Laura Allen’s Blog

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More Myths of Massage

Last week I wrote a post on Facebook about some of the myths of massage. My statement on this issue was and continues to be that I am not accusing anyone of telling a deliberate lie, nor am I attacking the character of any teacher who has helped to perpetuate these myths. I choose to believe that everyone has good intentions.

Before I became interested in the evidence-based practice of massage, I’ve been just as guilty as sharing some of them myself. There seem to be so many of them, and in my opinion  people tend to blindly accept what they learn in massage school. We view teachers as authority figures, but the fact is, teachers have a tendency to repeat what they were taught in massage school…so they pass that on to their students, who in turn share that false information with their clients, with the best of intentions. Some of those same students go on to become the next generation of teachers, and those same myths just keep being perpetuated.

Yesterday I heard from Lee Kalpin of Ontario, who shared a few more of these massage myths with me. I am presenting them here, and if anyone has any valid research references that will back these up as fact, please feel free to post it for our enlightenment.

– Massage removes toxins from the muscles.

– Lactic acid is responsible for DOMS (Delayed Onset Muscle Soreness).

– Massage can get rid of cellulite.

– It is contraindicated to massage a person who has cancer (or had cancer).

– If you massage a person who has consumed alcohol, it will increase the effects and make them more intoxicated.

– You can strengthen muscles by performing tapotement.

– You can straighten a scoliosis by doing tapotement on the weak side and stretching on the tight side.

– Manual Lymph Drainage causes the lymphatic channels to collapse for 20 minutes so you cannot do any other manipulations after MLD.

– You should never do more than 3 trigger point releases in a treatment (no reason stated for this one – it was just stated as a fact).

– Ischemic compression for trigger point release should be done as deep as possible.

– Only deep massage is therapeutically effective – as deep as possible. Lighter massage is just for relaxation.

– You should not massage pregnant women during the first trimester.

– You should not massage the feet and ankles of a pregnant woman as it may cause her to miscarry.

– Drinking lots of water flushes toxins out of the system – encourage the client to drink water after a massage.

– You cannot massage a person who has “high blood pressure” – definition needed about how high is high, and cause of hypertension.

– You must massage toward the heart or you could damage the heart valves.

– It is contraindicated to massage pitted edema.

I must say that I have heard all of these at one time or another. Where did they come from? I don’t know. As one FB friend said “I heard it from some reputable teachers.” And they probably heard it from their reputable teachers.  So let’s just let the buck stop with us. If the words “research shows” are going to come out of your mouth, then back that up with the actual research reference, and if you can’t produce any, don’t say it–to your students or to your clients. If all the evidence you need is that massage helps people feel better, then let that stand for itself and don’t make wild claims. And please, as I said above, if you have the research to prove any of these statements, share that with the rest of us.

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Local Legislation Often A Disgrace to Massage Therapy

I usually report on state legislation, but the fact of the matter is, educating legislators about massage therapy has to begin in your own backyard. In many places, whether there is state regulation of massage or not, local laws are so archaic and penalizing to massage therapists, it is just disgusting.

The latest thing to hit my radar is from the city of Indianapolis. The application required to practice massage in the city is entitled “Application for Massage Therapist/Escort/Body Painting/Nude Model License.”

I am shocked and appalled that this still exists. Where are the massage therapists who should be up in arms about this? Is everyone so complacent they just fill it out and don’t complain? Has anyone ever brought it up to the city government? Have any of our professional associations seized this opportunity to protect the rights of massage therapists?

A few years ago in the small town of Canton, NC, one of my former students excitedly opened her massage therapy practice, and within two days was cited for “massaging a member of the opposite sex.” She had no idea her hometown was a throwback to the Dark Ages, and she wasn’t going to take it lying down. She printed off copies of our Practice Act for every member of the town council, and got herself put on the agenda for the meeting, where she proceeded to enlighten them about the realities of being a professional therapist. The end result was the repeal of an ordinance that was enacted back in the 50’s in an effort to thwart illegal “massage parlors.”

I hope that the massage therapists in Indianapolis will take a lesson and rise up to do something about this. Unfortunately, it isn’t the only place where idiocy like this is perpetuated. After I posted this on my FB page, therapists started coming out of the woodwork with their own stories of unfair local laws. …locales requiring massage therapists to take tests for sexually transmitted diseases, applications that still say “Massage Parlor” and all manner of derogatory and unfair laws aimed at us.  All I can say is what I’ve been saying for the past few years: Don’t wait for someone else to do something about it. Take the initiative and get the ball rolling. Call your colleagues and ask them to appear with you at a town council meeting. Write letters and call your local legislators. Don’t sit on your hands. If we don’t educate legislators, nobody will.


