Texas Hold ‘Em

Texas has a few pieces of massage legislation in the offing. And while I don’t think most of it is as detrimental to the profession on the whole as the recent amendments to Utah’s regulations, I can’t say I’m crazy about it. I have a fundamental problem with regulations that are not clearly defined, and this seems to be one of those cases. Their language just plain ticks me off, as well.

HB 722 starts out with “relating to the regulation of massage therapists, massage schools, massage establishments, and sexually oriented businesses, providing penalties.” Do we see any legislation that starts out “relating to the regulation of bowling alleys, physician’s offices, funeral homes” etc that has to include “sexually oriented businesses?” No, we do not. Texas is far from the only state who refers to us in this manner.

As we read further, we come to an amended section (there are several amended parts) stating that it shall be against the law to provide or offer to provide massage “while nude or in clothing designed to arouse or gratify the sexual desire of an individual.”

Now here is where the language is offensive, to me. Of course, I am glad to know it’s against the law to massage in the nude. However, I think the second half of that sentence is extremely ambiguous, and is going to be open to the interpretation of whichever board members or judge in a civil or criminal court hears the first test case. While it’s obvious that lingerie from Victoria’s Secret might fit the bill, what about a v-neck top or a tank top? What about a pair of tight jeans, leggings, or yoga pants? A form-hugging sweater if you have large breasts? What about a pair of shorts, who is going to say how many inches from the knee they can be before they look “sexually arousing?”  There are some people who could manage to look sexy in a flour sack, and others who couldn’t look sexy no matter what they are wearing. In my opinion, that is a bad piece of legislation because it isn’t clearly defined. Furthermore, a couple of lines later it goes on to say that while you are in a massage establishment you may not “possess” clothing designed to arouse or gratify the sexual desire of an individual.  If you have a date after work, you’d better not hang your little black dress in the office so you can change, lest you be accused of something.

This bill also includes reflexology as a method of massage subject to their practice act. HB 722 is sponsored by Rep. Garza, (512) 463-0269,  or e-mail him here.

HB 556 seeks to exclude Muscle Activation Techniques from being covered under massage licensing. Muscle activation techniques include the detection and correction of muscle imbalances through the use of palpation and isometric exercises. HB 556 is sponsored by Rep. Howard, (512) 463-0631 or e-mail her here.

HB 1716 will exclude from licensure a lot of techniques that are commonly used by massage therapists–mostly energy work techniques including Healing Touch, polarity, craniosacral, body/mind techniques, Ayurveda, and a host of others. Strangely, the bill also includes the admonition to the public that people performing these techniques are not licensed and that they are free to seek a diagnosis from a licensed physician, chiropractor, dentist, nurse, etc and actually includes massage therapists and personal trainers in that group. Really? Diagnosing is out of our scope of practice as massage therapists and while I am usually concerned about our rights being taken away, I really don’t think it’s a good thing to say we can give a diagnosis just because we have a massage license. What’s to prevent some newbie fresh out of school from diagnosing someone?  It doesn’t matter if you’ve been practicing 25 years, you still shouldn’t be diagnosing people. We aren’t trained for that.

HB 1716 is sponsored by Rep. Harless, (512) 463-0496or e-mail her here.

I urge you to contact theses legislators to say Texas, hold ’em. None of these bills look like a good thing for massage therapists.

If You’re Not Moving Forward, You’re Backing Up

There have been several developments in the regulation of massage in the past few weeks that I personally find distressing. Earlier this week, Florida Senate Bill 584 moved a step closer to passage. This piece of special-interest legislation would amend Florida’s massage therapy law to allow graduates of certain board-approved schools to obtain a temporary permit and practice for six months without a license, until such time as they fail the exam or become licensed, whichever comes first. Although the bill states that they must work under the supervision of a licensed therapist, the terms of that are not spelled out. Does that mean the supervising therapist is on the premises, in the treatment room, or giving an occasional phone call? This is where boards frequently get into trouble and spend a lot of time with something bogged down in a policy committee—when something has not been clearly defined—and in this case, “supervision” isn’t clearly defined.

