Category: Ethics

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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 Board and 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 COMTA approval. 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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A Betrayal of Trust

Any time one of the major organizations in the massage field tries to fire up a project that will “advance the profession”, I get awfully suspicious. When a group of them get together to do something on the big scale, I go on full nuclear alert. That’s the case right now with a dubious education standards project introduced by ABMP in September 2011 at the Leadership Summit in St. Louis, which I detailed in my previous post, Behind Closed Doors.

As the title of that blog suggests, 100% of the activity surrounding this project has taken place in secret, with no information about the project being released to the massage therapy community—and no opportunities for review or comment before time, money and human resources are thrown at solving a perceived problem.

AMTA and FSMTB have signed on to this project, which will involve gathering information from the Federation’s upcoming Job Task Analysis survey, to use in a process that will “identify the rudimentary knowledge, skills, and attitudes required to pass a licensing exam and provide basic, but safe, massage in an early massage career.”

That doesn’t sound like a such bad thing—in and of itself—but the group intends to use this data to create an “evidence-based minimum educational requirement” for state licensing. This would be used as a rationale for changing state laws, and would likely be used to drive the curriculum standards for entry-level massage programs—basically telling schools what to do.

Goodness knows, there is a lot of inconsistency in massage education and regulation, but there is no problem in our profession that justifies one or a group of our so-called “stakeholder organizations” seizing the ball and marching down the field without our input or permission. I don’t give a rat’s you-know-what if they claim to be doing this in our best interests; this power play is a gigantic betrayal of trust. And I might add that I am personally in favor of the evidence-based practice of massage, but I don’t think one tiny group of people should get to decide what that is.

I’ve not yet been able to confirm the status of NCBTMB, Massage Therapy Foundation, AFMTE or COMTA as it relates to this project (mum’s the word all around). These four organizations, along with ABMP, AMTA and FSMTB just gathered on May 1-2 for another Leadership Summit—this time in Chicago. I’m taking bets that they will issue another sanitized press release that gives us regular folks in the bleachers little substance about what really happened in this meeting that has the potential to alter the very nature of our profession.

The only other info I’ve been able to glean is that ABMP, AMTA and FSMTB hand-picked a new workgroup of massage educators and other “experts” in instructional design and curriculum development to start this project on May 3-4, right after the completion of the Summit. Are you kidding me? Where was the public notice of this opportunity to serve on a panel that will influence the future of massage therapy? Who gave these organizations the authority to do this on our behalf?

No one. They took it on themselves, and that’s what stinks to high heaven.

In stark contrast, the Massage Therapy Body of Knowledge project had both fans and detractors, but it was carried out with a reasonable amount of transparency. The majority of the dissent on the project concerned the inclusion of energy work in the document and dissatisfaction with the way objections were handled—or not handled—in favor of evidence-based practices. The five organizations that comprised the MTBOK Stewards (ABMP, AMTA, FSMTB, MTF, NCBTMB) did a good job of not interfering with the project once it was launched.

Right now, we have a genuine crisis on our hands. The problem is that hardly anyone knows about it. This blog only goes so far. I never set myself up to be the New York Times of the massage field, but it seems like the major massage publications are afraid to get their teeth into the real breaking news that affects the practitioners, teachers, CE providers and schools that make this profession possible.

Friends, it’s up to YOU to let these organizations know that it’s not OK for them to act in your interest without your permission. As long as these “leaders” think they can get away with it, they will. Trust has been blown out of the water, and it will take a concerted effort to rebuild it.

A really good first step would be for ABMP, AMTA and FSMTB to release a full description of the project, including what they plan to do, how it will be done, who sits on the new workgroup, what the timelines are, and what money will be spent. And most importantly, we want to know what they intend to do with the “evidence”. When organizations that represent us are making major decisions that affect us, we deserve to be involved in the process.

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Behind Closed Doors

From the title, you might think this blog is about The Client List, the trashy new show on the Lifetime Channel that gives massage therapy a black eye. No such luck; the event I am referring to is the upcoming Leadership Summit #2, set to take place next week in Chicago.

The first Leadership Summit (to clarify: there were summits in 2003-04 before AFMTE and FSMTB existed) took place last September in St. Louis, with the executive directors and chairs of ABMP, AFMTE, AMTA, the Massage Therapy Foundation, FSMTB, COMTA, and NCBTMB in attendance. It was a historic event in that it was the first time all seven of these organizations had come together in the best interests of the profession. The purpose, according to the press release announcing the meeting, “was to hold a beginning conversation about major structural issues and impediments to profession progress. The desire is to have candid exchange about core challenges, quality concerns, consumer expectations and organizational roles.”

