NCBTMB: Quit the Small Stuff and Take the Bold Step

Nearly two years ago, the Tennessee Board of Massage Licensure voted to change its rule pertaining to the examinations approved for licensure of massage therapists. They chose to adopt the Massage & Bodywork Licensing Examination offered by FSMTB as the only approved exam – and sunset the use of the National Certification Examination for Therapeutic Massage & Bodywork offered by NCBTMB.

That decision was entirely within the Board’s authority, and was based on the fact that the MBLEx is owned and administered by FSMTB, which consists of its Member Boards. This structure gives state regulatory boards direct ownership and supervision over this exam, which has never been the case with the use of NCBTMB’s private certification exams for state licensure purposes.

Rule changes can sometimes take a long time to make their way through the administrative process, and Tennessee’s exam rule just came up yesterday for final approval before a committee of the State Senate. This could and should have been a simple legislative rubber stamp of an agency decision, but NCBTMB threw a monkey wrench into the works by sending in a representative to oppose the rule change.

I was told last year by former NCBTMB CEO Paul Lindamood that they were swearing off the battle against the MBLEx, and would no longer challenge state massage board actions around exam approvals. He stated to me at the time that he knew they weren’t making any friends by doing so. The new CEO, Mike Williams, who came on board last September, apparently does not share that point of view.

At the committee hearing, the Senators stayed the decision on the rule change for another 30 days and sent the matter back to the Board for further consideration. According to my sources, the hearing went poorly, with legislators failing to understand the difference in the exams, state board members unable to answer the question about what the pass rate is on the exam, and general confusion leading to the stay instead of a decision.

I spoke to NCBTMB President Alexa Zaledonis today, who stated that “We didn’t go to Tennessee to fight, but to state our position. There are still people who want to take our exams and we support them having a choice. We never desire to create controversy in the states. We have quality licensing exams, a lot of people do like them and ask us to help keep them available in their states. No malicious intent, just a desire to let those people have a choice and so we try to stand up for them in an appropriate fashion.”

Earlier this year, there was an ugly ruckus in Ohio over a similar kind of rule change. It ended in a Massage Therapy Advisory Committee member being removed after he asked the NCBTMB during the hearing: “How much money will it take to make you go away?” It was deemed unprofessional conduct at best, and an offer of a bribe at worst.

While I hate the way the question was put forth, it has more than a little basis in reality. I personally would paraphrase that to: “How much money will it take for you to get out of the entry-level licensing exam business?” 38 states are still accepting the NCBTMB exams, but all you have to do is look at NCB’s financials (available on to see that they’ve had their butt kicked by the MBLEx. The MBLEx is a licensing exam used for licensing purposes. It’s the right tool for the job, and the marketplace has affirmed it by an overwhelming margin. The state boards themselves don’t derive income from the MBLEx; FSMTB is a non-profit organization (as is NCBTMB) and the Member Boards pay annual dues to the Federation.

If you’ve been reading my blog for long, you know that this is a relatively new opinion of mine –that the NCBTMB should get out of the entry-level exam market. I argued against that for a number of years. Rick Rosen, (a fellow North Carolinian and industry thought leader), has argued that point with me here on this blog and in other forums a number of times, as have others, and I resisted that change for a long time. However, I finally came around to Rosen’s point of view. A few months ago when NCBTMB announced the creation of a new post-graduate Board Certification credential and the ending of the current entry-level National Certification credential, I truly felt like it was the best move to be made.

The issue is that ever since the appearance of the MBLEx, the value of being Nationally Certified has largely gone by the wayside. I’ve heard many accusations that the MBLEx is an easier test than the National Certification Exam. This is not a valid argument, because these are two different tests created for entirely different purposes. The real point here is that National Certification no longer distinguishes therapists from the pack like it did back in the days when it was the only credentialing exam in the massage therapy field. I have personally been NCTMB for 12 years. I have always maintained my certification, even after the MBLEx appeared, but I know many therapists who have let it go because they’ve reached the belief that it doesn’t mean anything in the marketplace.

Under the new plan, Board Certification includes the requirements of 750 hours of education, passing a new higher-level exam, 250 hours of hands-on experience, keeping CPR certification current, and a criminal background check. Those who are already Nationally Certified will not have to take the new exam. In our conversation today, Zaledonis stated “Our Board Certification exam is created to test individuals who have achieved 750 hours of education and are at a level of expertise that exceeds an entry level graduate. Over 8000 individuals responded to our JTA, these answers (after psychometric interpretation) along with a panel of subject matter experts were used to differentiate between a entry level licensed practitioner and a certified practitioner. Our Certification test is different from a licensing exam in that it uses more cognitive thinking over just recall using innovative items over traditional. This test, coupled with the other requirements, are the start of a program that truly differentiates licensing from certification.”

