietary supplement, or that special water or whatever it is that they’re selling. Paul Ingraham, one of my favorite writers on the Internet, has written about a lot of these things (see www.saveyourself.ca) Dr. Stephen Barrett has had his Quackwatch site up for years (www.quackwatch.org). Another favorite of mine is a water myth website, found at www.chem1.com/CQ/

I’m not a scientist, or a very technical-minded person. Fortunately, I have some friends and acquaintances who are. I have often asked them “Can you explain to me how ____ works?” The usual answer to this question is “It doesn’t.”

As I said at the beginning, I’m about to step on some toes here, but then again, I do that on a regular basis, so what the heck. Here are the facts on detox foot baths, and may I say, yes, I have in fact used one myself in years gone by:

There is no way an electric current passing through a part of your body can distinguish between “good” molecules and “bad” molecules (“toxins”), most of which are electrically neutral anyway.

The skin is impermeable to all but a few chemical substances; there is no evidence that any that are found inside the body can pass through the skin to the outside, with or without the help of an electric current.

All but a very few of the “toxins” produced as metabolic products are colorless— suggesting that what you see during these “treatments” is put there for show.

You can in fact put a zucchini, or nothing at all, in the foot bath, and the water will still turn color. I have personally witnessed this happening. Then we’ve got the “alkaline water” products, including a well-known MLM company that sells filters for about $4000 bucks. That’s a European vacation, folks. Not only that, but the actual components of that water filter can be purchased at any home improvement or hardware store for about $35. Here are the straight facts on that, and YES, THIS IS WRITTEN BY A CHEMIST:

“Ionized water” is nothing more than sales fiction; the term is meaningless to chemists.

Pure water (that is, water containing no dissolved ions) is too unconductive to undergo signficant electrolysis by “water ionizer” devices.
Pure water can never be alkaline or acidic, nor can it be made so by electrolysis. Alkaline water must contain metallic ions of some kind — most commonly, sodium, calcium or magnesium.

The idea that one must consume alkaline water to neutralize the effects of acidic foods is ridiculous; we get rid of excess acid by exhaling carbon dioxide.

If you do drink alkaline water, its alkalinity is quickly removed by the highly acidic gastric fluid in the stomach.

Uptake of water occurs mainly in the intestine, not in the stomach. But when stomach contents enter the intestine, they are neutralized and made alkaline by the pancreatic secretions — so all the water you drink eventually becomes alkaline anyway.

The claims about the health benefits of drinking alkaline water are not supported by credible scientific evidence.

“Ionized”/alkaline water is falsely claimed to be an anti-oxidant. It is actually an oxidizing agent, as can be seen by its ability to decolorize iodine (see video).

There is nothing wrong with drinking slightly acidic waters such as rainwater. “Body pH” is a meaningless concept; different parts of the body (and even of individual cells) can have widely different pH values. The pH of drinking water has zero effect on that of the blood or of the body’s cells.

If you really want to de-acidify your stomach (at the possible cost of interfering with protein digestion), why spend hundreds of dollars for an electrolysis device when you can take calcium-magnesium pills, Alka-Seltzer or Milk of Magnesia?

Electrolysis devices are generally worthless for treating water for health enhancement, removal of common impurities, disinfection, and scale control. Claims that “ionized” waters are antioxidants are untrue; hypochlorites (present in most such waters) are in fact oxidizing agents.

Claims that “water ionizers are approved for use in Japanese hospitals” are misleading: these “approvals” merely attest to the machines’ safety — that they will not electrocute you! My understanding is that the Japanese Health Ministry is highly critical of therapeutic claims made for alkaline water.

And yes, I have also drank alkaline water…several clients and a part-time staff member insisted on my trying it, and I did, but I can’t say it did anything for me that regular water wouldn’t have done.