Apparently, one of the hot topics at this week’s meeting is going to be the number of required entry-level education hours. Although this was not on the agreed-upon agenda at the first meeting, it was introduced anyway by ABMP Chairman Bob Benson, complete with a thorough proposal prepared by Anne Williams, Director of Education at ABMP. Basically, the proposal was for a task force to be formed immediately, and using Job Task Analyses that have been conducted by the NCBTMB and the FSMTB, to nail down a definite number of hours that should be required for entry-level education. This was contrary to the facilitator’s recommendation—and the group’s agreement— that they would spend the initial meeting identifying problems, and would address possible solutions for these problems at meetings to follow.

In the interest of the leaders being comfortable in speaking freely, these are closed meetings—no press and no other staff members in attendance—an executive session, so to speak. Certainly not without precedent; boards have executive sessions all the time—usually to discuss personnel matters or other things that would violate someone’s privacy if they were discussed in public.

That’s not exactly the case here; and while I am thrilled that our leaders—some of whom are from competing organizations—are sitting down at the table together, my concern is that a small group of people has the power to decide (or worse, just think they have the power to decide), what is best for the profession on the whole, without getting input from the people it affects—you and me. Practitioners, school owners, teachers, CE providers, the regulatory community, all have a vested interest in the future of our profession, and I don’t think that should be decided by an exclusive group behind closed doors.

Unfortunately, that is just what the ABMP proposal states in no uncertain terms. Verbatim, Williams’ proposal stated: There is no step in this proposal to obtain input from the broader massage profession or from other health-care or bodywork organizations during this project. The reason is simple—the work group is simply performing a work task in writing learning outcomes and objectives for job tasks defined by surveys already conducted by FSMTB and NCBTMB. It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught. The work group would be responding to what therapists report they do, on a day-to-day basis, in their massage-related environments as part of their jobs.

The sentence that disturbs me there is “It doesn’t matter what stakeholders, or other groups think should be taught or shouldn’t be taught.” Any time you start to think it doesn’t matter what stakeholders think, there’s a problem, in my humble opinion, no matter what the issue. Stakeholders are the ones it will affect, and to think their opinion isn’t important is just beyond the pale.

At the recent ABMP School Issues Forum in Austin, Texas, Bob Benson stated to those in attendance that there was 100% consensus in support of this standards-setting proposal from the organizations that attended the Leadership Summit. That’s not exactly so. COMTA, FSMTB, and AFMTE all expressed concerns after the proposal was introduced in September; they are not petty concerns, and they do not appear in any way to be based on politics or turf wars.

This is bad business for two primary reasons: First, any project that has the potential to affect the entire massage therapy profession should not be designed, approved, and launched in secret. Changing the baseline numbers of entry-level education required for state licensure is a huge thing, as it will affect schools, regulators, and future students.

By contrast, the MTBOK project modeled appropriate transparency, and the massage community had adequate opportunities for input along the way.

Second, it is more important right now that our primary stakeholder organizations learn to work together in an atmosphere of trust and cooperation—than to plunge headlong into a major problem-solving project when consensus has NOT been reached. The end does not justify the means. Some of my own issues are that the MTBOK and the competency-based curriculum standards set forth by COMTA aren’t even being given consideration. This proposal also overlooks the fact that the AFMTE is currently working on a National Teacher Standards Education Project. A huge amount of work has gone into creating both the MTBOK and the COMTA standards; a huge amount of work from some of the best educators in the business is going into the AFMTE project, and for these to be cast aside when they have direct relevance to this proposal is irresponsible to say the least.

During our troublesome economy of the past few years—and it doesn’t appear to be over yet—school owners have been seriously affected already, and having a nation-wide upheaval based on an “official” number of required hours is not the be-all end-all solution to licensing portability. It will just serve to put an additional burden into the mix at the present time. The lack of portability may be an irritant to our field, but it is not causing harm to the public.

The AMTA Board of Directors voted last October to support the project in its present form. As ABMP and AMTA are the two largest professional membership associations, they carry a big stick. That doesn’t mean their agendas should be force-fed to the profession, and I hope that they will reconsider both the timeline, and the very valid concerns raised by the other organizations before barging ahead with this project. I am certainly not saying that it never needs to happen. I am just saying it doesn’t need to happen on speed-dial until all of these issues have been ironed out. I hate to see good intentions canceled out by unchecked enthusiasm for rushing something to market; I hate to see valid concerns from the other organizations swept under the carpet; and I hate to see the opinion that what the stakeholders think doesn’t matter.

When you’re meeting behind closed doors, it’s easy to forget who the stakeholders are. I’m one of them. I’m a member of both AMTA and ABMP, a founding member of the AFMTE, a past delegate to the FSMTB, a Nationally Certified Massage Therapist & Bodyworker, an Approved Provider under the NCBTMB, and a current site reviewer for COMTA, so I do indeed have a vested interest. I don’t appreciate our national organizations acting as if my opinion and that of the other thousands of massage therapists, school owners, and others who enable your very existence on this planet don’t matter.