I personally know many of the people on the staff and on the Board of the NCBTMB. I have no doubts about their dedication to the profession, and when it comes down to it, the organization isn’t an island. A CEO serves at the pleasure of the Board, and Board members have to reach a consensus. Apparently the members who are currently serving the NCBTMB have agreed to follow this path of continuing to challenge state boards, and that distresses me. I think it is a misguided effort, no matter how good their intentions. Even the name of the organization speaks to that: National Certification Board. It isn’t the National Licensing Board. There isn’t a National License. There is no portability, and the swirling sewer of argument and confusion around the exams is not helping the situation. I think the time is ripe for the NCBTMB to get out of the entry-level market altogether and focus 100% of their resources on the development and rollout of their new post-graduate credential. This IS something that our profession needs, and I urge the NCB leadership to let go of the past and turn towards the future.

I imagine that money is a primary factor in the organization hanging on to entry-level testing, and in the decision to continue challenging state boards that are ready to drop them. It doesn’t take a rocket scientist to figure out that states don’t want a private certification organization coming in and telling them how to run their business. State board members are normally unpaid volunteers who give up home, family and work time to serve a board….and to have an outside party come in and tell them they did the wrong thing doesn’t sit very well, (as I personally know). I don’t want to see the NCBTMB crippled to the vanishing point. Going around challenging state agencies is expensive, and it doesn’t win them any friends.

So here we are with a Catch-22. It’s time for NCBTMB to exit the entry-level testing business, but they don’t have the money to sustain them while the new Board Certification program is getting built. They need a bridge to help them get where we would like them to go.

There is a straightforward solution to this situation. Since the lion’s share of revenue from entry-level testing has shifted over to FSMTB, they now have a significant cash reserve. It is in the best interests of their Member Boards to bring a quick and painless end to the “exam wars” and to establish the MBLEx as the single standardized exam for state licensure. The profession as a whole will benefit, and portability for therapists will be improved.

What needs to happen is that NCBTMB declares that it will no longer offer any of its exams for state licensure purposes as of a certain date. In exchange, FSMTB will give NCBTMB a certain amount of money over a period of time to compensate it for this move. The mechanism for this process is called a Transfer Agreement, and there is a clear precedent we can look at.

For many years, the American Physical Therapy Association owned and operated the national exam used by state PT boards for licensure. APTA (like our own AMTA) is a private non-profit membership association, with no accountability to state PT boards. Because of the same inherent problems we’ve finally come to recognize, the Federation of State Boards of Physical Therapy entered into negotiations with APTA, and engineered a Transfer Agreement to take over that exam in the late ’80s. It’s worked like a charm ever since. Physical Therapy has 50-state licensure, and a lot more consistency in their state-to-state regulations than we have in the massage field.

Having one standardized national licensing exam is one of the hallmarks of a profession. We are at a critical juncture, where the opportunity to take a major step towards professional status is within our grasp. This will take the willingness and cooperation of the leaders of both NCBTMB and FSMTB to come together to work out the details of this agreement.

Let’s stop wasting time on the small stuff. Take the bold step, for the betterment of all.




33 Replies to “NCBTMB: Quit the Small Stuff and Take the Bold Step”

  1. Rally Up, Gather Round: Mrs. Allen is Laying It DOWN!

    And I like what I read here, Laura: it is Time…and this is a logical way & means. Portability is the key Answer to the question “What to do?” I appreciate your Mission as a writer to include the term “Portability” and working toward that, during whatever opportunity in time our profession stands.

  2. Way to go, Laura! Thanks for your insight. I only hope both NCBTMB and FSMTB, et al will “get a clue” and stop the derisiveness and confusion.

    One thing I would like your opinion on: What are your thoughts on the fact that Massage Envy gave a check to FSMTB for $10,000 in support of their “educational initiatives?” If you’ve heard any further information on this subject, I’d love to hear about it.

  3. Thank you for bringing up the comparison between MT & PT, specifically here to address the concept of “hours of education”. When I first tried to join the AMTA, and in my later efforts to get my first state “license”, from FL, it flabbergasted me that I would have so much difficulty getting my accredited University-level “education hours” in Human Anatomy, etc. accepted by the AMTA, AMTA-related powers, etc. I was told that being instructed in Human Anatomy by a Ph.D. in Kinesiology who is a faculty member of the American College of Sports Medicine including multiple fresh cadaver dissection experiences and nervous breakdown inducing timed exams somehow wasn’t good enough, and that I should go back to learn “real anatomy” from an “real” “massage school”. WTF? Of course, I would have to pay using “real money”… I have mentioned before that the “massage” brothel across the street from my apartment is next to a corporate stock brokers office based in the UK, right? “Edward Jones”… The AMTA hasn’t returned my phone calls in 9 years, but the bank managing my student loans from my first year of law school calls me all the time… I only owe them $25k… no big deal… I emailed Kathy Flippin, CPA, about her being profiled the other day by NBC/Swimming World (don’t forget to look up how they are related to the Hearst Corporation, and the overall sponsorship NBC has to the Olympics/Paralympics) for her upcoming work for “Team USA” at the Olympics/Paralympics, & should have reminded her, I guess, that I own all the “Massage” signs from the 2002 Winter Paralympics… they are in my kitchen… Kathy Flippin, CPA was involved when Sally Hacking (formerly “Govt. Relations” for AMTA & NCBTMB, now with FSMTB) was ordered to screw me over and lead me on a wild goose chase… I’m very curious to see if Kathy Flippin, CPA, responds to me, and how…

