Laura Allen’s Blog – Page 11

July 21, 2012July 23, 2012

The Snake Oil Medicine Show

There’s nothing earth-shaking in the world of massage politics on my radar this week, so I’m just going to make a few observations. I know that I am about to step on more than a few toes here, but it must be said.

I’ve got a few thousand massage therapists in my social networks (FB, LinkedIn, Twitter, Google +). In the mornings, when I’m drinking my coffee, I visit those sites and scroll through to see what people are up to. I like to read that people are having success with their clients, enjoying their work, being active in their communities, growing their businesses, volunteering, and a lot of wonderful things that massage therapists do.

What I don’t like to see is what I call the Snake Oil Medicine Show. There’s a popular band here in NC by that name, so I’m stealing it for this blog. According to Wikipedia: The phrase snake oil is a derogatory term used to describe quackery, the promotion of fraudulent or unproven medical practices. The expression is also applied metaphorically to any product with questionable and/or unverifiable quality or benefit. By extension, the term “snake oil salesman” may be applied to someone who sells fraudulent goods, or who is a fraud himself.

There are a lot of products (and practices) out there that have no proven benefits at all, and many that have in fact been proven not to have any benefits. Massage therapists seem to be particularly gullible to falling into the trap of not only using them personally, but also promoting them and selling them to their clients. I don’t know the real reason behind this phenomenon, but I can guess at several: 1) The therapist is not interested in scientific evidence and buys into the hype on the product’s website. 2) The therapist is desperately looking for something to bring in additional income. 3) The therapist has a genuine desire to help people, and truly believes the wild claims made by whatever company is selling the product, and thinks that it’s a duty to share it with clients.

If you’ve been following me for any length of time, you know that I am interested in the evidence-informed practice of massage, and that I’ve been on a mission to bust the myths of massage. This problem goes beyond that; and if I tried to bust every unscrupulous product out there, I’d never have the time to write about anything else. There are a lot of “quackery” websites on the Internet that have done most of the work for me….if only people would read and believe. But the fact is, you can hit some people over the head with scientific evidence, and they’re not going to believe it. They’re too attached to that “detox” machine, or that dietary supplement, or that special water or whatever it is that they’re selling. Paul Ingraham, one of my favorite writers on the Internet, has written about a lot of these things (see www.saveyourself.ca) Dr. Stephen Barrett has had his Quackwatch site up for years (www.quackwatch.org). Another favorite of mine is a water myth website, found at www.chem1.com/CQ/

I’m not a scientist, or a very technical-minded person. Fortunately, I have some friends and acquaintances who are. I have often asked them “Can you explain to me how ____ works?” The usual answer to this question is “It doesn’t.”

As I said at the beginning, I’m about to step on some toes here, but then again, I do that on a regular basis, so what the heck. Here are the facts on detox foot baths, and may I say, yes, I have in fact used one myself in years gone by:

There is no way an electric current passing through a part of your body can distinguish between “good” molecules and “bad” molecules (“toxins”), most of which are electrically neutral anyway.

The skin is impermeable to all but a few chemical substances; there is no evidence that any that are found inside the body can pass through the skin to the outside, with or without the help of an electric current.

All but a very few of the “toxins” produced as metabolic products are colorless— suggesting that what you see during these “treatments” is put there for show.

You can in fact put a zucchini, or nothing at all, in the foot bath, and the water will still turn color. I have personally witnessed this happening. Then we’ve got the “alkaline water” products, including a well-known MLM company that sells filters for about $4000 bucks. That’s a European vacation, folks. Not only that, but the actual components of that water filter can be purchased at any home improvement or hardware store for about $35. Here are the straight facts on that, and YES, THIS IS WRITTEN BY A CHEMIST:

“Ionized water” is nothing more than sales fiction; the term is meaningless to chemists.

Pure water (that is, water containing no dissolved ions) is too unconductive to undergo signficant electrolysis by “water ionizer” devices.
Pure water can never be alkaline or acidic, nor can it be made so by electrolysis. Alkaline water must contain metallic ions of some kind — most commonly, sodium, calcium or magnesium.

The idea that one must consume alkaline water to neutralize the effects of acidic foods is ridiculous; we get rid of excess acid by exhaling carbon dioxide.

If you do drink alkaline water, its alkalinity is quickly removed by the highly acidic gastric fluid in the stomach.

Uptake of water occurs mainly in the intestine, not in the stomach. But when stomach contents enter the intestine, they are neutralized and made alkaline by the pancreatic secretions — so all the water you drink eventually becomes alkaline anyway.

