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The Good, the Bad, and the Ugly

With apologies to Clint Eastwood, I’m using the title of his classic Western to talk about three major announcements from the Federation of State Massage Therapy Boards, and what they mean to the rest of the profession. This all came down at the recent FSMTB Annual Meeting, held in Tucson on October 3-4.

The Good: FSMTB and NCBTMB reach an agreement on licensing exams.
Woo hoo! Praise the Lord and pass me the MBLEx! After six years of costly and damaging “exam wars” between the two organizations, NCB was unable to keep its market share of the entry-level testing business. As FSMTB’s exam revenue grew each year, NCB’s declined. NCB finally saw the handwriting on the wall and agreed to stop offering its national certification exams for state licensure as of November 1, 2014 – in exchange for an unspecified amount of money.

This is a huge benefit for the profession, as we can finally move towards having a single licensing exam that is under the direct oversight of state massage boards. (Only Hawaii and New York are still hanging on to their own state exams.) It means less confusion for students and massage schools, and a boon to portability of licensure in the future. This has been a long and painful struggle between FSMTB and NCB, and I for one am thrilled to see it come to a peaceful end.

The Bad: FSMTB adopts CE standards and license renewal recommendations.
Two years ago, FSMTB proposed a radical shift to the continuing education landscape, as outlined in their Maintenance of Core Competency proposal. The MOCC was slammed by organizations, schools, CE providers and individual therapists alike – and yet, the worst of it has made its way into FSMTB’s new continuing education and license renewal standards.

This is a classic case of “If it ain’t broke, then don’t try to fix it.” Overall, our existing CE system works reasonably well, so the last thing we need is yet another organization coming in with an agenda to transform and/or grab control of it. Last year, we suffered through an attempt by NCB to do just that. After a massive grassroots effort, NCB toned down most of the unacceptable changes they were trying to force on providers and sponsors of continuing education. They’ve been behaving themselves since then, and their CE approval processes have been operating more smoothly, although personally some of the classes they have approved are still an issue with me. I’d like to see some sort of designation for those of us who don’t practice or teach pseudoscience and don’t want to be lumped in the same category as those who do.

Now we have the FSMTB trying to flex its muscles. It’s like we just got King Kong calmed down, and now we have to do the same with Godzilla!

At the recent FSMTB Annual Meeting, state board reps passed a resolution from their CE Task Force to “implement a program that provides reliable, unbiased and appropriate vetting of continuing education providers and the classes offered to the consuming public.” That sounds high and mighty, but there is no reference to NCB and their existing national Approved CE Provider program in the resolution, and there was no mention of NCB when this resolution and the license renewal standards were presented to the Delegate Assembly for consideration. Did they think that no one would notice this sin of omission?
The LAST thing we need is another CE approval program! FSMTB could have easily solved their delegation of authority issue by entering into a partnership agreement with NCB to use their existing program. This should have gotten rolled into the exam deal between the two organizations, so that CE approvals could be consolidated.

It’s hard to believe, but the resolution was passed without any details on how FSMTB actually plans to vet CE providers and classes. Why should we trust that FSMTB can do this in an effective manner? They’ve been offering the MBLEx for six years now, and they still don’t have an online practice exam and exam study guide for massage students. The very worst of it is that FSMTB’s plan for CE and license renewal centers on “public safety”, while minimizing the role of CE for “professional development”. The problem is that there is no evidence that we have a widespread “public safety” crisis in our profession, so there’s no factual basis for what FSMTB is trying to do. (There are a lot of specific flaws in the CE standards and license renewal recommendations FSMTB has adopted. I’ll detail those in a future blog.)

What I can see from all this is a major threat to the existing CE provider and sponsor system in our field. FSMTB’s proposal is so completely out-of-synch with how CE is organized and delivered, and FSMTB stands to consolidate even more money and power if this model is adopted by state massage boards. We’re just coming out of a period where NCB tried to dominate the field. Now FSMTB is acting like they’ve picked up the NCB playbook and are trying to run with it.

The Ugly: FSMTB publishes the Model Massage Therapy Practice Act (MPA).
As I wrote about in my previous blog, the MPA was released after three years of behind-the-scenes work and two rounds of public comment. Most of its content is the kind of standard stuff found in all templates for occupational licensure. However, FSMTB really blew it in a number of key areas, and the final version contains both technical errors and some awful policy decisions. As FSMTB’s leaders had final say, the responsibility for correcting these fatal flaws rests on them.