  4. Laura THANK YOU so much for your support of our Boards actions. This has been a trying and challenging time for us. We as a Board feel strongly that we have made the right choice and we will continue to examine our options, we are not defeated yet. Please know that the REASONS that the committee mentioned are not solely due to lack of data regarding the pass rate. This data should be deferred to the administrative department it is not something that the board has access to, especially in front of the committee meeting. The pass rate was not actually applicable to the conversation in regards to the appropriateness of the exam… and not something I anticipated being asked (much to my chagrin-I am the board chair and was unprepared for that single question). We in Tennessee have been challenged before (at the beginning of this year in fact), in the end we emerged… victorious. I cannot in good consciousness allow for such a grievous error to remain on our rules. I for one will continue to stand up for our decision. I am also Nationally Certified and have been for 10 years, and I am ashamed of their actions towards State boards. The NCBTMB challenged us even after we kindly asked, at our last board meeting, for them to respect our decision (mandated by legislation) to use the Mblex as our test of choice for entry level examination, for licensure. This was not an idle choice, it was a sound decision we made after many hours of discussion. Reeks of bullying to me. You know, this really doesn’t make them very popular with the masses. It is self defeating on their part and a poor choice. Certification is a choice, and it needs to remain a choice. If they could focus on raising the bar in the industry, they would have the respect and support they need to grow. As it stands?…..they are becoming more unpopular and seemingly untrustworthy. What does that make my little credential? Hmmmm…
    I love your blog Laura, your great!!! Thank you for being such a strong and intelligent voice for our profession.

  5. Thanks Laura for bringing it all out to be looked at intelligently and thought provokingly. Being a LMT in Tennessee for only two years, I’m still trying to sort all of the functions of each entity out. This helped clear up a tremendous amount! And Ms. Collins, thank you also for your chairman perspective.

  6. Another reason I so dislike the big business of massage. So many parties are only interested in what their payout is. Another dislike of mine is the use of chemicals in all the products that are recommended to therapists in school. After being a Nationally Certified therapist for so many years and dealing with all the ramifications of a business that also has to deal with the not-so-honest people making the rules as well as the not-so-honest people coming in for motives we have all experienced. If you are going to stay in the profession and address every issue, I would suggest that everyone use products that are worthy of the human race, internally as well as externally. I take them with me whenever I go to a therapist because I am worth it. Hopefully the boards will begin to realize our worth also.

  7. Thank you, thank you, thank you. I feel like you just took a machete and hacked a path through the massage jungle, using language that even a state legislator could understand. I would love to see the new credential, and would love to see further credentials beyond even the proposed yardstick. I am a new therapist, and frankly didn’t even consider taking the NCETMB in it’s current state because I could see the future credential on the horizon and didn’t WANT to be grandfathered in. When it is in place and the initial kinks are worked out, I’ll go for a board certification with meaning, thankyouverymuch. Until then, there is very little distinction in the marketplace as far as the clients are concerned.

  8. When I first got licensed in 2001, no exam was required for TN, just a 500 hour course.
    The school I graduated from had excellent FL LMTs as owners and instructors and is now owned by the TN AMTA chapter President a graduate of that school and now owner. Since my 1997 Traumatic brain injury (TBI) it has been my greatest dream/desire to return to Central East Texas. At the time of my 2001 TNMLB, licensing TX only required 250 hours of school but did require the NCE. I worked my butt off to save the almost $500.00 fee to take the exam which asked a lot of questions regarding Eastern/Chinese medicine, protocols or modalities. Needless to say I failed the exam. When the MBLEX became THE exam, I didn’t have to work so hard to save the almost $200.00 for it. I took it and passed with a score of 651. Am now a CNA and my license has “to me” greater portability at a more affordable price through an “American” protocols and modality test. Plus it does not require I perform x number of hands on sessions each year. I do not recommend the NCBTMB in any form, size shape or format.

  9. As I am new to the political working of the massage profession, I confess that I really don’t understand this situation. Please take this in mind when reading what I am writing here. 🙂

    Wasn’t NCBTMB first on the entry level certification scene? If so then why should NCBTMB just move over and allow FSMTB MBLEx (which is relatively new) to become the new state approved entry level certification? One could make the argument that NCBTMB finds FSMTB MBLEx the competition. How dare FSMTB MBLEx move in and persuade state legislative bodies that their exam is the better exam.

    How is FSMTB MBLEx deemed more portable than NCBTMB entry level exam?