The claims about the health benefits of drinking alkaline water are not supported by credible scientific evidence.

“Ionized”/alkaline water is falsely claimed to be an anti-oxidant. It is actually an oxidizing agent, as can be seen by its ability to decolorize iodine (see video).

There is nothing wrong with drinking slightly acidic waters such as rainwater. “Body pH” is a meaningless concept; different parts of the body (and even of individual cells) can have widely different pH values. The pH of drinking water has zero effect on that of the blood or of the body’s cells.

If you really want to de-acidify your stomach (at the possible cost of interfering with protein digestion), why spend hundreds of dollars for an electrolysis device when you can take calcium-magnesium pills, Alka-Seltzer or Milk of Magnesia?

Electrolysis devices are generally worthless for treating water for health enhancement, removal of common impurities, disinfection, and scale control. Claims that “ionized” waters are antioxidants are untrue; hypochlorites (present in most such waters) are in fact oxidizing agents.

Claims that “water ionizers are approved for use in Japanese hospitals” are misleading: these “approvals” merely attest to the machines’ safety — that they will not electrocute you! My understanding is that the Japanese Health Ministry is highly critical of therapeutic claims made for alkaline water.

And yes, I have also drank alkaline water…several clients and a part-time staff member insisted on my trying it, and I did, but I can’t say it did anything for me that regular water wouldn’t have done.

What about the Chi machine? Actually, I used to house sit for a friend who had a Chi machine, and I would lie down in the floor and use it every time I was at her house. I personally found it very relaxing, and it felt good. In fact I would usually zone out and have a little nap while the machine was running. However, the big claim made about it is that it “maximizes the body’s natural absorption of oxygen.” Really? It’s shaking your ankles back and forth. How is that doing anything to maximize the absorption of oxygen? Can’t I just lie down and shake my own ankles and do the same thing without spending that $399? The websites touting the Chi machine go on about how cancer can’t survive when you’re fully oxygenated, disease can’t get you, parasites will disappear, and all illness will leave your body if you just have enough oxygen. The way I see it, I’m breathing, so I must have enough oxygen. How much more do I need? Am I going to breathe MORE if I shake my ankles every day? I don’t think so.

Shall I go on? There are so many dubious products out there, I could stop writing about the politics of massage altogether and have enough fodder to go on for years, but I’m going to stop here, for now. I’m sure those of you who sell the heck out of these machines will write in and tell me what a moron I am. Maybe ONE of you will perform a thorough scientific examination of the facts and decide that you’ve been hoodwinked into spending a few hundred, or a few thousand, dollars on something that doesn’t work, and you’ll quit trying to sell it to your clients. That would be nice.

References:

Reactionary Redneck Takes Over

I allowed my Reactionary Redneck to take over yesterday when I called out a massage therapist publicly for behaving badly on my blog. If you’re a regular reader, you may know of whom I speak. I’ve always been against censorship, but I’ve now stooped to that level; I’ve deleted the comments, which I had unfortunately allowed to go on for too long, and warned the person that future comments would be deleted. I also stooped to his level by talking about him on FB. I’ve deleted the thread, but it got a lot of comments (all supportive) before I took it down.

My Reactionary Redneck pops out occasionally…well, okay, regularly. I just don’t always put it in print. Sometimes I yell at the actual person I’m mad at. Or I at least call them up or send them an e-mail to voice my opinion. Sometimes I just sit here with smoke boiling out of my ears and don’t unload to anyone except my husband and the dog. Massage is one of those subjects I’m passionate about–and as my livelihood depends on it, the one most likely to spur a Redneck Reaction.

When I am writing about the politics of massage, I am frequently in the throes of a Redneck Reaction, but I try to channel that into constructive journalism. It’s sometimes a struggle to just report the news and offer an intelligent, balanced opinion on it when what I’d really prefer to say is “WHAT ARE THEY THINKING? HOW CAN THEY THINK THIS IS EXCUSABLE? WHAT ARE THEY TRYING TO PULL? THEY MUST BE STOPPED! WHAT A BUNCH OF MORONS!” My evil twin is cussing like a sailor, while my professional self is trying to write a professional, well-thought out, balanced piece of commentary. That’s what I strive for, anyway. Occasionally I fall short of the mark.

I don’t delete comments just because people disagree with me. I’ve been disagreed with by some of the most brilliant minds in this business. Most of the time we agree to disagree, and do it in a civil fashion. Sometimes, one of us comes around to the other person’s point of view. Occasionally, my Reactionary Redneck takes over. Yesterday was one of those times. A colleague called me out and pointed out that I was stooping to this person’s level, and I was. I hate it when that happens. None of us like to hear that. We tend to want to make excuses, and defend ourselves. It’s human nature.