What about the Chi machine? Actually, I used to house sit for a friend who had a Chi machine, and I would lie down in the floor and use it every time I was at her house. I personally found it very relaxing, and it felt good. In fact I would usually zone out and have a little nap while the machine was running. However, the big claim made about it is that it “maximizes the body’s natural absorption of oxygen.” Really? It’s shaking your ankles back and forth. How is that doing anything to maximize the absorption of oxygen? Can’t I just lie down and shake my own ankles and do the same thing without spending that $399? The websites touting the Chi machine go on about how cancer can’t survive when you’re fully oxygenated, disease can’t get you, parasites will disappear, and all illness will leave your body if you just have enough oxygen. The way I see it, I’m breathing, so I must have enough oxygen. How much more do I need? Am I going to breathe MORE if I shake my ankles every day? I don’t think so.

Shall I go on? There are so many dubious products out there, I could stop writing about the politics of massage altogether and have enough fodder to go on for years, but I’m going to stop here, for now. I’m sure those of you who sell the heck out of these machines will write in and tell me what a moron I am. Maybe ONE of you will perform a thorough scientific examination of the facts and decide that you’ve been hoodwinked into spending a few hundred, or a few thousand, dollars on something that doesn’t work, and you’ll quit trying to sell it to your clients. That would be nice.

References:

Foot bath

Alkaline Water

Chi machine

 

Come to COMTA

I just got home from doing a site review from COMTA. It was my third trip as a peer reviewer, and once again, an enlightening experience. COMTA is the Commission on Massage Therapy Accreditation. Gaining accreditation is a strictly voluntary process. It’s estimated that there are about 1500 massage schools/programs in the US, and less than 100 of them possess the accreditation. Obtaining COMTA accreditation for a massage school is not cheap, and it’s a lot of hard work, so you might wonder why a school would do it. After getting acquainted with all the ins and outs of it, the answer, to me, is that it’s a  hallmark of excellence. It’s a way to say “We’re going beyond what the state requires to prove that we have a superior school.”

Part of the accreditation process is a very thorough self-study report. Schools must review their policies, their procedures, the way they conduct business, the education they provide. If it’s not documented, it doesn’t exist. As a peer reviewer, my job is to study their documentation before getting to the site, and then doing an actual visit to the school. Every syllabus, every lesson plan, every piece of documentation related to their educational process and their business proceedings is reviewed. The curriculum needs to fall in line with the mission statement. The education offered must match the learning objectives that are stated. When the reviewers show up for the site visit, we basically review every piece of documentation they claim to have, to make sure it actually exists and to make sure it does what it claims to be doing.

The accreditation doesn’t just earn a nice label for the school. It provides a measure of protection to the student, as well. It assures that the school has definite policies on qualifications for insuring the competency of instructors, absenteeism, grading, following a carefully thought-out lesson plan, and much more. It assures that financial aid is being administered correctly and that student finances are carefully documented. It assures that their are policies on sexual harassment, and that instructors have to continually improve themselves with technical training and continuing education.

A COMTA school can’t rest on their laurels. It’s an ongoing process of maintaining the standards, and regular review. A school that is poorly managed isn’t going to cut the mustard. It’s safe to say there aren’t any diploma mills or haphazardly run schools among the ranks.

COMTA standards are on the organization’s website. Anyone can access them. I challenge every single school owner in the country to review them one at a time, and see how your school stacks up. Take the leap and apply for accreditation. When we review your documentation and show up for a site visit, we’re not there to thump you on the head for any shortcomings; we’re there to help you come into compliance with the highest standards in the massage profession.

COMTA is also always seeking competent peer reviewers. The training to be a reviewer is also available on the website. Visit www.comta.org, and come to COMTA.

 

A Betrayal of Trust

Any time one of the major organizations in the massage field tries to fire up a project that will “advance the profession”, I get awfully suspicious. When a group of them get together to do something on the big scale, I go on full nuclear alert. That’s the case right now with a dubious education standards project introduced by ABMP in September 2011 at the Leadership Summit in St. Louis, which I detailed in my previous post, Behind Closed Doors.