At this week’s Summit, the representatives of these seven organizations have an opportunity to address this issue that has divided the group, and to get their process back on track. I hope that they also remember the responsibility that they have to their own members, and to the profession as a whole. To use ABMP’s own slogan here, we “Expect More” from our leaders.

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CAMTC Responds to “Money Grab” Accusation from Massage Today

Update 09/19/2025: Massage Today was a long-standing industry publication that was bought by AMTA several years ago. The publication no longer exists, but there are some of the articles archived on the AMTA website. Most deal with anatomy, techniques, and business. No editorials or blogs are archived, so the article this blog refers to no longer exists. Lo these many years later, I agree with Peterson and the CAMTC is STILL on a money grab. The original blog is below:

Last week, Massage Today President Donald Peterson published an article entitled The CAMTC Money Grab. It cast the CAMTC in a very unfavorable light; to make a long story short, it appeared to expose excessive financial wrongdoing at the organization by stating that the CAMTC was paying the expenses and per diem for no less than 14 board members to attend the American Massage Conference. The AMC is a moveable event that is held each year in a different location, and this year’s event was taking place in San Diego.

Peterson backed up his claims of financial excess with a table showing who voted to spend the money and who didn’t, and also stated that Massage Today Senior Associate Editor Kathryn Feather had actually been on the CAMTC conference call when the vote was taken about spending the money. The criticism was that although it was not unanimous, that for the most part the people who voted to spend it were the people who were going to receive it. In reality, that’s the way it goes on all boards; board members vote on things, and that includes where and when to attend events and how much money will be spent on it, so there’s really nothing unusual about that.

I shared this article on my Facebook page, and immediately started hearing from board members of the CAMTC that Peterson’s story was very biased and not telling all the facts. Since I initially shared it and contributed to giving a bad impression of the organization, I made the offer to them that I would give them equal time on my blog to present their side of the story. The fallout from this has been swift, not the least of which is the resignation of Keith Eric Grant from the magazine, which he has been contributing to since 2002. Grant is a CAMTC board member, and someone I  have admired as a writer, a scientist, and a person from afar. He has been blogging about the politics of massage way before I started. I haven’t had the opportunity to meet him in person, but we have been FB friends for several years, and as I stated on my page, I would believe pigs would fly before I would believe that he would misrepresent the truth.

Grant’s response to the Massage Today article can be read in its entirety here.  Note: Grant’s response is still on his website. 

I also immediately heard from Joe Bob Smith, another CAMTC board member, whom I have personally met several times. Joe Bob’s response to my sharing the article on FB was this:

Laura, sometimes your quick fingers get something going without hearing from the other side. As a CAMTC board member, I believe that Massage Today wrote a biased piece with missing and incorrect information. I’ll be happy to defend the actions of the board any day. The CAMTC is made up of 20 terrific volunteers, many working massage therapists themselves. They put a lot of their own time (and time is money) into this organization. Many will be losing money by volunteering at the AMC. They deserve to be reimbursed for out of pocket travel expenses when on board business. And the per diem limit is $211/day (standard government established rates) which includes hotel, not just food. The CAMTC has a very proactive, working board that has done a lot to curb prostitution and human trafficking in the two and a half years it’s been in existence. I do hope you’ll seek me out next time you hear of CAMTC news. While we all have differences of opinions, I would like to make sure the other side gets at least equal opportunity.

I also heard from Mark Dixon, Vice Chairman of the CAMTC. His response to my offer to tell the CAMTC side of the story is printed here verbatim, and was actually his response to Kathryn Feather’s questioning him as to why he voted to support the members being reimbursed, and what his duties would be:

The importance of attending this meeting and interfacing with those attending is reinforced by my continuous attendance at national and statewide conventions of this type since 1975. My comments are strictly related to the question asked, and are about my own participation. It’s not hard, though, to extrapolate that purpose to the other volunteers who will attend the AMC.

Regretfully, CAMTC’s CEO, Ahmos Netanel, has been asked to return his attention to more pressing issues affecting CAMTC, and is unable to reply to your offer.
 
My response to Kathryn:
 
As I stated during the debate, I’d agree with the two other entities in disagreement if the event were anywhere but in California. But in San Diego there will be roughly 2000 local massage therapists and affiliated bodyworkers in attendance who either provide or manage massage services. In addition, the venue provides a valuable opportunity to network with influential individuals from around the country who have expressed strong interest in California’s unique massage regulation; in short, a chance to learn, teach and network in a setting that rarely comes to our state.
 