I’m putting my Reactionary Redneck back in the closet, and she’ll come out another day. I can guarantee it.

July 11, 2012

NCBTMB: Quit the Small Stuff and Take the Bold Step

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

July 2, 2012July 2, 2012

Report from the FSMTA Meeting

Champ and I spent the weekend at the Florida State Massage Therapy Association meeting in ChampionsGate, FL. It was our first time attending this event, and we went there to work in the Soothing Touch booth with Gurukirn Khalsa and his family. The event was held at the beautiful Omni Resort…a lush tropical setting and superior accommodations. It was hot as the devil–but it got up to 108 ° back here at home in NC while we were there, so I really can’t complain about it. The FSMTA meeting is huge. The organization has over 5000 members, and they had a great turnout.

In addition to working, we had plenty of socializing with friends old and new. I spent over an hour in conversation with Mike Williams, Executive Director of the NCBTMB and our interview will be appearing soon in a future blog. Our booth was right across from the NCBTMB booth so I spent a good bit of time chatting with Lori Ohlman and Donna Sarvello, and later Sue Toscano and Alexa Zaledonis. You may say whatever you like about the NCBTMB–it is staffed by great, dedicated people. Bruce Baltz of Bon Vital is also on the NCBTMB Board, and he gave me a great foot massage.

I spent some time with The Massage Nerd doing a few videos–I suspect they’ll be rolled out soon. Ryan Hoyme stayed busy doing videos for everyone present that wanted one. Since I was actually working, I had short visits with a lot of people instead of longer visits with a few people! Ruth Werner was there with her daughter Lily, as were Leslie Young Giase of Massage & Bodywork Magazine/ABMP and Paul Slomski, representing the Massage Therapy Foundation. Pete Whitridge, Cherie Sohnen-Moe, and Iris Burman were there for the AFMTE; Kate Ivane Henri Zulaski and Cliff Korn were there for COMTA, and the FSMTB was represented…this is a big meeting, so all the major organizations were in attendance. Massage Today and Massage Magazine folks were there, too. Vivian Madison-Mahoney and her husband John, Leslie Lopez, Pat Donahue and her hubby Joe, Angie Patrick, Scott Dartnall, James Waslaski, Karen Kowal, David Kent, Anita Shannon, Lynda Solien-Wolfe, Michael McGillicuddy….too many people to name but it was like a reunion of some of the nicest and most dedicated people in massage, even when I only got to see them for a minute.

Champ and I attended the FB Meet and Greet…I always meet a few of my FB friends at those events, and it’s turned into such a popular thing that all the major conventions now have one.

Speaking of major conventions, the one glitch was the same that I have noticed at other conventions, and that’s vendors getting upset with the schedule and/or location. I’m not picking on FSMTA here, because something similar seems to happen wherever we go. The particular issue this time was that the vendor hall was slam full of people Thursday evening at 5 pm, and they shut down the vendors so the association could have a 2 hour business meeting. At other organization meetings I have attended, the hall was either so far removed from the mainstream that people practically had to walk a mile to get there, or the hours coincided with the times people are in class and not much over or above that. I encourage EVERY group who organizes a massage event, whether it’s small or large, to give these people a break! Booth space is usually expensive, especially at major events, and these folks go to a lot of expense and trouble to support your events. You need to support them. I’ve heard the suggestion several times that registration should be held IN the vendor hall so that attendees had to walk through it to register, and that’s not a bad idea. As I said, I’m not picking on FL. It is a problem at many places.

The FSMTA has been around since 1939 and has 15 chapters throughout the state. That’s a pretty big accomplishment. I was pleased to meet so many of their members. I had a great time at their meeting and plan to attend again.

June 22, 2012June 22, 2012

Come to COMTA

I just got home from doing a site review from COMTA. It was my third trip as a peer reviewer, and once again, an enlightening experience. COMTA is the Commission on Massage Therapy Accreditation. Gaining accreditation is a strictly voluntary process. It’s estimated that there are about 1500 massage schools/programs in the US, and less than 100 of them possess the accreditation. Obtaining COMTA accreditation for a massage school is not cheap, and it’s a lot of hard work, so you might wonder why a school would do it. After getting acquainted with all the ins and outs of it, the answer, to me, is that it’s a hallmark of excellence. It’s a way to say “We’re going beyond what the state requires to prove that we have a superior school.”