As the title of that blog suggests, 100% of the activity surrounding this project has taken place in secret, with no information about the project being released to the massage therapy community—and no opportunities for review or comment before time, money and human resources are thrown at solving a perceived problem.

AMTA and FSMTB have signed on to this project, which will involve gathering information from the Federation’s upcoming Job Task Analysis survey, to use in a process that will “identify the rudimentary knowledge, skills, and attitudes required to pass a licensing exam and provide basic, but safe, massage in an early massage career.”

That doesn’t sound like a such bad thing—in and of itself—but the group intends to use this data to create an “evidence-based minimum educational requirement” for state licensing. This would be used as a rationale for changing state laws, and would likely be used to drive the curriculum standards for entry-level massage programs—basically telling schools what to do.

Goodness knows, there is a lot of inconsistency in massage education and regulation, but there is no problem in our profession that justifies one or a group of our so-called “stakeholder organizations” seizing the ball and marching down the field without our input or permission. I don’t give a rat’s you-know-what if they claim to be doing this in our best interests; this power play is a gigantic betrayal of trust. And I might add that I am personally in favor of the evidence-based practice of massage, but I don’t think one tiny group of people should get to decide what that is.

I’ve not yet been able to confirm the status of NCBTMB, Massage Therapy Foundation, AFMTE or COMTA as it relates to this project (mum’s the word all around). These four organizations, along with ABMP, AMTA and FSMTB just gathered on May 1-2 for another Leadership Summit—this time in Chicago. I’m taking bets that they will issue another sanitized press release that gives us regular folks in the bleachers little substance about what really happened in this meeting that has the potential to alter the very nature of our profession.

The only other info I’ve been able to glean is that ABMP, AMTA and FSMTB hand-picked a new workgroup of massage educators and other “experts” in instructional design and curriculum development to start this project on May 3-4, right after the completion of the Summit. Are you kidding me? Where was the public notice of this opportunity to serve on a panel that will influence the future of massage therapy? Who gave these organizations the authority to do this on our behalf?

No one. They took it on themselves, and that’s what stinks to high heaven.

In stark contrast, the Massage Therapy Body of Knowledge project had both fans and detractors, but it was carried out with a reasonable amount of transparency. The majority of the dissent on the project concerned the inclusion of energy work in the document and dissatisfaction with the way objections were handled—or not handled—in favor of evidence-based practices. The five organizations that comprised the MTBOK Stewards (ABMP, AMTA, FSMTB, MTF, NCBTMB) did a good job of not interfering with the project once it was launched.

Right now, we have a genuine crisis on our hands. The problem is that hardly anyone knows about it. This blog only goes so far. I never set myself up to be the New York Times of the massage field, but it seems like the major massage publications are afraid to get their teeth into the real breaking news that affects the practitioners, teachers, CE providers and schools that make this profession possible.

Friends, it’s up to YOU to let these organizations know that it’s not OK for them to act in your interest without your permission. As long as these “leaders” think they can get away with it, they will. Trust has been blown out of the water, and it will take a concerted effort to rebuild it.

A really good first step would be for ABMP, AMTA and FSMTB to release a full description of the project, including what they plan to do, how it will be done, who sits on the new workgroup, what the timelines are, and what money will be spent. And most importantly, we want to know what they intend to do with the “evidence”. When organizations that represent us are making major decisions that affect us, we deserve to be involved in the process.

Behind Closed Doors

From the title, you might think this blog is about The Client List, the trashy new show on the Lifetime Channel that gives massage therapy a black eye. No such luck; the event I am referring to is the upcoming Leadership Summit #2, set to take place next week in Chicago.