    What does “National Certification no longer distinguishes therapists from the pack like it did back in the days when it was the only credentialing exam in the massage therapy field” mean? Was it that back in the day there was no other national certification offered and few states required licensing and so therefore, if one went through the trouble of becoming nationally certified, it set you apart from your colleagues?

    How will FSMTB MBLEx better distinguish MT’s then NCBTMB has done in the past?

    As you can see, there are plenty of questions regarding this situation.

    I really don’t mind a professional organization offering an entry level certification and a more advanced certification to distinguish between the two levels. However, what does this mean to anyone other than our own kind in a way? Eventually, by staying in the profession and meeting the educational and hands on requirements we will all become advanced certification practitioners if we pay the fee and submit the requirements for review.

    While I agree we should not muddy the professional waters by having two different certification boards offering their national entry level exams to state legislators, there really should only be one approved national certification entry level exam but who says which organization is better? Why?

    Anyone who cares to shed the light on this situation with a bit more articulation of reasoning would be very welcome. Especially for newbies like me in our profession. Thank you.

  10. Following Rachel’s questions:

    Certification and licensure are different functions, traditionally administered by different types of entities for different purposes. In virtually all regulated professions, LICENSURE is the first step. It is mandatory to enter the practice of a profession, and is administered by state regulatory agencies. These governmental bodies are created by acts of their respective state legislatures.

    By contrast, CERTIFICATION is a voluntary process offered to licensed practitioners who seek to earn credentials in areas of specialized skill or practice. Certification programs are typically operated at the national level by private non-profit boards.

    What has caused so much confusion in the massage therapy field over the past 20 years is the fact that a national certification exam that was originally put forth by NCBTMB as part of a voluntary credentialing program — was heavily promoted for use by emerging state massage boards as a mandatory requirement for licensure.

    Because of its widespread role as test provider, NCBTMB gained a kind of gatekeeper status in the field, which gave it an inordinate amount of power, influence… and revenue.

    Prior to 2008, NCB’s certification exam was the only accepted national test on the landscape, so it appeared to “fit the bill”. However, as Laura pointed out at the top of this blog post, there were legal and structural problems with state boards relying on a test given by a private entity where there was no accountability back to those same boards.

    The emergence of the MBLEx in October 2008 finally gave state massage boards the correct tool to use. The MBLEx has nothing to do with certification; it’s a test specifically created for entry-level licensure purposes. It’s not a matter of consumer choice, or giving NCB a “fair shake” — a private certification exam is simply the wrong kind of test to use for state licensure. Most other professions have a national licensing exam in place, given by a federation of the state boards of that particular profession.

    Back when most of these state massage laws were getting passed (between 1992-2008), there was not the awareness of the problems that we recognize today. As an example from my own state of North Carolina: we happily included language that specified the national certification exam in the law we helped to get passed in 1998.

    However, based on the experience gained over the state board’s first decade, changes in both the NC statues and rules were made in 2008 that removed national certification as a requirement for licensure. In that same year, the MBLEx was approved by the NC Board of Massage & Bodywork Therapy as the sole exam for applicants graduating from in-state massage programs.

    From the standpoint of the NC Board, massage schools, and students graduating from schools who are seeking licensure, the exclusive use of the MBLEx has simplified and streamlined the process and has shortened the time between graduation and licensure. What has been accomplished in NC can be an example for other state agencies.

    It will take a number of years for the confusion between licensure and certification to get fully cleared. FSMTB, NCBTMB and the other stakeholder organizations in our field can all play a role in this effort.

  11. Wow! Thank you so much, Rick! What you wrote was what I needed to more fully understand what is being discussed here. Thank you for taking the time to explain it. I need to reread this again and let it sink in. 🙂

  12. Perhaps it is simply a bit too early to ask NCBTMB to step down. I admit (in spite of being on the Item Writing committee for this advanced certification exam) that I have my doubts about whether or not this Board Certification will actually be used, or useful in the profession. I can kind of see why NCBTMB might want to wait to see if this new project even flies or not before they relinquish all stake in the NCE.

  13. Well said. The irony of this whole situation is that NCBTMB could not only benefit substantially from the change, they currently are poised and cocked to do so. They suffer from an insidious disease called “Think small, be small.” The organization is a victim of its culture and they, like many other organizations in this country, are killing themselves from the inside out. Defense wins Superbowl games, but it doesn’t win mindshare, and certainly does not win customers. I hesitate to point to Ms. Zaledones’ quote to you given the last cheap shot that I received on my last response to your blog, however, it’s the best example I can find to support my point, and more important, the point that so many MT’s, including yourself, are trying to make….

    “We didn’t go to Tennessee to fight, but to state our position. There are still people who want to take our exams and we support them having a choice. We never desire to create controversy in the states. We have quality licensing exams, a lot of people do like them and ask us to help keep them available in their states. No malicious intent, just a desire to let those people have a choice and so we try to stand up for them in an appropriate fashion.”