Judging from how few comments were made on the three blogs I posted about the MPA, it looks like it doesn’t register as all that important. Wake up people! A model practice act is one of the bedrock components of a profession. It contains the Scope of Practice definition and other essential elements that influence both education and practice. If you haven’t taken time to read our new MPA, I urge you to get familiar with it and keep up the pressure on FSMTB to fix it. Remember that it doesn’t become law unless it’s adopted by a state legislature.

Let’s celebrate the Good, and get to work on the Bad and the Ugly!

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NCBTMB Making Major Changes to CE Provider Approvals

Disclosure: I have agreed to pass along comments, questions and concerns to the NCBTMB on this matter, and the management there reads my blog. They are fully aware that I use this blog to express my own opinion whether it is in line with theirs or not. Your comments here will be seen by the CEO, Mike Williams, and the Board of Directors.

The NCBTMB has announced major changes in the works to their Approved Provider program for continuing education. You can read those here.They have also set up a page for Frequently Asked Questions about it, and you can read those here.

As soon as they sent out the press release I started getting emails and FB messages from people asking questions about it, some applauding it, and some complaining about it.The biggest change is that they will no longer be offering organizational approval. Every individual who teaches a continuing education class will need to obtain individual approval as a provider. That’s going to affect a LOT of entities: AMTA, the American Massage Conference, massage schools, and other organizations who have previously been able to take people in under their umbrella.

It’s affecting me, personally. I have organizational approval myself. I normally host a dozen or more teachers at my facility each year, and while 90% of them are approved providers in their own right, a couple are not. I don’t perceive it to be such a big deal for me…it’s not going to be a problem for them to get their own approval, and I have until the end of 2013 to prod them along into doing so. All who are approved as organizations have until the end of 2013 to get your act together and come into compliance under the new rules.

One of the first complaints, naturally, was about money, and people having to pay yet another expense. Organizational approval up to this point has cost $400. In reality, an organization that only has two teachers has been paying the same amount as one that has twenty, and that’s not really fair. Under the new paradigm, approvals will cost $175 and will last for three years. You must also pay a $25 fee for each class you submit to be reviewed. As a clarification to one point that has been brought up, if you have a full class and you teach portions of that, as sometimes happens at conferences and conventions, you are not having to pay $25 for each version of it…just the one fee. That’s good. I teach for a lot of AMTA chapters and I am often asked to cut an 8 hour class down to 6 hours or make a 3 hour class last for 4, so it’s good to know you’re not paying $25 for all derivatives of the same course.

People have also stated issues with them requiring a criminal background check. Some state boards require that, and some don’t. My particular state does, and if memory serves I think the fee is $30 or $35. It may be duplicating efforts for the NCBTMB to require it in some instances, but not in others.

I have personally had discussions with the powers that be at the NCBTMB over the approval of course content. They are now vetting individual courses again–to a point. The first concern I got wind of was from a colleague who was concerned that they would throw out everything that doesn’t fit in the box of Western medicine. Have no fear. My own wish is that they would get rid of some of the more questionable classes that are approved….at least they were questionable to me, and of course, I’m just one person with an opinion in a sea of many.

They have no intent of getting rid of energy work courses and other classes that don’t have any basis in science…as long as the course content shows some connection to or lineage from massage, it will still likely be approved. I say likely because during the vetting process, they are paying more attention to quality, whatever that truly means. For one thing, they are asking you to turn in your complete handouts, which has never been done before and which also has some people concerned about letting their proprietary information out of the bag. I have expressed my own concern that some of these courses people have invented that don’t have any basis in science and in fact have in some instances been proven to be totally contrary to accepted scientific principles are still going to be approved, so I’m not sure how “quality” that is. A lot of people disagree with me on that front. There is obviously a very huge demand for those types of classes, or they wouldn’t continue to exist.

What I would personally like to see happen is a national certification for science-based education. I’m going to keep after them about that; you can count on it. People can do all the unsubstantiated things they like, but there are some who would like to have a credential that is based on the actual evidence-informed practice of massage. I am one of them. Does that mean I am claiming to be better than you? No, it does not. It just means I would like for there to be something out there that differentiates those who want to be known as evidence-based practitioners as opposed to those who don’t.