My specific duties include but will not be limited to meeting with counterparts from other state boards and professional organizations, directing participants to the specific part of the CAMTC that is most helpful to them, assisting with coverage of our exhibit, and following up/developing contacts during the years to come. I expect to be on duty from Friday morning to Sunday afternoon and plan to take one three-hour class at my own expense.
 
As the first meeting of this type attended by the CAMTC, I believe the small investment is a sound one that will place experienced, knowledgeable professionals before an important audience. I’ve been working meetings of this type since 1975, and have learned that a highly concentrated group of individuals in a convention setting affords an excellent opportunity to save considerable expense of travel and lodging.
 
Even so, as a volunteer I stand to lose considerably more in income than the reimbursement. Moreover, I attended last month’s AMTA-CA Chapter Educational Conference, representing CAMTC in continuous meetings throughout the weekend. I received zero reimbursement.

 

Although as Dixon said, CAMTC Executive Director Ahmos Netanel was too busy to reply to my offer to personally tell the other side of the story, Massage Today did print an e-mail that he sent to Peterson in response to the article. It is quite lengthy and can be read in its entirety here.

In summary, Netanel accused Massage Today of misrepresenting the facts in a biased and inflammatory way, and withholding information that would have cleared up the accusations to begin with. By the looks of Netanel’s rebuttal, this article would probably have never gone to print–at least not in its present form–had his responses been considered before the magazine went to press.

Since I’ve been accused of being inflammatory myself–and rightly so, at times–and because I shared the Massage Today article on my FB page, I felt compelled to present the CAMTC side of the story. In fact, Keith Eric Grant and Joe Bob Smith have both occasionally called me on the carpet over something, and I don’t resent that. Although I certainly have my own opinions and biases, it is never my intention to be so biased that I can’t see both sides of the story, or at least give them equal consideration. And like a lot of things, there’s one side, there’s the other side, and somewhere in the middle is the actual truth.

I will also state, in the interest of self-disclosure, that during my five years on the North Carolina Board, I was sent to several conventions on their behalf, and they paid my way. Board members on any board generally give up their own time to volunteer when they could be making substantially more money than the per diems allowed by boards (and in fact some don’t pay a per diem at all), not to mention their time away from their own families, businesses and other activities in the interest of service to the organization. I’m the office manager/receptionist at my own office, and every time I attended a board meeting, I had to pay someone to take my place. My per diem ($100 per day) didn’t come close to covering that, or the inconvenience of driving almost five hours both ways to attend a meeting. While it’s true that there is always going to be some abuse taking place somewhere, I believe that’s the exception and not the rule, and I don’t think this particular incident was a case of abuse of board funds. Mark Dixon quoted the late great Paul Harvey, who always signed off by saying “and there you have the rest of the story.”

My blog is my own opinion, and should not ever be considered to be the opinion of anyone else.

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Inquiring Minds Want to Know

I’ve spent the past couple of weekends teaching at AMTA meetings; first in SC and this past week in Alaska. One of the classes I taught at both meetings was “Using Research to Market Your Massage Therapy Practice.” I’ve been on my research soapbox for a while now. The big question is, “Who gives a flip about research?” My answer to that is, inquiring minds want to know.

Except when they don’t want to know. Consider this: IF research validates an idea, a theory, or a belief you’ve had, doesn’t that make you happy? Don’t you want to give a thumbs-up and shout “Yes! I knew it all the time!” That would make anyone feel good, wouldn’t it?

So when research shows something that’s contrary to what we believe, we don’t like that. We don’t want to accept it. We don’t want to listen to it. We want to act as if it doesn’t exist, or that it applies to everyone except us.

I’ve been surfing PubMed this afternoon and reading interesting studies. I don’t have any research to back it up, but my educated guess is that maybe, just maybe, 20% of massage therapists actually read research studies…or even know what the difference is in a peer-reviewed study performed within the parameters of scientifically accepted procedures, as opposed to website hype making all kinds of unfounded claims.

I’ve also been on a roll lately looking at some of the more dubious products that are out there that massage therapists buy into, and foist upon the uninformed public. Some of my favorite (NOT!) claims are: Causes detoxification. Regulates the endocrine system. Flushes your lymphatic system. Gets rid of cellulite once and for all. Causes you to lose weight without making any effort. Contains negative ions. Balances your chakras while simultaneously regenerating your brain cells and your liver and revitalizing your sex drive. Makes your body totally alkaline. Connects more strands of your DNA…I could go on all day, but you get the picture.

Most people, if they’re going to buy a new car, do a little research…they want to know the gas mileage, the safety rating, the bells and whistles they get for the money they’re paying. And they wouldn’t buy a house without checking out the foundation and whether or not there’s mold in the basement. But the same people will buy some whacky, over-priced gizmo that doesn’t have any basis in reality and couldn’t possibly do all, if any, of what it claims to do, without doing any research at all, other than reading the hype that appears on the website or listening to the sales pitch at a multi-level marketing meeting.