Part of the accreditation process is a very thorough self-study report. Schools must review their policies, their procedures, the way they conduct business, the education they provide. If it’s not documented, it doesn’t exist. As a peer reviewer, my job is to study their documentation before getting to the site, and then doing an actual visit to the school. Every syllabus, every lesson plan, every piece of documentation related to their educational process and their business proceedings is reviewed. The curriculum needs to fall in line with the mission statement. The education offered must match the learning objectives that are stated. When the reviewers show up for the site visit, we basically review every piece of documentation they claim to have, to make sure it actually exists and to make sure it does what it claims to be doing.

The accreditation doesn’t just earn a nice label for the school. It provides a measure of protection to the student, as well. It assures that the school has definite policies on qualifications for insuring the competency of instructors, absenteeism, grading, following a carefully thought-out lesson plan, and much more. It assures that financial aid is being administered correctly and that student finances are carefully documented. It assures that their are policies on sexual harassment, and that instructors have to continually improve themselves with technical training and continuing education.

A COMTA school can’t rest on their laurels. It’s an ongoing process of maintaining the standards, and regular review. A school that is poorly managed isn’t going to cut the mustard. It’s safe to say there aren’t any diploma mills or haphazardly run schools among the ranks.

COMTA standards are on the organization’s website. Anyone can access them. I challenge every single school owner in the country to review them one at a time, and see how your school stacks up. Take the leap and apply for accreditation. When we review your documentation and show up for a site visit, we’re not there to thump you on the head for any shortcomings; we’re there to help you come into compliance with the highest standards in the massage profession.

COMTA is also always seeking competent peer reviewers. The training to be a reviewer is also available on the website. Visit www.comta.org, and come to COMTA.

June 11, 2012June 11, 2012

Report from the AFMTE Annual Meeting

I spent last weekend in toasty Tucson, AZ at the Alliance for Massage Therapy Education annual meeting, and for the third year in a row since this organization started, it was one of the best things I have ever attended. There were quite a few new people attending this year, and attendance was up slightly from last year. The meeting was held at the El Conquistador resort, a beautiful venue with gorgeous mountain and desert views. I was late getting there and unfortunately missed the opening ceremony and the keynote presentation by Benny Vaughn, which I heard was fantastic.

As usual, there were great continuing education offerings…I attended Tracy Walton’s class on “Busting Myths and Critical Thinking Skills,” which was informative and entertaining, and I heard nothing but praise from attendees of the other classes, which included offerings by Stephanie Beck, Martha Brown Menard, Susan Beam, Cherie Sohnen-Moe, Terrie Yardly-Nohr, Nancy Dail, Pat Benjamin, and Ben Benjamin. Bear in mind, these classes aren’t your average CE class–they are directed at massage therapy educators. When these great teachers weren’t teaching a class, they could be found attending someone else’s class. That is one of the most wonderful things about this gathering to me; it is attended by some of the most well-respected and well-known educators in this profession–and they all have the attitude that they’re not finished learning. Kudos to every one of them.

Nancy Dail organized a “Meet the Authors” gathering, and it was amazing. I was humbled to be included in such awesome company. I doubt if I can name all these people in the correct order in the picture so I won’t even try. Mark Beck was out of the room when the picture was taken but he was present as well. The group included (in alphabetical order) Timothy Agnew, Sandra K. Anderson, Pat Archer, Ben Benjamin, Pat Benjamin, Andrew Biel, Celia Bucci, Iris Burman, Nancy Dail, Sandy Fritz, Julie Goodwin, Martha Menard-Brown, Carole Osborne, David Palmer, Cherie Sohnen-Moe, Ralph Stephens, Tracy Walton, and Terrie Yardley-Nohr. Also absent was David Lauterstein, who had an airline travel nightmare, but his book was present along with the others authored by these amazing people. I don’t know when I have ever seen such talent present in one room.

All the major organizations had representatives in attendance, with the exception of ABMP. I’m not sure if they were making a statement by not showing up or not. I had actually spoken to Bob Benson, the Chairman of ABMP, a few days before the meeting and asked him if they would be in attendance, and he did not make any mention of political reasons for staying away…of the likely candidates that would have attended, several were on vacation, one was attending a family wedding and so forth. Still, their absence was notable, no matter what the reason. AMTA, the FSMTB, and COMTA were all in attendance. There was also chair massage offered at the meeting to benefit the Massage Therapy Foundation, and thanks to the efforts of Taya Countryman who organized that effort, over $900 was raised for the Foundation.