Other questions I’ve been asked include exactly who is doing this, and the names of the committee members have not been released that I am aware of. They just state on their website (which is new and snappy-looking, incidentally) that it is a team of experienced practitioners and educators.

People ought to be aware that the buck doesn’t really stop with the NCBTMB. They, along with numerous other certification agencies,  are accredited by the Institute for Credentialing Excellence (formerly NCCA, National Commission for Certified Agencies).  They are the only national accreditation body for private certification organizations, in all disciplines, to demonstrate adherence to established standards. Among the certifying agencies that this organization accredits include healthcare programs in chiropractic, dentistry, EMT, nursing, medical assisting, nutrition, prosthetics and orthotics, and pharmacy. They also accredit certification programs in the arts, construction trades, and a host of other things. And ICE is accountable to the Council for Higher Education.

Bottom line: changes are coming, and you can either go with the flow or go away…while a few states have their own approval process, the vast majority still depend on the NCBTMB for approving continuing education.

I’d like to state for the record that I personally am acquainted with the majority of the people at the NCBTMB, and I have certainly written my share of criticism of the organization in the past–and patted them on the back when I thought they deserved it. The fact is that if they stand on their head and whistle Dixie, it is never going to suit all of the people all of the time. I think they are a dedicated and hard-working group of people. I certainly don’t agree with everything they do, and I take frequent advantage of my status as a certificant and an approved provider to let them know that.

Here’s your opportunity to comment, so take it. As I said, these comments will be seen by the CEO and Board members.

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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?

 

 

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MOCC-ERY

Last week, the Federation of State Massage Therapy Boards presented their long-awaited proposal for a new national continuing education approval program. They are calling it Maintenance of Core Competencies – or MOCC for short. As I indicated in my previous post, this proposal not only failed to deliver on the original promises made by FSMTB, it has turned the entire professional landscape on its ear by recommending that most continuing education should be voluntary, not mandatory for license renewal.

Under this “MOCC-ERY” of a plan, the only mandatory components of continuing education would be those FSMTB deems to be relevant to “public safety”. If that’s not bad enough, FSMTB is proposing to take control over the design and delivery of these courses. Except it isn’t continuing education … it’s proving that you still know the things you should have learned in entry-level massage training as it pertains to protection of the public.

As a licensed therapist, do you want to be taken back to subjects like Ethics 101, principles of hygiene and sanitation, and the naming of unsafe massage practices – EVERY TIME YOU HAVE TO RENEW YOUR LICENSE? I’ve been teaching professional ethics for 14 years, and frankly, I find this proposal to be an insult to my intelligence.

I was very gratified today to receive the press release from AMTA denouncing the plan. In part, important communication states:

“AMTA reviewed the proposal and has many concerns with the approach of the FSMTB, the proposal itself, its inconsistencies and the lack of support provided for their view. Some of our specific areas of concern are:

  • –Overall, the impact of this proposal is to lower standards for massage therapy practice. It would shift the focus of professional development from building on the entry level education massage therapists receive to that of maintaining very minimal requirements of public protection.
  • –The proposal contradicts its stated intent, previous FSMTB statements on the need for continuing professional education and the mission of FSMTB.
  • –The proposal would take away the freedom of choice of massage therapists to determine their own practice focus and to choose the continuing education providers they prefer to meet their own professional needs by creating a “one-size-fits-all” approach for license renewal.
  • –The proposal provides no empirical data to support the efficacy, efficiency or necessity for a transition to this model.”

AMTA goes on to list 20 objections in their press release.

Although ABMP as an organization has not yet made an official statement, ABMP President Les Sweeney came out in support of the MOCC Proposal in his recent blog. In addition to being a member of AMTA, I am also a member of ABMP. I think highly of Les and the rest of the management there, but this is one of those times when we’ll have to agree to disagree. Les does state that he supports the role of the NCBTMB in the arena of continuing education; but he personally thinks CE should be voluntary. That is a major policy statement coming from the top guy at the largest professional membership association in our field.

The thing that is most outrageous and unacceptable about the MOCC Proposal is not the “public protection” course material that could be mandatory for therapists. It is the fact that leaders of four of our major stakeholder organizations in the field came together behind closed doors and decided that the majority of continuing education should no longer be mandatory.

