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CE Providers React to NCBTMB’s New Approval Plan

In the past couple of weeks since the NCBTMB unveiled their new plan for CE providers, which includes doing away with organizational approval, the reaction of providers has for the most part been very negative–and frankly I’m not surprised. The long-standing organizations who are providing quality continuing education approved feel, for the most part, that the organization they have supported for many years is throwing them under the bus.

Some of the main concerns that I  have heard are from providers who have created proprietary classes and who have trained and approved their own instructors to go out and teach their work. They are now faced with the instructors that they have invested time and money in training and marketing classes for going out on their own, taking copyrighted teaching manuals and proprietary handouts with them, and acting as if they are under no obligation pay the percentage or per-student charge that they have agreed to pay as teaching members of the organizations. Those same instructors who have been mentored and marketed under our organizations are now saying “we’ll just be out on our own after 2014.” They are making it clear that they feel free to take our proprietary materials away with them—because the new rules are basically blessing that—and never give the organization that put them where they are another dime.

Those who have organizational approval do not want unqualified people teaching for their organizations and misrepresenting their good names, and have gone to considerable effort and expense to make sure that is not the case. While there is certainly nothing wrong with requiring us to provide proof of that, taking all instructors from under our organizational umbrella and putting them out there on their own is also going to create logistical nightmares. The organization has been responsible for collecting and maintaining registration forms, evaluation forms, etc. and issuing CE. In the case of Upledger, for example, now instead of one organization handling those administrative tasks, there will be more than 100 separate instructors keeping up with that. The organization will have no control and no more quality assurance that they will be able to exercise.

The organizations and schools that sponsor CE workshops at the national, state, and local levels will suffer from these changes as well. This is also financially crippling and over-burdensome to smaller organizations who may not teach that many classes each year. When it comes to education, quality and quantity are not the same thing.

The notion that having people turn in all their lesson plans as proof that they are a competent teacher is also flawed. My publisher hires me to write lesson plans all the time to go with their textbooks and for career schools who want customized plans. I’ve written at least 20 this year alone. If you have the money to hire me, I will write one for you. It still will not make you a competent teacher. A well-written lesson plan doesn’t necessarily indicate that you’re a great teacher; it indicates that you are either a competent writer, or that you hired someone like me to write it for you. Requiring people to send in a video of themselves teaching would be more indicative of whether or not they are competent, since the organization obviously cannot afford to vet every class in person.

In response to the outcry since the NCBTMB announced the plan, they have stated that they will consider some of these issues on a case-by-case basis. I would like to know how they plan to carry that out with volunteers—volunteers whose qualifications to judge us we have no knowledge of, as they are not releasing the names of the people on that committee. Are they experienced educators? Are they trained in teaching methodology? Are the research literate? We don’t know; we can only hope so.

I find it necessary to bring up that the reason the NCBTMB changed from vetting individual classes years ago was because the task became too overwhelming for the paid staff to handle and getting volunteers together to do it caused the process to move at the pace of molasses. It is unacceptable for someone to wait six months—as has been common at several points in time—to get their approval or denial. It is very apparent from the latest 990 filing that the NCBTMB cannot afford to hire new staff and that they will indeed be depending on volunteers until such time as this might generate enough money to enable that. This is one of the service problems that has come very close to knocking this organization to its knees in the past, and they do not need to go backwards instead of forward.

Considering things on a “case-by-case” basis also leaves this organization open to accusations of favoritism, if not worse. The massage community is a tight-knit and close community, in spite of the fact that there are thousands of us. Those of us who are organizational providers tend to attend the same events, and travel in the same circles. What you allow for one, you must allow for all. To do otherwise is simply unethical and unprofessional, and the first time it comes to light, and it certainly will, that any consideration given to one has not been given to all, it is going to be another public relations nightmare for the NCBTMB. I don’t think they can stand to have many more of those.

Let’s look at a few facts.

There are currently a half dozen states with their own CE approval process. The NCBTMB is not the only game in town…and it is that same complacency of thinking that has resulted in the FSMTB kicking their butt with the MBLEx. I would not fall into the mistake of thinking that the Federation isn’t willing to step up and do something about CE approval as well. They may seize upon the dissatisfaction of the current environment; they already have the infrastructure, and big cash reserves at their disposal. The Federation doesn’t “need” the money, and the perception here from providers is that the NCBTMB is trying to bail themselves out of the red with this plan.