The first Leadership Summit (to clarify: there were summits in 2003-04 before AFMTE and FSMTB existed) took place last September in St. Louis, with the executive directors and chairs of ABMP, AFMTE, AMTA, the Massage Therapy Foundation, FSMTB, COMTA, and NCBTMB in attendance. It was a historic event in that it was the first time all seven of these organizations had come together in the best interests of the profession. The purpose, according to the press release announcing the meeting, “was to hold a beginning conversation about major structural issues and impediments to profession progress. The desire is to have candid exchange about core challenges, quality concerns, consumer expectations and organizational roles.”

Apparently, one of the hot topics at this week’s meeting is going to be the number of required entry-level education hours. Although this was not on the agreed-upon agenda at the first meeting, it was introduced anyway by ABMP Chairman Bob Benson, complete with a thorough proposal prepared by Anne Williams, Director of Education at ABMP. Basically, the proposal was for a task force to be formed immediately, and using Job Task Analyses that have been conducted by the NCBTMB and the FSMTB, to nail down a definite number of hours that should be required for entry-level education. This was contrary to the facilitator’s recommendation—and the group’s agreement— that they would spend the initial meeting identifying problems, and would address possible solutions for these problems at meetings to follow.

In the interest of the leaders being comfortable in speaking freely, these are closed meetings—no press and no other staff members in attendance—an executive session, so to speak. Certainly not without precedent; boards have executive sessions all the time—usually to discuss personnel matters or other things that would violate someone’s privacy if they were discussed in public.

That’s not exactly the case here; and while I am thrilled that our leaders—some of whom are from competing organizations—are sitting down at the table together, my concern is that a small group of people has the power to decide (or worse, just think they have the power to decide), what is best for the profession on the whole, without getting input from the people it affects—you and me. Practitioners, school owners, teachers, CE providers, the regulatory community, all have a vested interest in the future of our profession, and I don’t think that should be decided by an exclusive group behind closed doors.

Unfortunately, that is just what the ABMP proposal states in no uncertain terms. Verbatim, Williams’ proposal stated: There is no step in this proposal to obtain input from the broader massage profession or from other health-care or bodywork organizations during this project. The reason is simple—the work group is simply performing a work task in writing learning outcomes and objectives for job tasks defined by surveys already conducted by FSMTB and NCBTMB. It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught. The work group would be responding to what therapists report they do, on a day-to-day basis, in their massage-related environments as part of their jobs.

The sentence that disturbs me there is “It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught.” Any time you start to think it doesn’t matter what stakeholders think, there’s a problem, in my humble opinion, no matter what the issue. Stakeholders are the ones it will affect, and to think their opinion isn’t important is just beyond the pale.

At the recent ABMP School Issues Forum in Austin, Texas, Bob Benson stated to those in attendance that there was 100% consensus in support of this standards-setting proposal from the organizations that attended the Leadership Summit. That’s not exactly so. COMTA, FSMTB, and AFMTE all expressed concerns after the proposal was introduced in September; they are not petty concerns, and they do not appear in any way to be based on politics or turf wars.
This is bad business for two primary reasons: First, any project that has the potential to affect the entire massage therapy profession should not be designed, approved, and launched in secret. Changing the baseline numbers of entry-level education required for state licensure is a huge thing, as it will affect schools, regulators, and future students.

By contrast, the MTBOK project modeled appropriate transparency, and the massage community had adequate opportunities for input along the way.

Second, it is more important right now that our primary stakeholder organizations learn to work together in an atmosphere of trust and cooperation—than to plunge headlong into a major problem-solving project when consensus has NOT been reached. The end does not justify the means. Some of my own issues are that the MTBOK and the competency-based curriculum standards set forth by COMTA aren’t even being given consideration. This proposal also overlooks the fact that the AFMTE is currently working on a National Teacher Standards Education Project. A huge amount of work has gone into creating both the MTBOK and the COMTA standards; a huge amount of work from some of the best educators in the business is going into the AFMTE project, and for these to be cast aside when they have direct relevance to this proposal is irresponsible to say the least.