Elections were held, and the standing officers were all re-elected. Two new board seats were also added. The AFMTE Board has let go of their management company and are handling it themselves, and the two new board members are needed to help with the many tasks of the organization. Stephanie Beck and Heather Piper were elected as members-at-large. I agreed to serve on the marketing committee….I don’t do boards anymore of any kind, since that would interfere with my blogging, or at least the perception thereof, but I’m glad to serve the organization on this committee.

Breakout sessions were held to discuss numerous topics of interest to educators, including all the various projects that are going on at the moment, not the least of which is the Teacher Education Standards Project. Other breakout sessions were to talk about the MOCC proposal from the FSMTB, the new policies announced by the NCBTMB, and other issues facing the profession. There weren’t any formal votes in any of the discussions I sat in on, but a number of people I talked to all said the same thing–that there are a lot of duplicated efforts going on, which is a waste of time and resources. John Weeks, Executive Director of ACCAHC, also gave a keynote address where he stated that we have a tendency to get ourselves trapped in whirlpools–and how much influence we could have because of our sheer numbers, if we would just get out of them.

During the business meeting, President Pete Whitridge announced that the organization has no debt. That’s a fabulous position to be in, but I would like to state that we need and welcome corporate sponsors, as well as individual members. The Alliance has worked very hard to keep membership fees reasonable–and to hold our meetings in reasonable places. Although the El Conquistador is the lap of luxury and a beautiful place, we got a room rate of $99 per night. Many meals were provided as well, so financially, it’s a bargain to join. Please visit the AFMTE website to find out about the many benefits available to you as a member. There are also vendor opportunities and sponsorship opportunities at the annual meeting. Thanks to exhibitors Biotone, Bon Vital, Books of Discovery, the Center for Embodied Teacher Education, F.A. Davis, the International Association of Massage Business, Massage Envy, the Massage Therapy Foundation, Massamio, the National Accrediting Commission of Career Arts & Sciences, Performance Health/Biofreeze, Wellx, and Wolters Kluwer Lippincott Williams & Wilkins. Thanks also to sponsors of the meeting, Massage Today, Massage Magazine Insurance Plus, the Florida State Massage Therapy Associaton, Massage Envy, Books of Discovery, Pearson, Biofreeze, and SOAP Vault. Soothing Touch , Oakworks, and Massage Warehouse, along with many others also donated door and raffle prizes.

On a personal note, I had a big fat time socializing with so many friends and making a few new ones. I had dinner the first night with Julie Onofrio, Kathleen Gramzay, and Karen Hobson. I met with Mike Noble, the new acquisitions editor at Lippincott, and Shauna Kelley, their marketing manager, for dinner on Friday night to discuss a couple of projects, and Saturday night, I had a blast with the team from Massamio and a bunch of other friends–both FB friends and the real variety. I went to lunch one day with Allissa Haines and Gregory Hurd…we went sneaking out to the In-and-Out-Burger for a junk food fix. I spent a couple of hours talking with Ryan Hoyme (aka The MassageNerd), and just in general enjoyed myself and enjoyed seeing everyone. I tried to sit with someone different at every meal and every class so I could visit with as many people as possible, and wish I could have personally talked to everyone there. I did have a few good but short conversations, with Sandy Fritz, Sue Toscano, Susan Beck, Mark Beck, and other good folks. As usual, there just weren’t enough hours in the day.

The biggest thanks, and deservedly so, goes to Cherie Sohnen-Moe. Tucson is Cherie’s home town, and she really went over and beyond the call of duty in helping to organize the event. She’s probably ready for a vacation!

I urge you to join the Alliance for Massage Therapy Education. We are hoping to accomplish some great things, and we need your expertise and your input. We are a non-profit organization and of course donations are welcomed, but what we’d really like is your membership fee–AND your participation. We want and appreciate active members! There are a lot of things going on in our profession right now, as I have reported right here. We need to be sure that education evolves in a way that serves the highest good of the profession, in total transparency, and that our membership gets plenty of input. That’s one thing that is very evident about this group of people–they do want to hear what the members think….and here we have some of the best and brightest minds in the business. You could almost get star-struck at this meeting–but there is not a standoffish person in the bunch. Don’t wait until the next meeting; join us now, and get involved. If you are an educator, school owner, administrator, or industry partner, we need you. And I’m going to shamelessly use the same quote that I used from Jan Schwartz at last year’s meeting: “If you’re not at the table, you’re on the menu.”