There is no evidence to support that regulation, including requiring CE, has contributed to the safety of the public. There have always been unethical and incompetent practitioners, and for that matter unethical and/or incompetent CE providers, and they will continue to exist, regardless of the amount of rules and regulations. Look at how things stand in other professions. There are 17 states that don’t require nurses to obtain CE. There are 10 states that don’t require PTs to obtain CE. Even MDs have 7 states that don’t require them to obtain CE—but all three of these professions are licensed in all 50 states.

Other than the 30 or so of us (including myself) who were present at the meeting the NCBTMB convened in Chicago to discuss this issue a couple of years ago, there has been no attempt to gather the input of the (hundreds of) providers that are currently under the auspices of the NCBTMB.  I believe this organization is in need of our support, not our animosity and distress.

I urge them to abandon this plan, and gather input from a much broader slice of the profession before considering such drastic measures again.

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The Financial Health of Our Organizations: FSMTB

Note: For the past few years I have done a series of reports on the financial status of the non-profit organizations that represent the massage therapy profession. I obtain this information from Guidestar, a financial information clearinghouse for non-profits. The organizations can provide their Form 990 (Return of Organization Exempt from Income Tax) to Guidestar, and if they don’t, the IRS does it for them. I will state for the record that I am not an accountant or a financial analyst; I just report what I see (and maybe offer a few opinions). I usually get asked the question every year why I am not reporting on ABMP. Associated Bodywork & Massage Professionals is a privately-owned for-profit company, and they are not obligated to release their financial information. Non-profits are on a different filing schedule than the rest of us, and there is variance amongst them in when their fiscal year ends. The deadline for filing is the 15th day of the fifth month after the end of their fiscal year. An organization can also request and receive up to two 90-day extensions, and due to the number who haven’t filed yet for 2011, it appears that some of them have done that.

It’s business as usual at the Federation of State Massage Therapy Boards…they’re rolling in the dough, and they appear to be immune to the slow economy. For the fiscal year ending 06/30/2011, they are showing a total gross revenue of over $4.3 million, well over a million dollars up from the previous year. Their total assets increased in a year’s time by almost $1.3 million, while their liabilities went down to less than $16,000—down from over $218,000 the previous year. Their net revenue after expenses is almost $1.5 million, up over $490K since the previous year. Their theme song could be “We’re in the money.”

One difference in the Federation and other organizations is that their Board members do not receive any reportable compensation. The only compensation listed on the form for key personnel is that of Executive Director Debra Persinger, who was paid $196,324 and received an additional $23,039, which is just listed as “other compensation from the organization and related organizations.” I’ve heard through the grapevine that she has received a big raise since this form was filed, but I guess we won’t know until next year.They do show about $24K in other salaries; I assume that is the office assistant. They don’t have a big staff.

I have to say that I find it a little bit funny that they only spent $5500 on advertising. I spent more than twice that advertising my massage business. “Occupancy” is listed as over $19,000; and travel is listed at a little over $14K. While I realize the need to travel to meetings and conventions, I will say one thing. When the FSMTB first came on the scene, they were very critical of the NCBTMB spending the stakeholder’s money holding meetings in fancy places….so I personally think they ought to police themselves a little more. This year, I hear they had a meeting in the Trump Tower in Manhattan–not exactly the Holiday Inn, I imagine.

Other than Persinger’s salary, their primary expenses are over $1.2 million paid to Pearson Vue for exam delivery, almost $900K to PCS for exam processing, and a little over $110K to Meaningful Measurement for exam development.Their office expenses were only about $15K.

No need to bore you with line-by-line details. I’ll just say the Federation is the poster child for being in good financial shape and let it go with that.

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The Financial Health of Our Organizations: NCBTMB

Note: For the past few years I have done a series of reports on the financial status of the non-profit organizations that represent the massage therapy profession. I obtain this information from Guidestar, a financial information clearinghouse for non-profits. The organizations can provide their Form 990 (Return of Organization Exempt from Income Tax) to Guidestar, and if they don’t, the IRS does it for them. I will state for the record that I am not an accountant or a financial analyst; I just report what I see (and maybe offer a few opinions). I usually get asked the question every year why I am not reporting on ABMP. Associated Bodywork & Massage Professionals is a privately-owned for-profit company, and they are not obligated to release their financial information. Non-profits are on a different filing schedule than the rest of us, and there is variance amongst them in when their fiscal year ends. The deadline for filing is the 15th day of the fifth month after the end of their fiscal year. An organization can also request and receive up to two 90-day extensions, and due to the number who haven’t filed yet for 2011, it appears that some of them have done that.