    First, the Tennessee MLB represents the LMT’s in Tennessee. They made a choice, NCB didn’t like it, so they fought it by meeting with legislators. It’s the best way to do halt legislation/rule making, and they know it. The intent of meeting with the senators to retain their exams in TN is, regardless of what you call it, starting a fight.

    Second, No one is questioning the quality of the NCB licensure exams, it’s the relevancy for licensure that is being questioned. Also, “a lot of people” should be making their voices heard at the Tennessee MLB meetings, and not to an external organization. Here’s the rub….rather than ending the entry level licensure exam, they are eliminating their National Certification components to their existing programs. What happens to the certificants who have National certification at that point? Overlooked, probably. Who is supporting their interests? I suppose the argument could be made that if they take board certification that issue would be resolved for the therapist, and would also provide an answer to the revenue loss they experience from the entry level exams. That’s good, right? But if I have Board Certification, where do I take that credential? Will the Mayo Clinic, Blue Cross/Blue Shield, etc., come out with a statement that only Board Certified Massage therapists will be accepted into their system? Perhaps shifting the limited resources they have to creating and nurturing the strategic alliances with these organizations would provide benefit to NCB as well as the massage therapy professionals desperately trying to stay in the field.

    Third, the section of the quote “We never have a desire to create controversy in the states…” seems delusional. Marcella Collins, Board Chair of the Tennessee MLB has graciously commented on this very blog…and feels bullied. I would hope that the NCB Board of Directors would start asking some serious questions about the actions in Tennessee, and would direct their staff to stand down. I’m not sure about the rest of you, but regardless of the words offered by NCB, their intent is crystal clear to me. It seems to me that the NCTMB Board is more focused on their pre-determined means rather than thinking about the end. They’re so focused on maintaining their course, they’ve forgotten where they are trying to end. Focus on the ends—not the means.

    Finally, world history has shown many instances where organizations have tried to “stand up” for others, even with the best of intentions. Sometimes, the few they are trying to stand up for, are wrong. Sometimes the organization has convinced itself that the population they are “serving” are unable to make the decisions that are “best for them.” That’s when things get scary….when an organization, or any collection of people decide that the masses are unable to make decisions that affect their personal or professional lives, and they are better at making those decisions, well, we all know how that turns out. The people will deal with it for awhile, starting talking, and then the power of the people, or profession in this case, will ultimately prevail. I certainly hope that NCB will consider this thread of posts in response to your blog, respect the decision of the Tennessee MLB and become an organization that the profession can support and fight for. I’d be right on the front lines, and I’m certain that many others would follow suit.

  14. This is shameful. I also had discussions at several conventions with former CEO Lindemood as well and was very impressed with his viewpoints and ideas on the future of our profession and how NCB was going to help move massage in a direction that would appeal to higher healthcare professions. I remember seeing things in magazines about it, buttons about advanced and how they were doing things to keep illegitimate people out of our business in human traffic. Good things. And they were being nice for a change. What the h— has happened there? They change directions like most people change underwear. I also heard they would not sue or challenge any more states. Now what Laura? – Tennessee is being challenged by who?? OMG. And what happened in Ohio? I cant keep up. And I don’t think I will ever care to again. I am ashamed, sick and feel like I have chosen the wrong field. NCB… I believed in you again. For a while. But now, please just get out of the way, out of the MBLX’s business and out of states business. Do what you said you would do last year and get us some respect where we need it. In the healthcare of the minds of people who need to care about what we are and can do — and across the country. With the nationwide change in healthcare options, there is a lot to be done. A lot to be gained. You are all missing the boat and the chance it seems to me. NCB you make me sad. 🙁

  15. Oh and one more thing Laura, I just re-read that the chairman said “We didn’t go to Tennessee to fight” and “there are still people who want to take our exams and we support them having a choice.” I am not a government scholar but what kind of double talk is that? If they meddle at the government level to change a BOARD decision, isn’t that fighting the desires of hard working people (board members) chosen by their state to best guide and regulate the profession in that state? This is silly semantics, and NCB is taking the professionals in TN for small minded people.

    I have taught in multiple states and NCB does not have licensing exams. They have old and tired certification exams that are USED as licensing exams due to an age old need that has long since been eclipsed by MBLX. And when their chairman says that “a lot of people do like them and ask us to help keep them available in their states,” well that is nonsense. Their exams go down in numbers I am told every year, and THAT is the truest indicator of “how many people want them.” No malicious intent maybe, but it seems like a smokescreen. NCB is confused or the chair is confused about her own organization and what we need out here, which is just as bad or worse. What we need is to be able to trust our highest level organizations, in charge of our highest level assets and ideals. We need a hero. Not fast talk, smoke and mirrors.