During our troublesome economy of the past few years—and it doesn’t appear to be over yet—school owners have been seriously affected already, and having a nation-wide upheaval based on an “official” number of required hours is not the be-all end-all solution to licensing portability. It will just serve to put an additional burden into the mix at the present time. The lack of portability may be an irritant to our field, but it is not causing harm to the public.

The AMTA Board of Directors voted last October to support the project in its present form. As ABMP and AMTA are the two largest professional membership associations, they carry a big stick. That doesn’t mean their agendas should be force-fed to the profession, and I hope that they will reconsider both the timeline, and the very valid concerns raised by the other organizations before barging ahead with this project. I am certainly not saying that it never needs to happen. I am just saying it doesn’t need to happen on speed-dial until all of these issues have been ironed out. I hate to see good intentions canceled out by unchecked enthusiasm for rushing something to market; I hate to see valid concerns from the other organizations swept under the carpet; and I hate to see the opinion that what the stakeholders think doesn’t matter.

When you’re meeting behind closed doors, it’s easy to forget who the stakeholders are. I’m one of them. I’m a member of both AMTA and ABMP, a founding member of the AFMTE, a past delegate to the FSMTB, a Nationally Certified Massage Therapist & Bodyworker, an Approved Provider under the NCBTMB, and a current site reviewer for COMTA, so I do indeed have a vested interest. I don’t appreciate our national organizations acting as if my opinion and that of the other thousands of massage therapists, school owners, and others who enable your very existence on this planet don’t matter.

At this week’s Summit, the representatives of these seven organizations have an opportunity to address this issue that has divided the group, and to get their process back on track. I hope that they also remember the responsibility that they have to their own members, and to the profession as a whole. To use ABMP’s own slogan here, we “Expect More” from our leaders.

Here’s the Plan

On any given day on my FB page, there will be massage therapists who are excitedly reporting an increase in their practice, talking about the big day or big week they just had, or some other joyful news related to their business. On any given day, there will also be someone posting that they’re closing up shop because they can’t make it, and taking a job they don’t really want because they have to have money to survive. And let’s be real, folks…none of us want to just survive. We want to thrive, don’t we? Be able to take a vacation, give money to charity, buy a new car when we need one without having a financial meltdown. All those things are hard to do when you’re worried about making the rent.

Nine times out of ten, it isn’t that they’re not a talented massage therapist that leads to their failure. Most of the time, it is a lack of careful planning that leads to the demise. Here’s a reality check:

Almost no business is profitable during the first year. Those folks who work from their home or who only do outcalls may be exceptions, but if you’re operating a massage business out of your own storefront, planning to do so, or  or even as a renter or independent contractor in someone else’s space, there are a lot of things to consider.

I’m going to get the independent contractors out of the way first. You are a self-employed person who performs your services in someone else’s space. You don’t have all the same overhead that a person in their own space does, but you still have certain expenses, and you’re working in someone else’s environment. They may–or may not–be throwing you a lot of business.  If you don’t have all you need or want, and it’s because you’re just sitting there waiting for the owner to do it all for you, you’re missing the boat. You still need to market yourself. That doesn’t mean taking out a big ad in the paper. It means you are actively engaged in trying to increase your client base on a daily basis, by networking, giving out business cards, getting yourself out there by performing community service, introducing yourself to people and telling them about the benefits of massage. Instead of blaming the owner for your lack of business, look at what you could be doing to increase it.

For those who are opening their own business, starting out without a business plan and a budget is a serious mistake. My advice is don’t take the plunge into opening your own business until you know you can survive for a year without a profit. When you initially open your business, you’re going to have a lot of one-time expenses–equipment, office furnishings, security deposits for rent and utilities. If you’re signing a lease, you’re committing yourself to paying rent (or a mortgage payment, if you’re buying.) You need to know what your monthly expenses are before you open the door.You need to include laundry, phone, Internet access, office and cleaning supplies, liability insurance, bank service charges and credit card processing charges, self-employment taxes–and that’s before you’ve spent any money on advertising.