The sad thing is, I don’t think most of these people are just seeing the dollar signs and thinking about how much money they can bilk clients out of. They just fall into believing these things actually work.

The Code of Ethics states that we are to avoid giving treatment when there is no benefit to the client and the only benefit is our own financial gain. It would serve everyone to think about that the next time they’re tempted to spend money on frivolous products with no proven benefits. If YOU want to lay out the big bucks for something and use it on YOURSELF, that’s one thing, but when you make claims to clients that this (machine, product, supplement, etc) is going to change their life, cure their disease, get rid of their pain, or whatever, that’s a clear-cut violation and one that you ought to be aware of. Do the research. Don’t just fall for every word on the company’s website and repeat that to the client like it’s fact. It isn’t.

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MOCC-ERY

Update 09/19/2025: The MOCC document no longer exists on the FSMTB website. The press release from AMTA mention below in response to it no longer exists on the AMTA website.

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.

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FSMTB Unveils Plan for Continuing Education

Last week, the Federation of State Massage Therapy Boards published a document outlining their proposal to jump into the continuing education market. They are calling the new program Maintenance of Core Competency – to be abbreviated as “MOCC”. I don’t know what planet this thing came from, but it sure ain’t from this solar system.

Update 09/19/2025: The MOCC document is no longer on the FSMTB website.

Coming fast on the heels of the unresolved conflict-of-interest mess with the FSMTB President spearheading legislation in her home state of Iowa that would eliminate the education hours from that massage law, the timing of this MOCC release is strange, to say the least.

But let me get to the main event here: When you have a problem on your hands, there’s nothing more aggravating than a solution that is worse than the original problem itself. That’s exactly what has happened.

For many years, those of us who teach continuing education courses, as well as the sponsors of continuing education, have had to put up with an absurd and ineffective system for CE approvals. Most regulated professions have a single national entity that handles this function; we have the national provider approval program run by NCBTMB, as well as individual approval processes operated by about 10 state massage boards. The standards are inconsistent, and it forces CE providers to go through redundant and costly approval processes to be able to offer their courses in more than one location.

There was a cause for hope when we started to see some activity about this last year at the national level. In a press release entitled “FSMTB to Establish New Continuing Education Approval Program” (dated March 29, 2011, and no longer available on their website as this was updated), the organization announced:

“…the launch of a project to develop a new national program for the approval of both continuing education courses and providers. Once it is established, the program will provide state regulatory agencies with a centralized quality assurance process for all courses taken by massage and bodywork therapists for the renewal of State licensure or State certification.

As the representative for the regulatory community, FSMTB has responded to requests from its Member Boards to create a unified system to ensure that continuing education courses are taught by qualified instructors, relevant to the scope of practice, and meet the needs of the regulatory community.”

This all sounds wonderful, but the MOCC Proposal does not resemble this in any way. What happened to FSMTB’s clearly stated plan?

The MOCC Proposal introduces a totally new concept to our field: that there is a limited group of subjects that are specific to the “core competence” of massage therapists, such as ethics and boundaries, hygiene and sanitation, scope of practice, and unsafe massage practices. These subjects are supposed to be more important to “public safety” than all the other subjects typically studied by massage therapists in CE seminars – which are lumped into a new category called “professional enhancement”.

Based on this concept, the MOCC Proposal makes three recommendations:

1) Requirements for the renewal of state licensure should focus on public protection and maintenance of core competencies. All therapists should complete a required educational program for re-licensure focused on public safety issues. FSMTB would be the provider of this educational program.

2) A transition phase addressing maintenance of core competence as well as current continuing education for professional enhancement will be needed. FSMTB will provide state massage boards with guidelines to assist in the transition phase.

3) After this transition phase, professional enhancement and continuing education is voluntarily attained at the discretion of the therapist and not mandated for licensure renewal.

Instead of working to get broad-spectrum CE mandated for license renewals in all states, the MOCC Proposal recommends doing the opposite. In light of the relatively low number of education hours to enter our field, CE is essential to help practitioners continue to build and strengthen their base of theory and methodology. The narrow scope of “core competencies” suggested in the proposal as the only mandatory elements for renewal do little or nothing to advance levels of skill and awareness of the craft. While looking into how some of the other associations and federations of state regulatory boards of licensed professions handle their CE approval process, I did not locate a single one that imposes a limitation to “public protection” on continuing education the way the FSMTB is proposing to do.

The proposal also contains a statement that, “It is important to the FSMTB that all stakeholders have a voice in the process. The FSMTB requests feedback on this proposal from the Massage and Bodywork community and other interested parties.”