June 2, 2012June 2, 2012

The ELAP Flap Continues

Earlier this week I received the ELAP (Entry-Level Analysis Project) Description from ABMP. I’ve been blogging about this for several weeks, first because I was upset that it was shrouded in secrecy; then last week because I finally got word of who is serving on this work group. While that information didn’t exactly smooth my ruffled feathers, I was gratified to see that I know some of the people working on it and know that they do the best job they can at whatever tasks they take on. And the document has changed quite a bit from the first proposal I saw, which I had numerous objections to (see previous blogs under this one). That being said, I’m still not thrilled with it.

I feel that there are some big pieces missing here, and that the profession would be better served by pointing resources in a different direction. To begin with, the document makes the point that how regulatory agencies arrived at the 500-hour minimum that has been a benchmark of entry-level education is unknown…that’s true, but it’s also unknown of how states with more hours arrived at those requirements. One thing that’s mentioned is the influence of federal financial aid, which presumably has led some schools to offer more hours (or states to require them). As is the case with a lot of things, following the money trail often gives insight into real motivation.

Personally, I don’t think financial aid, or the lack of it, should be influencing this project at all. As a former school administrator, I’ve been involved in the financial aid process first-hand in the past. Whenever a recession and massive job layoffs happen, as they have here in my home state for the past three years or so, there’s a phenomenon that occurs. There’s an influx of displaced workers into the community college system, where financial aid is a given, and I’ve been told by students who had never even considered massage as a career that “the job counselor said I could get my schooling paid for if I would study massage.” That’s just not the reason I want to see people coming into the profession.

I feel there are some other tasks that need to be completed before anything like this is undertaken. The ELAP description states only two goals, one of which is to assess how many program hours are needed to attain this KSA (knowledge, skills, and abilities) goal, assuming capable instruction.

That’s a major issue, in my opinion—because you can’t and shouldn’t assume capable instruction. The Alliance for Massage Therapy Education is working on a National Teacher Education Standards Project to define the KSAs needed by teachers, both entry-level and more experienced/advanced. There is also a line-by-line review of the MTBOK going on. To charge headlong into the ELAP before these two initiatives are complete seems like putting the cart before the horse. In all fairness, I am glad to see our organizations collaborating instead of refusing to play nice, but I would prefer to see them applying their resources to the National Teacher Education Standards project. The ELAP claims to be addressing what it takes to make a therapist able to practice competently. The fact is if the teachers aren’t competent in a 500-hour program, they’re not going to be any more competent in a 750-hour program until they are educated. We need educators who are competent enough to teach competencies, not just stand in front of a classroom for a longer number of hours.

Part of the rationale for this entire undertaking is the perceived lack of competence of entry-level therapists. While the FSMTB is about to launch a new Job Task Analysis Survey, and the NCBTMB recently did the same, we ought to bear in mind what it is that a JTA shows. They tend to be snapshots of a day in the life of a massage therapist: see the clients, do the laundry, keep up the paperwork. If the perception is that therapists are not doing what they need to do in order to keep the public safe and practice competently, is asking them what they do all day really effective for this purpose? I don’t think it is. As one of the comments on last week’s blog said, “They don’t know what they don’t know.” There will be also be an accompanying survey within the JTA survey, intended to eliminate the “experience bias” present in these types of surveys, but I think that’s a tricky proposition. The return rate on these surveys tend to be very small–and usually answered by the minority of us who actually give a rip about the state of things. JTA surveys tend to be long and somewhat boring and it’s a very small percentage of people who will even fill them out to begin with.

Reportedly, the ELAP project was conceived to help address the problem of portability of massage between the states. One of the statements reads in part “we need to identify the key KSAs required to pass a national licensing exam and provide competent, safe massage in an early massage career.”

Right there is another problem. While the FSMTB would like to see every state exclusively using the MBLEx, it hasn’t yet happened. Since the NCBTMB is increasing the requirements for National Certification, leaving them with only the NESL options for entry-level exams in the states that accept those, the MBLEx will undoubtedly become exclusive in some places, but New York is not going to throw over their exam for the MBLEx, in my opinion. There is no such thing as national licensing, and there is never going to be. National licensing doesn’t exist in any profession I am aware of. If you’re a doctor, you still have to get licensed in each state in which you want to practice. While portability is a pain in the butt for massage therapists, it has never been shown to be harmful to the public or to the profession on the whole. Inconvenient, yes; but harmful, no.