I know that in my office, 52 massages have to take place before I’ve covered the monthly overhead. That’s my break-even point, and you need to figure out what yours is. But you can’t stop there–especially if you’re a single person or if your family is dependent upon a two-income lifestyle.  You also need to figure your break-even point for supporting your household.

Let’s say for argument’s sake your office expenses are 1500. a month. Imagine that at home, you need $500 for rent, $100 for  utilities, $100 for the phone, $200 for a student loan payment, $300 for credit card payments, $300 for groceries…then you’ve got clothing, medical care, insurance if you’re paying for that.  If you’ve got children, I don’t have to tell you how much that costs. So if you need $1500 to run the office, and $2000 to run your household, you need $3500 a month to cover your expenses. If you’re charging $60  for a massage, that means you have to perform 58 massages in a month just to make ends meet. That means you aren’t making a dime of extra money that you could spend on the previously mentioned vacation, charity, and any other extras you might like to have, until you’ve done 58 massages.  And if you’re self-employed and also having to take care of the cleaning, the laundry, the bookkeeping, and all the other things that go with that, be realistic about how much you can do.

You must also have a contingency plan…what if you don’t get those 58 massages during the first month, or the first few months? What if it snows and you miss a week at work, or you get sick and miss a week at work? What if your car needs an expensive repair, like mine did last week? Can you still meet your obligations?

In any business, and in service businesses in particular, the biggest mistake people make is sitting around waiting for business to come to them. Unless you own a funeral home, that’s a bad idea. Word of mouth is of course the cheapest and best form of advertising, but you have to get those people in the door first. And the chances are you don’t have a big advertising budget, so what are you going to do? These are just a few of the things I’ve done to increase my own business, and it has worked well for me.

I spend 30 minutes every morning on marketing activities intended to increase my business. That could mean working up a new ad, writing the client newsletter, calling clients I haven’t seen in here lately, sending out a welcome postcard to a new one, or any number of things, as long as it is something that will help spread the word about my business.

I am very active in our Chamber of Commerce (in fact, at this point in time, I am on their Board of Directors, but that’s a very recent development.) I’ve been active in it since the first week I opened my business. I attend as many networking functions, grand openings of other people’s businesses, open houses, etc. Why pay to belong to the Chamber if you’re not going to take advantage of all they have to offer? If you’re joining just to get a certificate on the wall that says you belong, then save your money.

I give a business card to two new people every day. You’re out somewhere every day where you have the opportunity to meet new people, or where you see someone you may already know–at school, church, the grocery store, the doctor’s office. Strike up a conversation with someone and give them a card. It takes three minutes.

Track your clients. Create a simple form on your computer listing the places you are advertising, plus referrals from doctors and clients, and ask each client, “Where did you hear about us?”  Write that down. If  a month or two has gone by and not one person says they’ve come in because of the ads you’ve been running in the Woman’s Weekly, it’s time to spend that money elsewhere.

Before you spend money on an ad, think about the potential return on investment. If you spend 100. to advertise in a regional magazine that goes to 5000 people, when you could spend that same 100. to place an ad in the local newspaper that reaches 50,000 people, it doesn’t take a rocket scientist to figure out which one you ought to do.

These days, people expect every business to have a website. If you’re using some obscure url for a free site, they’re not going to find you. Spend the money to have a real website, one that is search-engine optimized and user-friendly.

You don’t have to be a financial whiz, or even a marketing whiz, to succeed in a massage practice, but you do need to take a realistic look at what you need to do in order to have a profitable bottom line. So before you start out, take a good hard luck at your budget and your personal financial situation…and don’t depend on opening a business to get you out of some financial mess you might already be in. And once you hang out your shingle, don’t sit on your hands waiting for business. Go out and get it. You can see more of my business tips, along with tips from Irene Diamond, Allissa Haines, Michael Reynolds, Felicia Brown, the Massage Nerd, and many more great educators on the Massage Learning Network.