The National Certification Board for Therapeutic Massage & Bodywork has filed their 2011 Form 990 in a timely manner so I’m going to start with them this year. I’ll be following that up with my report on the Federation of State Massage Therapy Boards. The financial status of these two organizations are intertwined for one reason: since it’s introduction in 2008, the MBLEx has taken a substantial market share of the entry-level exam market away from the NCBTMB. For many years, the NCBTMB exams were enjoying a monopoly, except for the few states that require their own exam.

In 2008, the first year that the MBLEx was available, the NCBTMB’s revenue from exams was in excess of $6 million. By 2011, that had dropped to $3,380,813. Instead of a monopoly, they had a 47% share of the market. I confess that I was expecting it to be even less, since the Federation has relentlessly encouraged their member states to use the MBLEx exclusively. I think the fact that the NCBTMB has retained as much as they have is proof that plan has not yet come to fruition. The income at the NCBTMB from people recertifying dropped by a little over $5k, and sales of their exam guide were down about $17k. Sales of their mailing list also took about a $20k hit this year.

They are showing a total revenue of $5,357,738 for 2011. From 2010 to 2011, the NCBTMB’s total revenue went down to the tune of $443,312. That’s not exactly a shocking figure in this time of recent recession.

The 2011 return, due to the timing of the NCB’s fiscal year, reports the salary of former CEO Paul Lindamood; although the filing was signed by his replacement Mike Williams. Lindamood’s compensation and benefits amounted to over $257,000. No word on what Mike Williams is doing the job for. Non-profits have to report the breakdown of compensation of officers, directors, trustees, key employees, highest compensated employees, and independent contractors. All together, the NCBTMB paid out over $1.7 million in compensation during 2011. Their other major expense is over $1.3 million in exam administration fees.

The bottom line is what tells the tale for most businesses–for profit or not–and their net revenue after expenses for 2011 is $227,326 which is down over $240,000 from 2010.When you consider that during Paul Lindamood’s reign at the helm, the organization went from being almost $270,000 in the hole in 2009 to having a net income of over $469,000 in 2010, it looks like it’s time to either slash expenses, the way he did, or generate more money.

That’s exactly what the NCBTMB hopes will happen in the coming year(s) on both fronts. They are rolling out the new rules for national certification, as well as the new rules for continuing ed providers, and doing away with organizational approval. The requirement that each individual be approved as a provider in their own right should generate some additional funds. The new rules for becoming nationally certified, in my humble opinion, is initially going to cause a further decrease for them. Since the new rules are jacking up the education requirement from 500 hours to 750, and requiring 250 hours of work experience, that will automatically disqualify people who might have otherwise taken the exam for entry-level licensing. The NESL is still an option in some states, but with the entry-level exam revenue steadily declining for the past four years, and the MBLEx becoming more firmly entrenched with the member states as time goes on, I’d be surprised if they don’t continue to lose ground in that market.

Their expenses could go back down. The application and recertification processes are online, and that’s going to knock a few staff members out of a job. They spent about $40k more in 2011 attending conventions than in 2010. I feel that they should be present at all major massage meetings, so I don’t begrudge that money…conventions are never held at Motel 6 so unless I’m an invited speaker, I feel that one in my own pocketbook. Legal expenses also increased by about $13k this year, but lobbying decreased by almost that same amount. It does cost money to go in and challenge a state that is considering dropping your exam–or appealing to one that has already dropped it to reinstate it.

On a positive note, total assets increased by about $70k, while total liabilities decreased by about $142,000.

All in all, it wasn’t the best year they’ve ever had–and it wasn’t the worst, either. The NCBTMB has had some administrations in years gone by that seemed hellbent on bankrupting the organization. I feel pretty safe in saying that isn’t the case here; they have some dedicated staff and board members that are determined to make it work, and we’ll just have to wait and see what happens. In the meantime, their new website is very snappy. You can check it out and all the new changes they are implementing at www.ncbtmb.org

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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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North Carolina Rocks the AMTA National Convention!

My husband Champ and I attended the AMTA National Convention in Raleigh this week, and a good time was had by all! Congratulations to all our colleagues in the North Carolina Chapter for pulling off a fabulous event! I’m not going to take any credit because other than teaching and sitting in the House of Delegates, I am afraid I didn’t have the time to do much else. Champ was all over the place helping out….lifting and toting, working in the massage room and whatever else he could do to be useful. Thanks, honey!

On Tuesday, I attended the Board of Directors meeting. Those are open to everyone, and I wish more members would attend so you can see the Board at work. It’s worth the effort. I sat beside Leena Guptha, a past National President, and one of the funniest and warmest people in the world. We had a nice little visit.