That’s a very open-sounding invitation, but does it strike you as odd that the MOCC Proposal makes no mention whatsoever of NCBTMB and the Approved CE Provider program they’ve been operating for the past 20 years? I would consider NCBTMB a stakeholder – and I’m relatively certain they’re an interested party. Last May, a rep from FSMTB attended the multi-stakeholder summit held by NCBTMB that looked at improving their CE approval program; it doesn’t appear that the invitation was reciprocated.

As I see it, the recommendations contained in the MOCC Proposal will drive the two organizations further apart, and will make it impossible for a global solution to be developed. This is both foolish and unacceptable. There is general support for continuing education being tied to license renewal, as it benefits both practitioners and their clients. Ongoing coursework in certain key subjects (like ethics) can continue to be written into state standards to ensure that licensees stay current with the behavioral aspects that influence their work.

If we’re going to have a single entity handling CE approvals on behalf of the entire profession, which should it be: FSMTB or NCBTMB? In reality, it could be either one – but it would take new levels of cooperation, along with well-crafted agreements to satisfy all the legal and structural considerations. Creating a unified approval program should be the focal point of discussions between and among the major stakeholders in this arena. Anything else is a waste of time.

When it comes down to it, FSMTB is a collective of the state regulatory boards; it has no regulatory authority in and of itself. They cannot force this plan on any state that doesn’t want it. Any state approving their own providers will be free to carry on, and any state that wants to continue to accept courses taught by the NCBTMB-Approved Providers will be free to carry on. The MOCC Proposal states that another document will be forthcoming that details recommended standards for states that choose to continue their own approval process.

As mentioned above, this is currently just a proposal and FSMTB is seeking feedback. I definitely encourage you to give it to them.

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A Disgrace in Iowa

Update 09/19/2025: The current law in Iowa still requires 600 hours of education.

Iowa House File 2342 has been on my radar for several weeks (initially introduced as HF 2126). Yesterday, I received a further communication on it, which stated that “the bill as written will not be brought up for consideration unless Matt Windschitl (the sponsor of the bill) requests it. The understanding is he will hold the bill until next year so there will be time for positive feedback from the profession and new language can be, at that time,  introduced with the support of the massage community.”

That’s good, because at this time, it doesn’t have the support of anyone except the misguided person who set it in motion, nor should it.

I was initially stunned at the poorly-written and  ill-conceived bill that eliminates the education requirement for massage therapy, which is currently 600 hours. The first draft of the bill I saw just struck through the education requirement altogether, although line 25 still says “meets or exceeds Iowa’s educational requirements.” This upset me to the point that I called on several Iowa residents and people in the know, who basically assured me that it was a “placeholder” bill….a simple explanation of a placeholder bill is that “the deadline for introducing any bills is imminent, and we’ve got to get something in there now that we can revise later”….one of those quirks of politics.

As of February 21, I hate to report that the revision doesn’t look any better. The language getting rid of the 600-hour requirement is still there, and nothing to take it’s place.

I have had three reliable sources state to me that this bill was introduced at the request of a school owner who is upset about federal regulations on financial aid, and that the true intent of the bill is to change clock  hours to credit hours. However, that isn’t spelled out. This legislation is a piece of crap in its present form that sends massage right back to the dark ages in Iowa.  It’s being discussed on several Facebook threads, and the consensus is that the Iowa Board of Massage had nothing to do with it, that AMTA has nothing to do with it–other than expressing their displeasure and urging their members to contact their legislators to kill it–and that the Federation of State Massage Therapy Boards–as an entity–has nothing to do with it. Interestingly enough, the bill also places two school owners on the Iowa Board.

Kathy Jensen, the current President of the Federation of State Massage Therapy Boards, who is an Iowa resident and a school owner, and former Chair of the Iowa Board, in direct response to my asking on my FB page if any Iowa residents had a clue on this, stated “Wearing my own hat and not FSMTB hat….. HF 2126 is as Keith Grant mentioned, was a place holder. Iowa has in place in their rules “600 clock hours or the equivalent in credit hour”, that has not changed. The education requirements have not been eliminated or changed for the state. The new language for the bill will support consistency in statute and rules. If the statute requires only clock hours and the rules state both there is inconsistency. I don’t see this as a big change for Iowa since it has been in the rules for a long time without issue. I do see the additional acceptance of credit hours in statute as a step forward for the massage industry.”

That’s well and good–except for one thing: The ongoing sermon from the Federation is portability. Nearly every other state is still operating on the clock hour requirement for massage education, so I don’t see how this is going to serve portability in any way. It’s a common practice in community colleges to use the credit hour system, but in most states, they actually have to convert that to clock hours on their transcripts to prove clock hours to the satisfaction of the state board. If you look at the state requirement charts for licensing that are regularly printed in our trade journals, every one is listed in clock hours, not in credit hours. The one revision that has taken place on the bill doesn’t do anything to clear up the language or the issue. It is just striking the 600 hours and leaving the “education requirements” part, without spelling out what that is.