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Texas Hold ‘Em

Texas has a few pieces of massage legislation in the offing. And while I don’t think most of it is as detrimental to the profession on the whole as the recent amendments to Utah’s regulations, I can’t say I’m crazy about it. I have a fundamental problem with regulations that are not clearly defined, and this seems to be one of those cases. Their language just plain ticks me off, as well.

HB 722 starts out with “relating to the regulation of massage therapists, massage schools, massage establishments, and sexually oriented businesses, providing penalties.” Do we see any legislation that starts out “relating to the regulation of bowling alleys, physician’s offices, funeral homes” etc that has to include “sexually oriented businesses?” No, we do not. Texas is far from the only state who refers to us in this manner.

As we read further, we come to an amended section (there are several amended parts) stating that it shall be against the law to provide or offer to provide massage “while nude or in clothing designed to arouse or gratify the sexual desire of an individual.”

Now here is where the language is offensive, to me. Of course, I am glad to know it’s against the law to massage in the nude. However, I think the second half of that sentence is extremely ambiguous, and is going to be open to the interpretation of whichever board members or judge in a civil or criminal court hears the first test case. While it’s obvious that lingerie from Victoria’s Secret might fit the bill, what about a v-neck top or a tank top? What about a pair of tight jeans, leggings, or yoga pants? A form-hugging sweater if you have large breasts? What about a pair of shorts, who is going to say how many inches from the knee they can be before they look “sexually arousing?”  There are some people who could manage to look sexy in a flour sack, and others who couldn’t look sexy no matter what they are wearing. In my opinion, that is a bad piece of legislation because it isn’t clearly defined. Furthermore, a couple of lines later it goes on to say that while you are in a massage establishment you may not “possess” clothing designed to arouse or gratify the sexual desire of an individual.  If you have a date after work, you’d better not hang your little black dress in the office so you can change, lest you be accused of something.

This bill also includes reflexology as a method of massage subject to their practice act. HB 722 is sponsored by Rep. Garza, (512) 463-0269,  or e-mail him here.

HB 556 seeks to exclude Muscle Activation Techniques from being covered under massage licensing. Muscle activation techniques include the detection and correction of muscle imbalances through the use of palpation and isometric exercises. HB 556 is sponsored by Rep. Howard, (512) 463-0631 or e-mail her here.

HB 1716 will exclude from licensure a lot of techniques that are commonly used by massage therapists–mostly energy work techniques including Healing Touch, polarity, craniosacral, body/mind techniques, Ayurveda, and a host of others. Strangely, the bill also includes the admonition to the public that people performing these techniques are not licensed and that they are free to seek a diagnosis from a licensed physician, chiropractor, dentist, nurse, etc and actually includes massage therapists and personal trainers in that group. Really? Diagnosing is out of our scope of practice as massage therapists and while I am usually concerned about our rights being taken away, I really don’t think it’s a good thing to say we can give a diagnosis just because we have a massage license. What’s to prevent some newbie fresh out of school from diagnosing someone?  It doesn’t matter if you’ve been practicing 25 years, you still shouldn’t be diagnosing people. We aren’t trained for that.

HB 1716 is sponsored by Rep. Harless, (512) 463-0496or e-mail her here.

I urge you to contact theses legislators to say Texas, hold ’em. None of these bills look like a good thing for massage therapists.

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If You’re Not Moving Forward, You’re Backing Up

There have been several developments in the regulation of massage in the past few weeks that I personally find distressing. Earlier this week, Florida Senate Bill 584 moved a step closer to passage. This piece of special-interest legislation would amend Florida’s massage therapy law to allow graduates of certain board-approved schools to obtain a temporary permit and practice for six months without a license, until such time as they fail the exam or become licensed, whichever comes first. Although the bill states that they must work under the supervision of a licensed therapist, the terms of that are not spelled out. Does that mean the supervising therapist is on the premises, in the treatment room, or giving an occasional phone call? This is where boards frequently get into trouble and spend a lot of time with something bogged down in a policy committee—when something has not been clearly defined—and in this case, “supervision” isn’t clearly defined.

New Hampshire is trying to abolish massage licensing altogether, as a cost-cutting, government-reducing move. That would of course mean back to square one, where anyone who knows absolutely nothing about contraindications for massage, endangerment sites, or professional ethics can feel free to call themselves a massage therapist.