New Hampshire is trying to abolish massage licensing altogether, as a cost-cutting, government-reducing move. That would of course mean back to square one, where anyone who knows absolutely nothing about contraindications for massage, endangerment sites, or professional ethics can feel free to call themselves a massage therapist.

Utah just amended their practice act to remove the key word “therapeutic” from the scope of practice definition and added in the word “recreational”, in what is in my opinion a misguided attempt to thwart sexual activity being conducted in the name of massage. Other than the fact that I think House Bill 243 is a big step back for our profession, I was just as shocked that the government relations folks in the Utah chapter of AMTA supported it to start with. I’m an active member of the North Carolina chapter, and I cannot imagine the leadership of our chapter supporting that.

I was gratified a few days ago to see Les Sweeney, President of ABMP, and a few days later Bob Benson, the Chairman of ABMP, weigh in with the same attitude I have about this legislation. Rick Rosen, who is a former Chair of the North Carolina Board of Massage & Bodywork Therapy, former Executive Director for FSMTB, and currently the Executive Director of AFMTE, made a comment on Bob’s blog that I think nailed the important points of this issue:

The most critical component of the state law for any regulated profession is what’s known as its Scope of Practice definition. The list of prohibited acts in a law is important, but less so than the scope definition. If what you want to do in your massage therapy practice is not listed in the scope, you can’t legally do it.

The Utah action that removed the term “therapeutic” from the scope definition, and added the term “recreational massage” may have the effect of narrowing the scope of practice for massage therapists. At the very least, it takes massage therapy out of the realm of health care and into the murky world of “other business activities”, which includes adult entertainment.

Considerations around enforcement of a Practice Act should not take precedence over the scope itself, and it is not a sound justification for downgrading the law. That’s what has occurred in Utah, and the Licensed Massage Therapists of that state will have to deal with it.

Every single word in statues and rules that regulate the practice of massage therapy is important. What you think it says is not always what it means — or what it will produce in the daily administration of a regulatory program. That’s why we need experienced and competent government relations professionals representing our interests.

I report on the legislation of massage, and I have future aspirations of working in government relations. I’ve spent a lot of time in the past few years doing research on boards and practice acts, and while I’m certainly not as experienced or learned as Rosen, I think I’m at the point of recognizing a piece of bad legislation when I see it. The way I see it, if you’re not moving forward, you’re backing up.

The Utah Brouhaha

A couple of the officers of the Utah Chapter of AMTA are upset with me for a video I put out yesterday about H.B. 243 that is in the works in their state. You may read the bill here.

This bill removes the term “therapeutic” from the description of massage. It also modifies the language in their Practice Act to include “recreational massage.” Is there anyone among us who would like to be known as a recreational massage therapist? Please weigh in on that. I am personally not acquainted with anyone who would like to be known that way.

I read the bill in its entirety, when it was brought to my attention, and then, AMTA member that I am, went to the Utah Chapter’s website to see what they were doing about this. I was shocked to see no mention of it anywhere, so during the course of the video I encouraged AMTA members to get in touch with their board members and mobilize them to take action on this, and I urged all Utah therapists to contact their legislators to protest what in my opinion is a detrimental change in their language. I posted it on the Utah Chapter’s FB page, as well as my own.

Imagine my disbelief when I received a communication from one of their officers on my youtube channel telling me that I should have contacted them before making my video and telling me to take it down asap. They are of course free to remove it from their own page. They are not free to tell me to remove it from mine. It has had over 700 hits in the last 24 hours and been shared by over 400 therapists. One therapist had made a positive comment about H.B. 243 on FB, the last time I checked. Too many others to count were all as distressed about it as I was.

I also received a lengthy and polite response from one of their officers, that stated  “There is no mention of this on the Utah Chapter website. This matter has purposely not been published on our website at AMTA Utah Chapter precisely for the purposes of NOT bringing attention to the fact that the Massage Therapy Practice Act was being “opened for changes” in this legislative session,” and ended with the request that I remove the video without comment, and to check with them in the future before I make any reference to Utah again.

Sorry, but that will not be happening. Perhaps you have heard of the First Amendment.