Wednesday morning, the Opening Ceremony was fabulous. President Cynthia Ribeiro is a very engaging speaker and her Portugese accent just makes her more so. The keynote speaker was Molly Barker, founder of Girls on the Run, and she was one of the best speakers we’ve ever had, in my opinion. Wednesday afternoon, we had the preliminary meeting for the House of Delegates. I have been honored to serve as a delegate for the past two years, and it is a wonderful experience. During the preliminary meeting, there is always a mock position statement and mock recommendation put forth so new delegates can get the gist of what goes on during the actual meeting. Ken Swenson, Iowa delegate, facilitated the fake recommendation that we should be required to sing a song before every massage, by performing “Rub it In,” and it was the high point of the meeting. You can watch that here.

Wednesday evening, Champ and I attended  the annual author’s dinner hosted by Lippincott, Williams & Wilkins, my publisher. We sat with the ever-entertaining Diana Thompson, former President of the Massage Therapy Foundation, and Mary Beth Braun-Hanson, former President of National AMTA. Also present was Ruth Werner and her husband Kurt, Celia Bucci, Joe Muscolino, Leslie Young Giase, a bunch of LWW folks, and I hope I am not forgetting anyone but I probably am! Ruth shared that someone had called her husband Champ earlier that day–they’re both good-looking, so it was an honest mistake!

Thursday was the House of Delegates meeting, ably facilitated by the awesome Dan Barrow, and John Combe of Oregon did a great job as the leader of the House. Ann Blair Kennedy of SC authored three position statements that passed muster and were officially adopted by AMTA. They are: 1) It is the position of the AMTA that massage therapy can be effective in reducing low back pain, 2) It is the position of the AMTA that massage therapy can be a beneficial part of an integrative treatment plan for those who suffer with fibromyalgia syndrome, and 3) It is the position of the AMTA that massage therapy can help improve sleep. Congratulations to Ann!

Thursday night, the Bloggers had a meetup thanks to the organizational efforts and generosity of Allissa Haines, author of Writing a Blue Streak. Michael Reynolds, Kelli Wise, Katherine Mayerovitch, Lisa Santoro, Christopher and Xerlan Deery, and Champ and I had a big time eating, drinking, and being merry.

Friday morning, I taught Using Research to Market Your Massage Therapy Practice. Friday afternoon, I taught One Year to a Successful Massage Therapy Practice. It was my first time teaching at the National Convention, and I totally enjoyed both classes. Both were very interactive with students sharing a lot, so it was just a great experience.

Friday night, I attended the reception for the Massage Therapy Foundation. I had to duck out early, but I did stay long enough to see the awesome Tina Allen receive the Humanitarian Award sponsored by Biofreeze and Performance Health. A $2500 donation was made to the MTF in Tina’s name. If you haven’t met Tina, she’s dynamite in a small package and the founder of the Liddle Kidz™ Foundation. Please watch this video about her work in Japan, and you’ll see why she is deserving of this award.

I left the MTF reception and went to the NC Chapter BBQ and Beach Music Blast! The National Shag Champions were there demo’ing how to do the shag. The food was good, the music was good, and the fellowship was good. People were dancing out on the sidewalk! I had a great time visiting with friends from all over.

The one black mark on my visit was the fact that Friday morning, I woke up with terrible low back pain, something I actually never have. Usually my aches and pains are in my shoulders, but I was in terrible condition, and I had to teach all day wearing a happy face! Saturday morning, Kathleen Gramzay of Kinessage® Massage through Movement worked on me for about an hour in the exhibit hall, or I probably would not have made it to the dinner dance. She was a great help!

We sat with the other NC folks but of course I had to get up and socialize. I saw a lot of my favorite massage people this week and only got to spend a minute or two with most of them, but I’m so grateful to have seen them all and to have met so many FB friends, a lot of whom were in my classes.

I ran into Jaime Huffman, former President of the North Carolina Board of Massage & Bodywork Therapy. I served on the Board with her for five years and she is the newly elected President of the Federation of State Massage Therapy Boards. I also took the time to stroll up the street to the North Carolina Board offices, since my last Board meeting was in 2010 and I hadn’t seen my friends there in a long time. I had a good visit.

I also spoke with Bob Jantsch, the delegate to the Federation from Pennsylvania, who attended the FSMTB annual meeting in New Orleans just before coming to AMTA. Bob introduced the amendments to restore the original bylaws–and subsequently the balance of power–and although the were defeated this time around, I personally applaud Bob for having the guts to get up and start the ball rolling. The opera ain’t over ’til the fat lady sings, and I can just about guarantee that this one isn’t over. Bob is also in the AMTA House of Delegates, and I must say he knows the drill! Bob has served this profession in many ways over the years and kudos to him.

