Licensing Portability: Not in My Lifetime

I get at least two or three questions a week from massage therapists who intend to move to another state–or horrors–have already moved and found out that they can’t practice massage in their new destination. It’s a sad state of affairs. That’s particularly so when the person has been practicing 20 years or so, but they either a) don’t have the proper amount of education, b) haven’t taken the exam required in that state or c) both of the above. As a former state board member who served on the license standards committee, I also spent a lot of time reviewing those applications for “licensing by endorsement,” a procedure that we had in place to address that issue. Sometimes people get licensed; sometimes they don’t.

We have kind of  a weird situation in North Carolina. Our state no longer accepts the National Certification exams for entry-level licensing. We exclusively accept the MBLEx, unless you’re moving in from out of state and you’re already Nationally Certified. In that case, you don’t have to take the MBLEx, but you do still have to prove that you’ve had the proper amount of education. It’s strange to me that the NCBTMB exams are considered okay for citizens from out of state, but not our own citizens.

There are still many states that have the minimum 500-hour education requirement. My state does. However, we’re picky about how that’s broken down. If your 500 hours from out of state doesn’t match up to the breakdown of our 500 hours, you can be refused a license until you bring yourself into compliance by taking additional classes at a community college or through continuing education. While moving is a choice for most people, I feel particularly bad for those therapists who are moving with a military spouse and not able to get licensed in their new state without jumping through a lot of hoops and going to a lot of expense.

The Federation of State Massage Therapy Boards is working towards portability, whatever that means. They would like for all member states to adopt the MBLEx exclusively, and some have. Other states continue to give applicants a choice, and a few states have their own exam. There isn’t any consistency in the number of hours of education that’s required, nor in the breakdown of those hours.

I reposted both of Ralph Stephens’ editorials on “Challenging Sacred Cows” on my Facebook page, where they attracted a lot of comments. Ralph and I have sometimes disagreed and agreed to disagree, but I do agree with some of the statements he made in these articles…namely, that the education hours required for licensing are arbitrary and not any guarantee of competence. The examination system isn’t without flaws; nothing is. The fact is that some people are good at memorizing facts, and good at test-taking, and some people aren’t. Currently, though, it’s the only system we have, and one that is used in nearly every licensed profession.

Last year at the 2011 meeting of the FSMTB, a delegate posed the question, “Who thinks portability is a myth?” I would estimate there were 120 or so people in the room, and if memory serves, myself and one other person–who happened to be a member of the FSMTB Board of Directors, raised our hands. Everyone else was either holding on to the promise of future portability, or they just didn’t want to publicly state that it isn’t going to happen.

In order for portability to work on a nationwide basis, there has to be a nationwide agreement on what’s acceptable in the way of required education and required examinations. It’s as simple as that. In the meantime, massage therapists will continue to have a struggle to cross state lines.