My five years of service on the North Carolina Board of Massage & Bodywork Therapy ended last year. I’ve never owned a school, but there were a few times when I had to recuse myself from a disciplinary hearing, vote, or discussion, because of a conflict of interest or something that could be perceived as a conflict of interest. People who are serving on public boards need to recall at all times that not only are you obligated to avoid a conflict of interest, you are obligated to avoid the appearance of a conflict of interest. Yes, you have a life–and rights–as a private citizen, and as a school owner. When that is in conflict–or appears to be in conflict–with the obligations you have agreed to carry out for the Board you are serving, you have a choice. You either recuse yourself, you resign and get out altogether, or you put yourself and the entity you serve at risk. I would urge whatever school owners who serve the Iowa Board, and anyone who serves any board, to remember that fact.

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E-mail Etiquette 101

I’ve had a few meltdowns over e-mail in the past couple of weeks. In spite of my attendance at one of Michael Reynolds’ brilliant presentations on how to be an e-mail ninja and have a “zero inbox,” I confess I just haven’t gotten there. And I’m wading through a field of spam.

I have a good spam filter on all my email accounts, so basically most of those trashy emails advising you on how to enlarge your anatomy, how to collect the $40 million that the dead person in Nigeria has left you in his will, and offering to sell you cheap prescription drugs get trapped there.

What usually doesn’t get trapped there are all the unsolicited mailing lists and newsletters from massage therapists and other health practitioners who have taken the liberty of adding my name to their list. Most of them are people from Facebook or LinkedIn…they apparently just harvest the e-mail address from everyone they see on their networks, and add them on. That’s not a good thing. In fact, it’s just plain spam.

You have to ASK me in order to be added to any of my mailing lists. My websites have the little click-on feature for that, if you want to be added, but just visiting my websites is not going to cause you to receive any e-mail from me.

I use Constant Contact for my newsletters and group e-mail. I have it set to automatically give people the link to unsubscribe if they wish, and to allow people to share it on their networks, if they desire. It’s $30 per month, but I don’t have to be concerned  about removing people who ask to be removed; it’s done for me. If you are sending group e-mails to anyone, whether it’s from a company like Constant Contact or just through your own e-mail, you should have a simple link for people to unsubscribe. Some companies make it such a hassle, by sending you to a new website to create a new account and answer a couple of captchas, before they will allow you to unsubscribe to something that you never subscribed to to begin with. I think they count on it being such a hassle to unsubscribe that you’ll just choose to stay on the list.

The other thing you don’t have to worry about, when you use such an e-mail service, is failing to use BCC (blind carbon-copy)  for group e-mails. It will be automatically done for you. Some people do not realize–and others do realize it but just don’t care–that when you send more than one person an e-mail and you don’t use the BCC function, everyone it is sent to can see everyone else it is sent to, including their e-mail address. The cc may list the people by name, and not e-mail address, but by right-clicking beside the name, or in some cases hovering over it, you can see the address. That opens a can of worms–spam, not to mention exposure to viruses and worms. The most serious thing about it, for a massage therapist or any other health care provider, is your failure to maintain confidentiality. Some people cling to the idea that massage therapists don’t have to abide by HIPAA rules, but that’s beside the point. You are obligated to abide by the Code of Ethics, and safeguarding client confidentiality is a big deal, in case you haven’t ever noticed that.

According to the dictionary of computer-speak, SPAM stands for “Stupid Person’s Advertisement.”  When people turn on the television or open the newspaper, they expect to see advertising. It’s part of the deal. Does it have to be part of the deal on e-mail, too? Apparently so, judging by the amount of it that’s out there. I dumped my spam filter a moment ago, and in the two weeks since I dumped it last time, I have received 694 pieces of spam…in just one of my several e-mail accounts.

People sometimes use e-mail to inquire about a job opening at my facility. While it’s one thing to use emoticons, techno jargon and computer-speak on your FB page, don’t do that in a professional business e-mail. How does this look: “Dear Mrs. Allen, OMG, I saw your job listing and IMHO, I am the best person for the job 🙂 FWIW, I am a graduate of MMMS….” you get the picture. They’re not getting an interview with me.

I found an interesting website that lists the 32 biggest mistakes in e-mails (Update: the website no longer exists). There are quite a few on the list that jump out at me. Spell-check, for one. Sending out your newsletter full of typos doesn’t do anything for your professional image. Using all bold and all caps isn’t good, either. Forwarding chain letters is another. People have good intentions, but really, just like some of the stuff people continually repost on FB, I’ve received requests to pray for someone who died a year ago. Why in the world would you send those to a business acquaintance?