All in all, this was one fabulous week. I’ve attended about ten national conventions, and this was one of the best. Thank you so much to all the folks who came from far and wide to attend–we hope you enjoyed North Carolina, and we all enjoyed having you!

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Politics and Cliques

This week’s blog is about the elections at the upcoming Federation of State Massage Therapy Boards annual meeting in New Orleans on September 27-29. Who gets chosen to serve on the Board of Directors of this organization is important, because FSMTB controls the administration of the MBLEx– the primary licensing exam in our profession, and is in the process of trying to adopt new national standards for continuing education.

These upcoming elections are shaping up to be a joke, and a bad one at that. I reported last week on the bylaw changes that have resulted in handing over all the power that should belong to the Member Boards to a 3-person Nominating Committee, removed the Delegates’ rights to nominate anyone from the floor, took the power of choosing officers out of the hands of the Delegates and put it into the hands of the Board of Directors, and extended the total length of time a Board member can serve to three 3-year terms.

I don’t know who the Nominating Committee has chosen as their “slate” candidates, but I can tell you some of the people they have overlooked. Two of them are sitting members of the FSMTB Board of Directors: Phyllis Salyers of Tennessee and Billie Shea of Nevada. Both are eligible, and as far as I can tell, both are qualified. Shea was in fact just reelected as the Chair of the Nevada State Board of Massage Therapists for the seventh time. Salyers has been off the Tennessee Board of Massage Licensure for about a year, but still acts as a consultant to the Board and under the Bylaws of the FSMTB is still eligible to serve two more terms. Since they were elected the first time, one assumes that they both still possess the skill sets necessary to the job. Since both have been faithful servants to the organization, you have to wonder why they have been passed over for another term.

Another person who didn’t make the cut is Mark Dixon, currently serving as Vice-Chair of the California Massage Therapy Council. Dixon has been a massage therapist for almost 25 years and his list of qualifications and past service to massage organizations would be another whole blog. He is genuine leadership material, yet he was not even granted the courtesy of an interview by the Nominating Committee.

I actually have the biggest issue, not with the candidates, but with the Bylaw change allowing the Board of Directors to serve three 3-year terms. Since Board members can continue to serve after their service to their state massage board is over, this could effectively result in the entire Board of Directors being composed of people who are no longer on their state boards. I don’t think that was the intent of this organization when it was started–and their very name indicates that.

The issue, to me, is that when you are no longer on a state board, you are no longer obligated to follow the agenda of that board, whatever it may be. In fact, as a non-board member, you are in all likelihood not even privy to the goings-on behind closed doors when there is an executive session.  You can have your own little agenda, and that’s what I find disturbing. Due to the various election schedules of the FSMTB Member Boards, I am not suggesting that anyone should be thrown off in the midst of their term, but I think serving out that term is the way to go–and then let another sitting board member have that position.

So, here we have no nominations from the floor; a 3-person committee deciding who is best for the job instead of all the delegates from 42 Member Boards getting to put forth someone they might like to nominate; two sitting members denied another term in spite of their service and qualifications and bylaws that currently allow them to serve; a well-qualified applicant denied; and bylaw changes that are totally contrary to what is in the best interests of the state boards.

Out here in the heartland of the massage therapy profession, we’re counting on our colleagues who do the usually thankless job of representing state boards to do the courageous thing here. I will make another plea for the Delegate Assembly to stand up at the annual meeting, say that this is not acceptable, and to propose amendments to the FSMTB Bylaws that restore an appropriate balance of power and authority.

 

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Massage Therapy: Integrating Research and Practice

I have never before devoted my blog to a book review, but I’m doing that this time, because (other than my own books, of course) I think this is one of the most important books that has been published for our profession. I’m speaking of Massage Therapy: Integrating Research and Practice, edited by Trish Dryden, MEd, RMT of Centennial College, Toronto, and Dr. Christopher Moyer, PhD, of the University of Wisconsin-Stout, Menomonie. This book was published by Human Kinetics and has only been out for a few months. I got my copy about a month ago, and I’d like to see one in the hands of every massage therapist, every student of massage, and in particular, every massage therapy educator.

The contributors to this book are an impressive group of people. Besides Dryden and Moyer, there are contributions from Janet R. Kahn, PhD, LMT, who has one of the most impressive resumes in the galaxy, culminating in a recent appointment by President Obama as a Member, Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Diana Thompson, LMP, former President of the Massage Therapy Foundation; Bodhi Haraldsson, RMT, Research Director at the Massage Therapists Association of British Columbia; Albert Moraska, Assistant Professor of Research at the University of Colorado at Denver, and a couple of dozen other highly-educated people with an interest in the evidence-supported practice of massage therapy.