The FSMTB is also working on the Model Practice Act, as mentioned in the ELAP description. While I wouldn’t go so far as to say it’s a waste of time, I don’t expect any influx of the regulated states lining up to change their existing practice acts to whatever the FSMTB comes up with. I’m sure it will be a helpful guideline for the unregulated states if and when they decide to join the fold, but it will be interesting to see how that document ends up harmonizing with the ELAP. Since the MBLEx has been an exam that uses the 500-hour threshold (and in fact, you can take that exam at any point during your education, prior to graduation), if this project somehow demonstrates that more hours are needed, is the FSMTB going to jack up the requirement to sit for the MBLEx? The Model Practice Act project was also undertaken prior to the ELAP project starting up, and while I haven’t seen a draft and don’t know what it includes, my prior knowledge of state practice acts demonstrates that those generally spell out required education and the breakdown of those hours, so presumably the ELAP would affect the Model Practice Act project as well.

Another part of the hoped-for result of this project is to cut down on the number of lawsuits and ethics complaints against entry-level massage therapists. Personally, I believe someone who is going to act unethically is going to do it regardless of how much education they have. When it comes right down to it, the injuries resulting from massage are a tiny fraction of what they are in other health-care related fields. I’m not saying there aren’t any, but on the whole it’s relatively insignificant when compared to the number of practitioners.

Lest anyone think I am against raising the standards of the profession on general principles, that’s not so. I don’t own a school, and I’m already licensed, so it’s not like this is going to inconvenience me personally. In fact, a few years ago when I was on the North Carolina Board of Massage & Bodywork Therapy, we looked at raising the hour requirement here (currently it’s 500 hours). Like any good organizational beaurocracy, the result of that was to appoint a committee to study the situation. The research they conducted was to ascertain whether or not students from schools with higher number of hours had a better pass rate on the exams than students from 500-hour schools. The answer to that was a big fat “no.”

I’m not sure how much money is being spent on this project; the first proposal I saw mentioned between $60-70,000 to be shared as an expense between the organizations. I urge, or rather, challenge, all of these organizations to pour an equal amount of money into the AFMTE Teacher Standards project. Improving the KSAs of entry-level educators—many of whom tend to be last year’s star students, who may be talented at massage but without a whit of experience and training in teaching methodology—will improve the KSAs of the students, the entry-level practitioners. That should be the important first step—the key word there being first. Don’t try to build a house without a good foundation. It’s a waste of time and money, and ultimately, it doesn’t work.

May 24, 2012May 25, 2012

ELAP Work Group Members Announced

Anne Williams of ABMP has confirmed to me today the members of the group that are working on the Entry-Level Analysis Project that I have been blogging about for the past few weeks. Since the secrecy surrounding this project has been my main complaint about it, I will share that information here. The members are:

Cynthia Ribeiro, President of AMTA (National), educator, and school owner.

Tom Lochhaas, University-level educator, author, editor with 24 years experience in developing college-level textbooks and ancillaries.

Elan Schacter, Massage therapist, instructor, text reviewer, contributing author.

Clint Chandler, Massage therapist and instructor, experienced in curriculum development.

Rick Garbowski, Massage therapist and instructor, experienced in curriculum development.

Jim O’Hara, Instructional designer.

Anne Williams, Director of Education for ABMP.

Williams stated that she was in the process of compiling the comments of those who were present at the Leadership Summit; that everyone present was now in support of it, and that much more information about the project would be forthcoming in the next two weeks. She further stated that this was intended to be a research project, and that what people do with the information will be their choice. As I said in my last blog, neither ABMP, AMTA, or any of the other organizations present at the Leadership Summit are regulatory organizations, and none of them have the power to dictate legislation. (Clarification: the FSMTB is an organization of regulatory boards, but is not regulatory in and of itself).

I am acquainted with several of the people on the work group. Cynthia Rebeiro, Pat Archer, and Elan Schacter do good work in all they endeavor to do. I would have liked it if this information had been put out there immediately, along with the rest of the details, but you don’t always get what you want. And actually, the fact that you don’t always get what you want is sometimes a good thing. As I also previously stated, the wheels of legislation turn very slowly…and just because our organizations want something to happen doesn’t mean it’s going to. If the evidence produced by this project turns out to show that 750 hours ought to be required for entry-level education, it will take many years for that to happen in every state. That’s my prediction, and I’ll be glad to take any bets on that.

I’ve been reviewing COMTA standards for the past couple of days in preparation for a site visit, and it would be great if those were a requirement for every school. I think the quality of education would increase exponentially if every school had to jump through the hoops to prove they’re doing things diligently and going beyond what most of the state boards require. I’ve also been revisiting the MTBOK, and while I still have a few issues with it, I certainly hope it is taken into consideration.