In a nutshell, if you’re going to use e-mail to market your practice–and you’re missing the boat if you don’t–go about it in the right way. You want your e-mail marketing to be effective–and ethical.

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Ethics Violation, or Communication Breakdown?

This year I wrapped up five years of service on the North Carolina Board of Massage & Bodywork Therapy. Anyone who has ever sat on a board will probably agree with me that disciplinary hearings involving massage therapists are one of the most stressful parts of that job. It was for me. I estimate that during my time on the Board, I had to sit through approximately fifty of them. It was very distressing to see my fellow massage therapists trying to defend themselves–and in a few cases, just outright admitting to the violation–whenever they were accused of something.

Nine times out of ten, the accusation was of a sexual nature. 99 times out of 100, it involved a male therapist. I’m dead certain there are female therapists out there performing sexual favors every day, but most men won’t come forward to complain about it. Go figure.

My question to myself at those hearings was always this: “Did this person have an intent to do something evil, or was this a communication breakdown or simple mistake that could have happened to you or me?”

If you’ve been practicing longer than a year or two, the chances are good that in spite of your best efforts, you have accidentally exposed a body part. Or you have said something that the instant it left your mouth, you thought “why did I say that?” The very first massage I ever gave, I accidentally touched the man’s penis. I went to tuck in the drape, and all I can say is there it was. He was supine on the table, his eyes were closed, and when my hand grazed it, I saw his eyebrows shoot up. I said “I’m sorry,” and carried on. If I had made a big deal out of it, I could have just made it worse than what it was.

If your only intent is to give a therapeutic massage, then your major obligation is not just about giving the massage; it is clear and direct client communication. This has come home to me again and again, and most recently when one of my friends was accused of a sexual violation. The case has not been settled yet; it hasn’t even been to court, but he has been crucified in the press and by a number of bloggers–none of whom were present in the room and have no idea what truly happened there, but I’ve been watching what amounts to a feeding frenzy by a bunch of sharks who are determined to hang him from the highest tree. He is apparently guilty until proven innocent. And since no one was in the room except for him and the alleged victim, I am fearful of the outcome. Of course I do not want a sexual predator turned loose on the public. But after a career that has spanned about 30 years with no previous complaints, it’s a shame to see that going down the tubes. He has loyal clients who are still patronizing him (including women), but what do you think the chances are of him getting any new ones while this is going on? Zilch.

You can’t be too careful. Let’s be realistic. Most massage tables are set up so that the table is at about crotch-level. That’s a fact. We lean over people. We use our body weight on people. Some therapists get on the table with people. In my younger, skinnier days, I’ve crawled up on the table when someone was prone. I’ve done pelvic work on people of both sexes. I’ve done pectoral work on people of both sexes. I’ve worked on the gluts of both sexes. If you’re performing medical massage, you’re going to find the need to touch those areas–with the client’s informed consent.

Think for a moment about the muscles that originate on the pelvis. If you want to make the belly of a muscle relax, you need to make the origin and insertion relax. That’s just the way it is. If you’re ignoring the origin and insertion, you might be giving a relaxing massage, but you’re not getting to the root of the problem. However, if you abruptly touch someone’s pelvic bone without discussing that with them beforehand, you’re the next disciplinary hearing waiting to  happen. The general public doesn’t know squat about origins, insertions, and actions of muscles. It’s up to you to educate them. And it’s up to you to abide by their comfort level. If they prefer not to have their gluts worked on or you getting near their pubic bone, then you don’t do it, period. I have found it helpful to have a muscle flip chart in the treatment room. That allows me to pick it up while someone is on the table and show them the muscle, where it begins, and where it ends. It’s a professional thing, to me.

There is also no excuse for careless draping. The law in my state says that “the drape may be temporarily moved in order to accommodate treatment.” Yours probably says something similar–or not. Working through the drape may not be ideal, but if that’s the law in a your state, then I suggest you abide by it. Don’t expose more than you need to expose, and don’t leave it exposed. If you have moved the drape in order to work on the gluts, that doesn’t give you license to perform the whole massage with someone’s butt shining. Get it done and cover them up.

Be aware of the comments you make. It’s okay to tell someone they have taut bands or active trigger points in the gluts. It is not okay to tell someone they have a tight ass. You might be thinking it, but keep your mouth shut.

You may think you’re all above-board as a therapist and that you’re never going to be accused of anything. Guess what–all those people who have been accused didn’t expect it to happen to them, either. Two things that did become apparent to me during my  years on the Board…one, there are indeed predators out there who decided this profession would be a good place to meet a fresh crop of victims, and two, there are just therapists out there who are guilty–of failure to communicate. Don’t let it be you.

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