The layperson sometimes panics at the word “research.” People get the erroneous idea that they can’t read, much less conduct, a research project unless they have a doctorate in elementary statistics. Although this book introduces some complicated (at least to me) concepts, they’re broken down into plain enough language that anyone can understand.

The explanations of qualitative and quantitative research methods, as well as mixed methods of research, has enlightened me. I don’t mind saying that while I have supported the Massage Therapy Foundation to the best of my ability, and been a vocal proponent of the evidence-informed practice of massage for the past few years, I realize after reading this book just how in the dark I’ve been about the particulars of what actually constitutes valid research.

The main purpose of the book is to introduce massage therapists to the various concepts of research, and how to apply that information to your every-day practice of massage.  There is a whole section, Populations and Conditions, that contains chapters on working with pediatric clients, pregnant clients, athletes, geriatric clients, and adults with a history of sexual trauma. The conditions that are covered include back pain, headaches, neck and shoulder pain, fibromyalgia, cancer, and anxiety and depression–the things that we are all confronted with on a regular basis.

Ruth Werner, current President of the Massage Therapy Foundation, contributed the Foreword to the book. She states the five crucial things that this book addresses:

1. It makes the compelling case that research literacy is a necessary skill even among entry-level massage therapists.

2. It introduces key concepts in a way that is both simple and accurate. Werner states that “As a teacher of a complex topic, I know how often the tipping point between simplicity and accuracy is narrow indeed.”

3. It emphasizes the application of research by giving clear examples of tying published findings to everyday practice scenarios.

4. By emphasizing the practical application of research findings, it acknowledge the importance of the feedback loop that must exist between clinicians and researchers.

5. It lays the groundwork for its own future development as the mass of evidence about massage therapy continues to grow.

Every time a client comes out of the treatment room and says “I feel better,” yes; that’s evidence. However, resting on those kinds of laurels is a big mistake, in my opinion. There are many massage therapists (other than myself and the contributors to this book) who want to see massage therapy gain the respect we think it deserves. The way to do that is research, research, research, and more research.

We don’t all have to BE researchers. We DO all need to know where to find it and how to make heads or tails out of it. Massage Therapy: Integrating Research and Practice, is the only book that I am familiar with that explains it so that those of us who are not scientists can understand it. I urge you to get this book. And as I mentioned earlier how important I think this is for massage therapy educators, let me go a step further and say that if you are teaching in a school that does not address the need for research literacy, then you be the change in that. It is doing students–not to mention the massage-seeking public–a huge disservice to ignore the subject.

While I’m on the topic, The Massage Therapy Foundation has a free toolbar you can download from their website to keep in touch with the latest research developments. Research costs money. I encourage you to donate to the Foundation in whatever amount you can afford to give. Every dollar helps.

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Report from the World Massage Festival

I just returned from attending the World Massage Festival in Las Vegas, and what a blast! I’ve been attending this annual event for several years, and this was the best one yet. My husband, Champ, accompanied me, and we really had a fabulous time. This event is like a family reunion every year, so I really enjoyed seeing so many people I know and don’t get to see often. The Festival was held at the Tuscany Casino and Hotel, which turned out to be a wonderful place…I think my suite was as big as my house.

We arrived on Sunday and I spent the afternoon helping out at the registration desk with our fearless ringleader, Cindy Michaels. Cindy is Mike Hinkle’s better half; Mike cooks up all kinds of great ideas and Cindy puts them into action.  Jenny Ray and Janelle Lakman, the Sacred Stone Medicine ladies, were also working registration so we all had a big time visiting in between. Sunday night was the Hall of Fame ceremony, emceed by Judi Calvert, and it was very enjoyable. This year’s honorees are Cindy Ballis, Karina Braun, Eric Brown, James Charlesworth, Scott Dartnall, Robin Fann, Irene Gauthier, Sally Hacking, Ryan Hoyme, Andrea Kelly, David Kent, Mark Lamm, Paul Lewis, Rena Margulis, Karen Menehan, Angie Patrick, Donald Peterson, Sharon Puszko, Art Riggs, George Skaroulis, Kevin Snedden, Cherie Sohnen0Moe, Les Sweeney, and Ruth Werner.