Perhaps you have also heard that all legislation is an open book–or it is supposed to be. It is the public’s right to know. If something is affecting massage therapists, it is the massage therapist’s right to know. And it is the mandate of any public board and any non-profit organization to operate in a transparent manner. Anything less than that is unacceptable. Nothing is, nor should it be private, about changes in a Practice Act.

The two AMTA representatives, one of whom emailed me and the other who left a comment on my youtube page,  obviously feel differently than I do about this, and that’s their right. We can agree to disagree. But as much as I am personally mortified by this bill, I am even more mortified that someone would think that massage therapists shouldn’t be informed of what is going on in their own state, given the opportunity to weigh in on it, and to openly hear their professional organization’s stance on it, until after the fact. That doesn’t work for me, and it shouldn’t work for you. I have preached this sermon many times about knowing what is going on in your state, and this is a prime example of that.

Any state’s Practice Act may be up for changes at any time.  And when a precedent is set in one state, it’s that much easier to get it passed in another. Practice acts are always “open” to changes, assuming any interested party can manage to get it on the legislative calendar. Here in NC, we had a detrimental change that our Board had no knowledge of  at all until it was a done deal. That’s not a good thing–and keeping secrets from the massage therapists who are affected by proposed changes in legislation is not a good thing, either. I refuse to apologize for spreading the word, or for expressing my opinion on it.

Pay in Massage Therapy: What’s for Real?

I just finished reading AMTA’s 2011 Massage Profession Research Report. It’s 66 pages of information that was created from several surveys conducted by AMTA and supplemented by government statistics.

The report covers many topics, including consumer demographics, information about massage schools and their students, where massage is fitting into the general scheme of health care in the US, and statistics on the practitioners themselves.

According to AMTA’s report, during 2010 the average massage therapist worked slightly less than 20 hours per week and made $41.00 per hour including gratuities. That was down from 2009, when the average therapist reportedly worked 20.4 hours per week and made 44.90.

In looking around for verification and figures to compare these to, I checked out the Massage Metrics by ABMP, and also referred to the AMA Health Care Careers Directory for 2009-2010 and the Bureau of Labor Statistics (BLS). The BLS has faulty statistics as far as I’m concerned, because they are based on a therapist working 40-hour weeks year round, which is usually not the case. Their formula shows the median pay to be $16.78 per hour. Many therapists only work part-time, sometimes keeping other jobs that provide them with needed benefits. The AMA publication cites therapists who do more like 15 hours of massage per week and make between $15,000-30,000.

I also conducted an informal survey recently of the 1200+ massage therapists who are on my Facebook page. I asked how much money self-employed therapists charge for massage, and asked for their location, and was not surprised to see how much variance there is from place to place. I got everything from $35 in rural areas to $120 in some of the bigger cities. However, you have to remember that’s the gross, and doesn’t take into account that the self-employed have overhead that can really cut into that. By the time one pays for space, advertising, telephone, utilities, laundry, and supplies, actual take-home income is probably half that, if not less.

As far as those who work for someone else, I personally know of a licensed massage therapist who makes less than $9.00 an hour working for a chiropractor. Another acquaintance who works in a ritzy day spa in Cape Cod during the summer makes as much as $2000 a week in take-home pay, but when she’s in North Carolina in the wintertime, has worked in day spas here for as little as $12 an hour plus tips. My own staff members are paid between $30-45 an hour depending on the work they do and how long they’ve been here, and I constantly hear from therapists who work elsewhere that I am the best-paying employer in our small town.

I believe all the above organizations did the best they could in compiling these reports. I also think they are all somewhat skewed (and in fairness, AMTA does quote a 3% + or – confidence level) by several things. No survey can possibly take in every massage therapist in the US. There are still unregulated states, and any therapist who isn’t a member of a professional organization or unrecognized by a licensing or certification board isn’t going to be included in any surveys. And people tend not to answer surveys; according to www.quora.com, a statistics site, a 3% return is about average on e-mail market studies. 10% is magnanimous. According to the laws of statistics, you can get an accurate sample from a little as a 1% response rate, but I think most of us have a hard time thinking that what happens with 1% applies to the rest of us.

When it comes to pay in massage therapy, what’s for real? It’s hard to say.