Massage Regulation: A Comedy of Errors

I’ve spent the last hour reading legislative updates pertaining to the regulation of massage…in the past, I’ve sometimes referred to this as the good, the bad, and the ugly. This time, I’m just going to call it a comedy of errors. I don’t know whether to laugh or cry.

I’m not even going to address all the discrepancies in the number of hours of required education and/or exams required for licensure, or the discrepancies in the hours of required continuing education, or even the wide variances in licensing fees. I’ve commented on that a number of times, and that situation isn’t likely to change at any time in the near future.

Everybody has seen those “outdated laws” posts before, silly laws that are still on the books, like “It’s illegal to ride a horse without a saddle on Main Street after 5 pm every other Sunday.” You get the picture. Some of our massage laws seem about as archaic. You just have to wonder at the logic that goes into some of these things…and you also have to believe that these most assuredly were not proposed by, nor are they likely supported by, massage therapists. It’s the bureaucracy at work.

Many of the statutes that have been proposed or enacted in the past few years are a direct result of the economy and state governments being so deep in dept. Several states are now taxing, or considering taxing services (like massage, hair and nail services, even grass-mowing). Even self-supporting boards have in some cases had their monies raided in the interest of feeding the state’s general operating fund. NH is seeking to abolish their massage board altogether, in the interest of saving money. And in the state of West Virginia, HB 2502 seeks to combine the administrative functions of the massage board with the acupuncture board (not so weird) and with the forestry board (weird), the board of licensed dietitians, and the hearing aid dealers board (at least the last two are still health-related). It makes you wonder what we have in common with foresters. Are foresters out there planting trees while naked or committing some other unethical act? Maybe so.

A lot of states don’t require any fingerprinting and/or criminal record submissions of applicants for a massage license. A convicted rapist or violent criminal can get one. Some states require licensees to provide proof of liability insurance, but most don’t. I personally think that one’s a good idea.

There is so much discrepancy between the states on modalities that have to be licensed. In NC, where I live, Bowen therapy, craniosacral, Rossiter, Zero Balancing, and 24 other modalities are specifically spelled out as requiring a massage and bodywork license.  We don’t regulate reflexology, which I really don’t get. I’ve had plenty of reflexology and I would have to say that there is at least as much tissue manipulation going on as there is during a session of acupressure, which we do require licensing for.  NY licenses both acupressure and reflexology, and Polarity therapy. I know practitioners who will argue that every modality mentioned in this paragraph is energy work and not massage. You might as well agree to disagree and get a license if it’s required of you.

Speaking of NY, earlier this year SB 1030 was proposed, got stuck in the Higher Education committee, and may have expired due to lack of action. It provides that the commission of prostitution offense by any person upon premises at which a massage therapist regularly engages in his or her profession, or the commission of any such offense by a massage therapist constitutes professional misconduct; provides that upon 3 or more convictions of such offenses upon such premises, or any conviction of a massage therapist of any such offense, the massage therapist’s license shall be revoked. So basically, you can prostitute once or twice, but don’t do it three times or you’ll lose your license. You might even lose it if you weren’t personally prostituting but someone else on the premises was. It’s worded a little vaguely, in my opinion.

In the summertime, not much is happening, because legislatures tend to pack it up and go home. Some things are always left on the table for the next session, and some (hopefully) will never see the light of day again. And some things are urgently needed, like regulation in the 8 states that don’t have any. In each of those states, there are therapists working for licensing, and just as many fighting against it.

You can find regular updates about what is going on in the regulatory world of massage on the legislative briefing pages on the websites of both ABMP and  AMTA.