Monday morning, I was honored to participate in a Student Day panel with Lynda Solien-Wolfe, Cherie Sohnen-Moe, David Kent, Joe Bob Smith, James Waslaski, David Otto, Ryan Hoyme, Michael McGillicuddy, and Angie Patrick. I hope I didn’t forget anyone! The students were so appreciative; all got a goody bag, there were lots of door prizes, and one lucky soul got a starter kit–massage table, massage chair, rolling stool, bolster, sheets, and all kinds of products.

Monday afternoon, I taught my Educated Heart ethics class, which was well-attended by a great bunch of therapists. Champ and I had dinner with Lynda Solien-Wolfe and Joe Bob Smith and we had a great time.

Most of the day Tuesday, I spent in the exhibit hall. I worked a little in the Sweet Serenity booth–speaking of which–I was determined to win the fabulous quilt so I bought 30 tickets. All the proceeds went to the Shriner’s Burn Center and over $1200 was raised, last time I got the count. Ryan Hoyme and I did a book signing of our new Manual for Massage Therapy Educators. I woke up with a crick in my neck, and James Waslaski and Bruce Baltz both worked on me. We had lunch with Bruce and Ryan and Yvette Hoyme. Tuesday night was the awards ceremony. David Kent was the keynote speaker and he did a fabulous job. David is an emotional speaker. Enid Whittaker jumped up on a massage table and did a Bonnie Prudden warmup and she was great! Vivian Madison-Mahoney received the Legislative Award. ABMP was honored as the Association of the Year (again!). The wonderful Michael McGillicuddy was named Teacher of the Year. I was personally surprised with receiving the Distinguished Service Award. After getting home at 1:30 this morning, I am going blank on the rest of the winners, but I’ll be sure to announce them on FB as my memory returns!

By Tuesday night I was feeling slightly under the weather. I slept in Wednesday morning, and Champ attended James Waslaski’s Pelvic class in my stead. He loved it. I ended up having a late breakfast with Judi Calvert, owner of Hands On Trade Association and the premier massage historian of the world. At noon, when all the classes broke for lunch, the drawings took place. One lucky winner received an Office Makeover package worth over $11,000–and I did indeed win the quilt! I was thrilled to death!

I would have to say that the highlight of my trip this year was meeting Mark Lamm of Bio Sync, and his beautiful wife Leah. Mark has been my FB buddy for several years, and I was shocked to find out that he is 84 years old. He looks at least 20 years younger than that and is just one of the most vibrant people on the planet. He did some work on my aching shoulder and it was amazing. HE is amazing. Leah and I snuck out to the restaurant for a little while and I felt as if I’d known her my whole life. They are both just beautiful people. Mark is committed to teaching at the Festival in 2015. I’ll be there!

Other highlights, and there are just too many to name, but I was glad to see my buds Scott Dartnall, Eric Brown, Christopher and Xerlan Deery, catch up with Lori Ohlman of the NCBTMB, Dari Lewis, Stephanie Beck, the totally awesome Judith Aston, and all the other folks I only get to see once or twice a year. The vendor hall was jumping this year…I got a few goodies myself! I also met a few of my FB buds: Andrea Lipomi, Bert Davich, Rob Flammia and saw some of my NC peeps, too, like Jake Flatt.

Wednesday night, I attended the Board meeting of the Massage Therapy Alliance of America. I’m not on the Board; I just take care of their website, but I love this group of dedicated people. They are stewards of the Hall of Fame and advocates for the rights of massage therapists. Then we had a late dinner with Mike and Cindy, Darcy Neibur and her husband Dennis, and Mike Hinkle’s parents, who are always helping at the Festival.

The World Massage Festival is come as you are. Leave your suit and tie behind and be casual. The instructors and class offerings are top notch, the price is as low as they can possibly keep it, and the atmosphere is all about family and friends. The 2013 Festival is being held on the Queen Mary in Long Beach, CA. I will definitely be there!

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I’m in Pain

Yes, I’m in pain. Believe it or not, it pains me to write negatively about the National Certification Board for Therapeutic Massage & Bodywork. I am personally acquainted with many of the people who work there, from the CEO, Mike Williams, on down, to Board members, staff members and volunteers. I count some of them among my friends. I know for a fact that they are dedicated and hard-working people.

I’ve been NCTMB since 2000 and an approved provider of CE since 2002. I’ve seen the ups and the downs of the organization: the days of great service, and the days of bad service. I’ve seen the leaders who had the best interests of the profession at  heart–and one or two who were on a personal mission to bring down the organization with their wild spending and lack of professional ethics. And I’ve seen–and even been a party to–some of their missteps. A couple of years ago when they announced an advanced certification exam, I signed right on. I even appeared in an advertising campaign for it, along with quite a few other well-known massage therapists, educators, and even some illustrious physicians. The failure of that project, I believe, was because it was a general thing, and not a specialty certification–which the profession has been requesting for quite some time.