It looks like there may have been major flaws in the process that led to this consensus document. Was the work of the eight-member Task Force shared with the full leadership of AMTA, ABMP, AFMTE and FSMTB with sufficient time to review and comment on this plan before it was published? Something doesn’t line up when AMTA comes out with a total smackdown of the plan, while their Immediate Past President was part of the team that was responsible for its development. Does that seem odd to you?

What we do know is that the decision making process took place in a vacuum, and there was no opportunity for public comment. Yes, the disclaimer says that “The MOCC is just a proposal and we’re seeking your feedback”, but input should have been sought from a broad range of constituents in the field before such a proposal was even made.

Continuing education classes that actually teach you anything new, under their plan, will become optional. Only the classes from the Federation, which they plan to make available on their website, will be required for license renewal. My opinion is that instead of being satisfied that the MBLEx has taken most of the exam revenue away from the NCBTMB, they would now like to take the continuing education dollars away, too. This plan will not only take dollars away from the NCBTMB, but also away from continuing education providers. (Disclosure: I am an NCBTMB Approved Provider of Continuing Education.)

The Task Force intentionally excluded representatives from the NCBTMB, and that’s another point that disturbs me. The Federation should be working in collaboration with NCBTMB. I was present at the AFMTE 2011 Annual Conference during FSMTB Executive Director Debra Persinger’s initial presentation about the Federation’s intent to create a CE approval program. NCBTMB Chair Alexa Zaledonis was in the audience at this session, and she publicly stated that her organization was willing to cooperate with FSMTB. It’s a shame to me that in light of their 20 years of experience in administering CE provider approvals, they are being left out of this loop. I’m gratified to see they’re not waiting around for an invitation, but instead, have gotten on with the business of making their own improvements.

In May 2011, NCBTMB convened a meeting of the Massage Approved Provider Panel, which was intended to improve and enhance their current CE approval program. Most of the stakeholder organizations in the field were represented there, including FSMTB. Based on feedback from the participants, NCBTMB will begin reviewing and approving CE courses as well as CE providers this summer.

Personally, I did learn what I needed to know about protection of the public while I was in massage school. I am one of those people who enjoy attending continuing education courses. I don’t want it to be mandated to me that I have to take a no-fail test—which isn’t really a test if you can’t fail it, is it, of things that I already know—to meet my license renewal requirements. I don’t think that serves me, as a massage therapist, and I can’t see how it’s going to serve the public. The Federation seems to think this will wipe out complaints of unethical or unsafe behavior. I don’t believe that for one minute. Anyone who is going to act unethically is going to do it, no matter how many classes they take or whom they take them from. Unsafe behavior needs to be addressed in entry-level massage school. I would much prefer to see the FSMTB come up with a model program of public safety education for schools, instead of requiring therapists who have been practicing for years to take a ridiculous no-fail test.

Times are changing, as Les said in his blog, and our organizations are changing with them. It remains to be seen whether it’s for the better or the worse. I have supported the FSMTB in the past, because I believe the state boards coming together in an effort to solve common problems is a good thing. I still believe that’s a good thing. Unfortunately, I do not believe that this is an example of the kind work they should be doing, or the way they should be doing it. You can let them know how you feel about it here.

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A New Day, A New Blog

Welcome to my new blog site! For the past couple of years, I’ve been blogging about the politics of massage on the Massage Magazine website. More recently, I’ve also been contributing to the WIBB (Women in Bodywork Business) blog on the Massage Today website. I finally decided it’s time to put up my own blog, on my own site.

I’m always opinionated, and sometimes controversial. I like to keep up with what’s going on in the political arena of massage, report that, and offer my opinions on it. The issue with that in the past has been that the magazines that host my other blogs accept advertising from the entities I sometimes report on, and it makes them a little uncomfortable when I slam a big advertiser. Of course, the big advertiser doesn’t like it, either.

Having my own blog site will take care of that problem. Now I can be just as offensive as I dang well please, and the magazines can relax, secure in the knowledge that I am not upsetting their advertisers on their playground. And I won’t worry about being censored or being asked to tone down my opinion to make an advertiser happy.

I support freedom of speech, and I don’t mind when people disagree with my opinions. It would be a pretty boring world if we all thought alike. All comments will be welcomed.

There’s also an “About” page here, and a page with my schedule of classes. Thank you for reading my blog!

Peace & Prosperity,

Laura Allen