  16. Well, we practiced massage before NCB, and we’ll practice it after NCB as well. I’ve never once in the 20 years I’ve been Nationally Certified had anyone express any interest in it, other than the question “are you certified?”, so as a marketing tool it’s crap. The service aspect of it has been poor all along, although I know they’ve improved it some in the recent past. No one every says they “like them” in reference to a testing experience. Wouldn’t hurt my feelings in the least to see NCB dry up and blow away, except here in Virginia, there is no discreet Board of Massage Therapy, our certification is administered by the Board of Nursing and is based on obtaining and keeping current the National Cert., so I don’t know what would happen here in that circumstance.

  17. Yes yes yes and yes to all of you wonderful comment makers. And by btw way we in Tennessee have NEVER said we don’t support the NCBTMB. Just that the exam isn’t appropriate for ENTRY level licensure. An individual ALWAYS can choose to take the test. It’s exhausting. Thank you to all of you for your support and reasonable comments. If we change the way we see things the things we see change…right?

  18. I have been asking, pleading and hoping that NCB would get out of the licensing business since the MBLEX became available. You hit the nail on hte head about the finances Laura and have suggested as well as supported Rick Rosen on the proposal for the Federation to “Buy Out” the licensing process of NCB. The Federation needs to step up and help the NCB transition and the NCB needs to transition.

  19. It is obvious how many people fight and argue over this – as shown on this blog, on Facebook, etc.

    A few people have the right idea, so I will keep this short and make my echo where appropriate.

    1) Entry level and advanced are different and should be treated differently
    2) Licensure and certification are two separate things
    3) The medical field has board certifications – these are the hallmark for quality in that particular area of practice (and many places require it.) It helps move people forward.

    So whether NCBTMB is or isn’t right for what they’ve done, I think a good point is made – let MBLEX be the entry-level exam, in every state, and in order to allow NCBTMB to focus on moving our PROFESSION forward (as it needs to), the FSMTB should do the buy-out/’Transfer Agreement’ – it makes sense and ensures something doesn’t need to be started over by a new group.

    Instead of attacking NCBTMB off the bat, lets look at just the fact that Board Certification can mean something for us as a PROFESSION. We need to focus on all of us at points, as opposed to just ourselves. Even if you do not want to be in the ‘medical field’ or accept insurance, or do something extra, by allowing (and promoting) the forward movement of our profession in that way (or some similar means), you ultimately help yourself because it gives each of us more credibility in the end. It has worked well in practically every other profession, so it is just a matter of sorting the bubbles out and ensuring we can help it along without attacking back.

  20. I haven’t read all of the above posts, so maybe this has already been said. My biggest concern dealing with this issue is the process of individual states no longer accepting the NCB exam. I have already heard of one person who wants to move to Nashville, has been a therapist for 15 years, passed the NCB exam in the mid 90’s and is now required to take the MBLEX to get licensed there. How annoying!!! The Federation’s goal was to create a foundation for reciprocity but that has not happened. in fact, if the trend continues for states to no longer accept the NCB exam, the state to state problem will become worse than it is now.

  21. Following Wanita’s concerns:

    Getting a Transfer Agreement between NCBTMB and FSMTB negotiated and signed is just the first stage of this process. The second stage will involve various technical changes from state to state that will have to be made to statutes, rules and administrative procedures. The exact solution for each state will depend on the current language for the exam that is specified for licensure, and the board’s process for approving the exam. These changes will take time and professional expertise. I’m sure that FSMTB will be able to provide support to its Member Boards to facilitate this process.

    In the states where the National Certification Examination is currently used as the exclusive test for licensure, there will need to be technical workarounds created to allow the MBLEx to “replace” the NCE, and be accepted immediately. These are the kind of details that will be handled by board staff and legal counsel. No licensure program should have to be stopped while changes to the state law are made (which take a much longer span of time).

    In general, there are two categories of applicants for state licensure: 1) new candidates who have graduated from massage therapy schools/programs approved by the state; and 2) already licensed massage therapists coming into a state from another state. The structure of “reciprocity” has never really worked in our field, as the laws are too inconsistent from state to state. Reciprocity also requires two-way relationships between each pair of states, which is unwieldy.

    The better solution — which is used in many other regulated professions — is called “Licensure by Endorsement”. With Endorsement, the state board will grant a license to a person who holds an equivalent license in another regulated state, as long as they have a current and valid license with no disciplinary sanctions. There may be other requirements, such as moral character references, criminal background checks, a jurisprudence exam on the massage laws/rules of that state, along with licensing fees. The need to take another licensing exam is generally avoided, as the current license from another state is regarded as demonstration that the licensee is competent to practice.

    With that said, passing a competency exam 10 or 20 years ago is not evidence of current competency. It is reasonable for a state to require passage of an exam in a more recent span of time — such as 5 years.