CEO Mike Williams responded to my Wish List blog last week. I met Williams at the AFMTE meeting a couple of months ago and spent a very enjoyable couple of hours talking with him one-on-one. I hear (from other folks, he wasn’t bragging) that he has a proven track record of helping floundering organizations get back on track. He even joked to me that he had learned everything he needed to know about the NCB from reading my blog.

You can’t please all of the people all of the time, and I know that just from the comments I receive on this blog. However, distress at their latest action seems to be shared by more than a few people. The NCBTMB sent out an application for a new assigned school code to massage schools this week. Now, the organization has required a school code since the beginning; it’s just a number that students must include on their application to sit for one of the NCB exams, and it is supposed to demonstrate that the school is legitimate. That’s good in theory; and I think the original intent was to keep schools and/or individuals from falsifying diplomas and transcripts.

A number of school owners went up in arms this week when they received the application. True, it is just seven pages long, and that’s way less than what is required for a state board school approval or COMTA accreditation…but therein lines the issue: except for the schools in the few unregulated states, these schools have already been approved by their state boards, and in some cases, one or more accrediting bodies as well.

One school owner on my FB page said “We are opting out. The list of required paperwork is oppressive. Our school is now sending them all off to the Mblex. It’s moves like this that, in my opinion, will seal the deal of completely making the NCBTMB irrelevant. We had a school code with them, we maintain state approval which can be verified easily on the state website. The additional hassle which this organization seems to thrive on is over my tolerance level.”

Another sore point is the human trafficking angle. Now, I don’t think anyone is in favor of human trafficking except the people who are making a living off of it. As background, there has been legislation introduced in a few states requiring massage establishments to post notices about human trafficking–something that isn’t required in a convenience store (in other words, they’re picking on us again, supposedly because massage is a business in which it’s a big problem). On their 2010 990 filing, the NCB reported giving a $5000 donation to the Polaris Project, which fights human trafficking. They also started publishing brochures about human trafficking and selling them (at 2.50 for 25 of them, I don’t think they’re getting a big revenue stream off of that).

On the application that came out this week, school owners are being asked to sign a pledge about not participating in human trafficking, and doing whatever they can to stop human trafficking. I got calls from a few people that were upset about that; they stated to me that the NCBTMB was overstepping its boundaries and giving a false impression of having regulatory or law enforcement authority. Personally, I think any entity donating money to the Polaris Project and doing their part to fight human trafficking is admirable, but as someone on my FB page pointed out, is there really any school actually participating in such a thing that wouldn’t just sign the pledge anyway? It’s like asking people if they use illegal drugs on a job application. No one is going to write down that they have a cocaine habit, are they?

On the NCBTMB website, there are a couple of dozen schools listed as having their school code suspended, revoked, or denied. The reasons are not given, so one doesn’t know whether they were found to be participating in human trafficking, running a diploma mill, or what.

In his response on my blog, CEO Mike Williams talked about the forthcoming improvements from the NCB. Let me say, as much as it pains me: different singer, same song. I must make it clear that I have wanted this organization to survive, and thrive, but I am very concerned. And as Angela Palmier pointed out in her comments, people laughed when there was talk of another entity creating a licensing exam. In the meantime, the MBLEx has proceeded to saturate the market and it will just continue to get bigger and bigger–even if the NCBTMB steps in to challenge the states’ right to choose, like they did last week in Tennessee. They did actually prevail there, but at what cost? The Board members were upset, the GR rep from AMTA was upset, and in the end, the decision for the Board to acquiesce was based on their desire not to see their other impending legislation get scrapped in the crossfire.

In addition to the FSMTB sticking their toe in the water to test the profession’s reaction to their CE plan, I’ve recently been contacted by several people about starting (yet another) CE approval body. It wouldn’t happen overnight, but there’s no reason to think it can’t be done. For that matter, there is nothing to prohibit another entity from starting another certification agency….just like there are numerous accrediting agencies besides COMTA. It could happen.

I don’t doubt that the NCB has good intentions–but as we all know, good intentions are sometimes misguided. Placing an additional and very unnecessary burden on school  owners is misguided and the perception is that it’s one more example of duplicated efforts in this profession. Challenging state boards is misguided. The NCB needs all the public support they can get, and that isn’t winning them any friends. It is creating ill will, period. Hanging on to entry-level licensing instead of focusing on  becoming the one true certification agency is misguided. That’s my story and I’m sticking to it.

 

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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?