8 Replies to “Massage Regulation: A Comedy of Errors”

  1. Alaska has no state licensing. However the city of Anchorage requires a graduation from a massage school with 600hr or so.. I cant remember exactly.. and a police check, before you have legal permission to be a massage therapist( they issue a city license).. However insurance companies are now denying payment to therapists that are working in chiropractic offices and so on…weather nationally certified or not.. So something is going to happen here…a friend of mine Heather will contact you Im sure, to discuss the situation…I just hope they create a grandfather clause so I wont have to deal with all the HOOPS.. Interesting situation though. – Gordon

  2. Hi Laura! I’m from NY and disappointed that the Legislature failed to act on the Worker’s Compensation bill. Hopefully next year, I believe we have a good chance at getting it passed, it moved further along this year than it had in the past. Thank you for highlighting the fact that Reflexology is regulated and you must be an LMT to practice the modality. Whether some agree with it or not, it is what it is and it’s the law here. I’ve turned in a cosmetologist several times because she believes she can practice CST and Reflexology because she took courses and has a certificate. I even know of an LMT that says unless she’s shut down then I’m going to keep going to her for Reflexology because she’s good. Her investigation is still underway. The other bill that you mention that is stuck in Higher Ed., from what I understand, why are massage therapists being singled out and associated with prostitution. This should have nothing to do with massage therapy or massage therapists. Prostitution is illegal and anyone whether an LMT, dentist, lawyer, police officer or accountant should be subject to the same penalties if they are operating should have their licenses revoked or whatever other penalties apply. Thanks Sue

  3. This is a good post. As a teacher and former Board member I hope you will continue to help the profession by encouraging a national education standard that fits the times. Integrative medicine (IM) includes massage therapy BY DEFINITION. My time at the ACCAHC meeting opened my eyes to the potential we have to serve populations at the community based care level and through health centers that focus on prevention, health promotion, and wellness. A curriculum for educating massage therapist must be adopted nationally that reflects holistic education in massage therapy and embodiment. The scopes of practice also need to come into alignment if we are going to take our place in the integrative medicine paradigm. If we don’t, we will continue to be marginalized and kept outside the very place we can help the most. Therapist everywhere will benefit from reading the Clinician’s and Educator’s Desk Reference for CAM health professions. Link:

    Of course Laura, this is not glamourous work and everyone involved will have to get the picture that the longer we wait to codify and align our education and scopes of practice the further behind we will be. Here’s to a positive outcome where all the groups align to move the field forward in the name of health, wellness, and health promotion. Not sickness care. Hope you are feeling better. Enjoy WNCU. P>

  4. I have heard from Ms. Sally Hacking, the undisputed Queen of Government Relations in the world of massage, that I am behind the times, and that the number of states without regulation is actually 7: Alaska, Idaho, Kansas, Minnesota, Oklahoma, Vermont, Wyoming.

    I am personally acquainted with massage therapists in several of those states who have been trying to get a massage board and regulation off the ground–in some cases for quite some time. I might suggest to all unregulated states, calling on the Federation of State Massage Therapy Boards for guidance, and if you are extremely lucky, they might even send Sally around to help you out!

  5. “Hello, Ma’am. I’m from the government and I’m hear to help.” Sound familiar? Comforting?

    This post provides many excellent examples of the problems that government interference has caused massage therapists, and so it begs the question, why do we want any government licensing and regulations imposed upon our profession? I fail to understand how government regulation and licensing will provide legitimacy to our profession. While it may help some massage therapists to receive payments from third party insurers (another practice that makes no sense to me whatsoever, but that’s an issue for another day), it certainly does not make me a better practitioner.

    I urge all massage therapists to carefully consider what they are asking for when they urge state, local and even Federal governments to become involved in our profession. Voluntary, self-regulation, is a far better system in order for our profession to flourish. Those who are professionals will behave like professionals with or without imposed regulations. Those who are not professionals will never be so regardless of how many constraints anyone tries to put on them. The consumer can and will protect themselves by inquiring after a therapist’s professional associations, which can and should make their membership roster open to the public.

    Please don’t invite more government into my profession! They are already here, in Virginia. They cost me hundreds of dollars every year and I get zero benefit in return. If I get any more “help” from the government, I’ll go broke!

  6. Massage has been used as one of the oldest forms of therapy in ancient medical practices. Massage can be defined as the treatment of the soft tissues of the body either manually or mechanically. Massage therapy enhances your life by dropping stress, improving blood circulation and flushing out toxins and improving your immune system. And one of the best-known types of body massage is Swedish massage.`;,*

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