    The Endorsement process will not handle every possible combination of state-to-state movement for therapists, because of the inconsistency of standards in the massage therapy field. For example, a therapist licensed in Connecticut (with a 500-hour educational requirement), would not be able to cross the state line into New York (with a 1000-hour requirement) and get a license by endorsement. The discrepancies in education hours and scope of practice definitions is part of what FSMTB is working with currently in its efforts to develop a Model Practice Act.

    There is no “magic wand” that can be waved over the massage therapy field to create instant 50-state portability. All of these changes will take time, cooperation among the states, and a willingness at the level of our national organizations to take the steps needed to bring the standards into greater consistency. Resolving the confusing and wasteful struggle around licensure exams will be a crucial step towards this goal.

  22. I am the person that coordinated the meeting in Ohio and the intent was to educate our members (AMTA) about the two organizations. That being said what follows are my statements as an LMT, not offiliated with any organization.
    In Ohio we have been licensed by the medical board for almost 100 years, we require 750 hours of education, a background check and a comprehensive test (Jan 24, 2012 Mblex was accepted with a sunset rule to review NCB’s test and determine by Jan 2013, prior to that it was a state administered test).
    What I observed is that most people do not understand the difference between licensure and certification, nor were they knowledgeable about the organizations. I have found that too many people I encounter have opinions with little fact. Both FSMBT and NCBTMB were asked to attend to provide facts so that people can understand first hand about the organizations missions, not mine or anyone elses opinions. The time frame was too short, but it was a step in achieving our chapters mission of “growth in engaged members”.
    What I heard from our licensing entity on the topic of accepting Mblex was:
    Licensure is “bare minimum standards to protect the public”, that is our role.
    At first that frustrated me because I was always told “we are licensed by the medical board” and thought that meant more. However, from the meeting that occurred at the Ohio convention I believe I may have gained clarity and facts. (I sometimes need to hear things many ways before I have understanding, please correct me if I still haven’t got it!)

    Licensure is meant to protect the public, it is a foundation. We need to have that foundation across the nation to build upon, so I can see the need for licensure and the Mblex development.
    However, I believe that the NCB’s future board certification is what most massage therapist’s in Ohio where lead to believe their license means (at least I did). They are more than the bare minimum, they have 750 hours of training, anatomy, physiology and modality literacy above just keeping the public safe.
    I was on the JTA for NCB this year and the board and staff members I met do appear to have our profession best interest as their focus. I do not want to interpret Ms. Zaledonis’s comments, but when she stated “…we support them having a choice. We never desire to create controversy in the states. We have quality licensing exams, a lot of people do like them and ask us to help keep them available in their states. No malicious intent, just a desire to let those people have a choice….” I believe her. I think NCB is trying to create development paths for people to take without taking 2 exams to get there. For example the way I saw it could be in Ohio was: Take NCB entrance exam if you choose a career path and advancement, choose Mblex if you choose general wellness. I thought they were meeting the need of 2 entry points.

    I now see that certification should not be legislated, it should be a professional choice to be the best you can be. As Angie said, it’s not our role to decide for the masses, but I do like the idea NCB has to create paths for people to follow and develop.

    So, if a transfer agreement could be feasable for NCBTMB and FSMTB, and the help of the profession and professional organizations educating therapists and the public, career paths can mean something.

    The momentum is there and the conversations are happening, lets keep it positive! Thank you Laura for bringing what was said in Ohio into a positive possible solution for our profession.

  23. Diane said:
    “At first that frustrated me because I was always told “we are licensed by the medical board” and thought that meant more. ”
    “Take NCB entrance exam if you choose a career path and advancement, choose Mblex if you choose general wellness.”

    MBLEx does not mean general wellness, NCBTMB does not necessarily mean career path and advancement, and wellness does not mean a stalled career or lack of opportunity for advancement.

    The notion that general wellness is less important, less involved, less advanced, or somehow lesser than condition-specific work is a myth. Also, the notion that, to be worth something as a profession we need to “medical”-approved misses the mark; massage therapists have the right to be here on their own merit.

    As a new landscape is created in massage therapy, it is important to rid of old myths and prejudices.

    There should be paths and opportunities for in all areas, and I hope that as the profession evolves there will be certifications and specializations in wellness and prevention massage as well.

  24. I am please to read the above comments. They indicate to me that there is a glimmer of clarity happening in this muddy situation. As Lucas pointed out for the massage profession to advance we MUST HAVE a valid certification process that occurs above and beyond licencing which as Dianne has comment concerning the function of licensing-. There has been a financial shift from the money collected when someone takes one of the tests. Today, instread of the NCB rolling in the money it is the Federation of State Massage Boards. The Federation revenue will increase and since the exam is required for licensing the Federation can be assured of financial stability. Not so with the National Certification organization. Board certification will aways be a voluntary process meaning that those motivated to take the certification exam will be a percentage of those licences which in turn reduces the income into the NCB. I believe that the Federation needs to support the transition and finacially stabilize the NCB for a short period of time until the new board certification process takes hold. Ethics can be defined as doing the right thing and this is the right thing to do.