I personally still think that education should be about quality, and not quantity. 500 hours is arbitrary to me–and so is 750. Look at some of the Canadian provinces…their required hours are 4 digit numbers. Those are arbitrary too, when it comes down to it. It should be about competency, not about hours. From my own experience, and someone has made this comment to me before–in entry-level massage school, you learn what not to do. It’s when you begin practicing that you begin knowing what to do. My real education started when I walked out the massage school door, and it’s been that way for a lot of us.

This project is going to be released for comment in a couple of weeks, according to Williams. I urge everyone to take the opportunity to comment–beyond any job task analysis survey that gets spread around. Those show tasks, and don’t reflect opinion. This is of too much magnitude to the profession for opinion not to be considered. School owners in particular need to speak up. If you run a 500 hour school, how many of you can afford to increase that be 250 hours? How many would just fold? I advise you not to sit on your hands. It’s like an election. If you don’t vote, you can’t complain, and complaining after the fact doesn’t have any impact. Express your opinion.

May 22, 2012

Top Secret Standards Project: No News is NOT Good News

I’ve been on vacation…I took a deliberate ten-day break from the Internet and from all the politics of massage while I was enjoying my annual sojourn in Ireland. I didn’t visit any Internet cafes. I didn’t read the paper and I didn’t watch the news. I left my cell phone at home, too. It was quite refreshing and restorative to be unplugged for that period of time, but now it’s back to the grind. From the look of things, it would seem that the powers that be are enforcing a news black-out as well. They have apparently been sworn to secrecy. It looks like a covert operation from the CIA.

The press release from the Leadership Summit, held in Chicago May 1-2, and attended by the leaders of our national organizations, was released May 9. I was expecting a white-washed version of the events, and I was not disappointed.

Out of nowhere, the press release mentions casually: “An ongoing discussion of the Entry-Level Analysis Project (ELAP) occurred and input from the leadership organizations was discussed.”

Wait just a minute… isn’t this the very first public mention of this project? No one outside of the inner circle of secret-keepers knows what the ELAP is, who the driving forces are behind it, and what its real purpose is. They can’t just drop a profession-altering project onto the landscape like it’s a known quantity, wave a little flag that promises us some future opportunity to have input into the project, and then expect us to salute the results whatever they may be.

The Leadership Summit press release mentions that massage therapists are going to get some input into this project—through a “companion” survey to the FSMTB Job Task Analysis. That may sound promising, but let’s remember that FSMTB is an exam provider, and their major focus is on the MBLEx. The Job Task Analysis survey is not necessarily the best way to determine what an entry-level massage therapist needs to know.

The big problem with the use of these and other surveys in our profession is that many therapists received insufficient education in their entry-level massage training programs. It’s unfortunate, but these folks don’t know what they don’t know. Asking this group what constitutes safe and effective massage therapy practice is barking up the wrong tree.

If all you’re looking for is a snapshot of the hours per day one spends doing massage and performing the laundry and other mundane chores that go along with that, it will suffice. But what about seeking opinion and honest-to-goodness input? What about addressing the concerns that the people who will be affected the most by whatever plan comes down the pike? Primarily, that will be small school owners, many of whom are already struggling to survive.

There are still so many things I find disturbing about this whole process, not the least of which is that none of our massage news outlets is saying anything about it. You’d almost think I’m the only one who cares. With the possible exception of a surprise birthday party, I tend to mistrust anything that has to be carried out in secret. So the nice sentiment (which I am glad to see has replaced the “we aren’t seeking input” statement that I found so offensive in the original document) that “A key component to the success of this project will be broad input by the massage profession” notwithstanding, I’ll repeat the call to action from my last blog:

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.

In spite of my objections to this whole cloak-and-dagger scene we’re being subjected to, I am comforted by one thought…and that is that the wheels of government turn slowly. Whatever plan the ELAP work group comes up with is just that: a plan. I don’t visualize state lawmakers running to the legislature floor intent on helping them get it off the ground. AMTA is not a regulatory body, and neither is ABMP. For that matter, the FSMTB isn’t either. The individual member boards are regulatory bodies, but the organization in and of itself is not. They don’t have any law-making power.

I don’t know what’s happened to the transparency that we should expect from our organizations, but it seems to have gone to hell in a hand basket. Frankly, I think that would be a good topic for the next leadership summit. The peons like me who pay your membership dues deserve it.

May 5, 2012

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.