  25. Emmanuel I would like to clarify that I do not believe the notion that wellness is “lesser”, I believe it to be the foundation, therefore the most important.

  26. I think it’s interesting that Angela Palmier invited me to Link to her on LI recently, so maybe we’ll dialogue about this a bit in the future. I InMailed Angela & pointed out that I feel that because I resigned from the NCBTMB in 2005 due to their extremely corrupt & hypocritical positions on dealing with language issues & prostitution, if we are to reconcile then I should be issued “reparations” relating to the money lost I could and should have made teaching CEU’s for them during the past 7 years since I resigned. I originally asked for a minimum of $350,000. That price is going up, every day.

    My actual point in re-posting today here is actually to address Laura Allen’s blanket statement at the end stating, “Having one standardized national licensing exam is one of the hallmarks of a profession.” I suppose points of view may differ here, but most educated people probably agree that the 3 core largest & oldest professions in the US, other than prostitution or the military, are Law, Medicine, and Clergy. Law & Medicine do not have national exams, and the clergy aren’t regulated at all generally, at least in terms of education. The most obvious example of this is the fact that Louisiana’s legal system is French, while the rest of the US uses an English system. You can be an Ivy-League legal scholar and still have to jump through all kinds of hoops to get a Law License in LA. Furthermore, when I was studying for my Doctorate in Physical Therapy under Stanley Paris in FL, before I was “expelled” for having pierced ears and a few other academic disagreements came up, and since I can get in to any Chiropractic college in the US, I am very aware of the fact that Stanley Paris is best known among chiropractors because of the multiple lawsuits involving Stanley Paris vs. Chiropractic over scope of practice concerns. The first time I met prostitution=massage AMTA lobbyist and California MT Council creator Beverly May was at a Massage Convention in Sacramento where I ended up talking to a PT for awhile, and his only career advice to me was to seek freedom from government oversight, essentially. His primary concern as a PT was what “freedom” he might have to practice without required medical referrals, and the ability to open multiple practices and clinics, a practice which is illegal for PT’s in many states.

    Why do you think all-powerful Massage Envy has such a cozy relationship with the Hearst Corporation, which openly advocates using massage as a front for promoting prostitution in it’s newspapers like the San Francisco Chronicle? Why does Angela Palmier work for a publishing house based in Amsterdam? Why does Massage Today, which Laura Allen works for, have such a cozy relationship with Massage Envy? and there we are again, back to Edward Jones stock brokerage, and the brothel next door… & the ludicrous email Ryan Hoyme sent me claiming “I didn’t know you InMailed me…What’s LinkedIn? I’ve never heard of it!” Put a W before the H in his last name, and change the Y to an RE…

    Off to SF today, where the SF Main Library has a huge sign by the front door promoting pro-pedophilia activist Harry Hay… & somehow I’m a criminal for wondering if that’s a good idea?

  27. NCBTMB recertification takes each state power as its own. Things like background checking, CE hours. Each individual, if applying for a specific state license or renewal, will undergo background checking and CE hours auditing. Why Ncbtmb doing the duplicate job, to make extra money? to differentiate it from other? or try to be on the top? NCBTMB should focus on exam quality, and let the board of massage of each state do their jobs.

  28. I wanted to thank you all for participating in this discussion, it has helped me get a grasp on a the situation.
    I have held a current massage license for fifteen years and I am licensed in two states. I am now trying to get licensed in yet a third state and therefore I am forced to take one of the exams. I have never taken a national cert exam as I never found it necessary (or been forced to, haha) until now.
    After reading through this blog and others, I am going to give my money and support to the FSMTB. As I stated before, I don’t feel that I need a national cert at this point in my career, I simply need to get licensed in a state that requires an exam. Honestly, I have always felt that having the certification means more to colleagues than to your clients. The people that we are providing service to, whether you have a private practice, work in a cooperative or at a spa, really don’t know what it all means! For them, it really comes down to professionalism and experience. Oh yes, and let’s not forget the basis of the industry…compassion!
    I realize that there is a business side to all operations. The idea in all operations is to create a delicate balance between the business and the people that business serves. I feel that the NCB has gotten cozy collecting fees and doesn’t want competition. In that complacency, they have lost sight of the people the organization serves.
    The NCB set a precedent in the bodywork industry and for that they deserve credit. Having said that, all things evolve, and they need to jump on that train. I agree with the rest of you that say they need to focus on bettering themselves to again perhaps set another precedent, rather than wasting energy trying to debunk the inevitable competition. Monopolies are always happy until they are challenged!
    A Board cert is the perfect opportunity for them to do this. Our health care is also evolving and it is a great opportunity for them to set some standards for that scope of practice. Having worked in hospitals, I find a specific cert applicable, as hospitals are a different animal. Perhaps they could somehow help tackle getting more bodywork covered by insurance companies?
    I think it is time that they think more about being positively progressive as stagnancy has no place in an ever changing world.

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