Utah just amended their practice act to remove the key word “therapeutic” from the scope of practice definition and added in the word “recreational”, in what is in my opinion a misguided attempt to thwart sexual activity being conducted in the name of massage. Other than the fact that I think House Bill 243 is a big step back for our profession, I was just as shocked that the government relations folks in the Utah chapter of AMTA supported it to start with. I’m an active member of the North Carolina chapter, and I cannot imagine the leadership of our chapter supporting that.

I was gratified a few days ago to see Les Sweeney, President of ABMP, and a few days later Bob Benson, the Chairman of ABMP, weigh in with the same attitude I have about this legislation. Rick Rosen, who is a former Chair of the North Carolina Board of Massage & Bodywork Therapy, former Executive Director for FSMTB, and currently the Executive Director of AFMTE, made a comment on Bob’s blog that I think nailed the important points of this issue:

The most critical component of the state law for any regulated profession is what’s known as its Scope of Practice definition. The list of prohibited acts in a law is important, but less so than the scope definition. If what you want to do in your massage therapy practice is not listed in the scope, you can’t legally do it.

The Utah action that removed the term “therapeutic” from the scope definition, and added the term “recreational massage” may have the effect of narrowing the scope of practice for massage therapists. At the very least, it takes massage therapy out of the realm of health care and into the murky world of “other business activities”, which includes adult entertainment.

Considerations around enforcement of a Practice Act should not take precedence over the scope itself, and it is not a sound justification for downgrading the law. That’s what has occurred in Utah, and the Licensed Massage Therapists of that state will have to deal with it.

Every single word in statues and rules that regulate the practice of massage therapy is important. What you think it says is not always what it means — or what it will produce in the daily administration of a regulatory program. That’s why we need experienced and competent government relations professionals representing our interests.

I report on the legislation of massage, and I have future aspirations of working in government relations. I’ve spent a lot of time in the past few years doing research on boards and practice acts, and while I’m certainly not as experienced or learned as Rosen, I think I’m at the point of recognizing a piece of bad legislation when I see it. The way I see it, if you’re not moving forward, you’re backing up.

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The Utah Brouhaha

A couple of the officers of the Utah Chapter of AMTA are upset with me for a video I put out yesterday about H.B. 243 that is in the works in their state. You may read the bill here.

This bill removes the term “therapeutic” from the description of massage. It also modifies the language in their Practice Act to include “recreational massage.” Is there anyone among us who would like to be known as a recreational massage therapist? Please weigh in on that. I am personally not acquainted with anyone who would like to be known that way.

I read the bill in its entirety, when it was brought to my attention, and then, AMTA member that I am, went to the Utah Chapter’s website to see what they were doing about this. I was shocked to see no mention of it anywhere, so during the course of the video I encouraged AMTA members to get in touch with their board members and mobilize them to take action on this, and I urged all Utah therapists to contact their legislators to protest what in my opinion is a detrimental change in their language. I posted it on the Utah Chapter’s FB page, as well as my own.

Imagine my disbelief when I received a communication from one of their officers on my youtube channel telling me that I should have contacted them before making my video and telling me to take it down asap. They are of course free to remove it from their own page. They are not free to tell me to remove it from mine. It has had over 700 hits in the last 24 hours and been shared by over 400 therapists. One therapist had made a positive comment about H.B. 243 on FB, the last time I checked. Too many others to count were all as distressed about it as I was.

I also received a lengthy and polite response from one of their officers, that stated  “There is no mention of this on the Utah Chapter website. This matter has purposely not been published on our website at AMTA Utah Chapter precisely for the purposes of NOT bringing attention to the fact that the Massage Therapy Practice Act was being “opened for changes” in this legislative session,” and ended with the request that I remove the video without comment, and to check with them in the future before I make any reference to Utah again.

Sorry, but that will not be happening. Perhaps you have heard of the First Amendment.

Perhaps you have also heard that all legislation is an open book–or it is supposed to be. It is the public’s right to know. If something is affecting massage therapists, it is the massage therapist’s right to know. And it is the mandate of any public board and any non-profit organization to operate in a transparent manner. Anything less than that is unacceptable. Nothing is, nor should it be private, about changes in a Practice Act.

The two AMTA representatives, one of whom emailed me and the other who left a comment on my youtube page,  obviously feel differently than I do about this, and that’s their right. We can agree to disagree. But as much as I am personally mortified by this bill, I am even more mortified that someone would think that massage therapists shouldn’t be informed of what is going on in their own state, given the opportunity to weigh in on it, and to openly hear their professional organization’s stance on it, until after the fact. That doesn’t work for me, and it shouldn’t work for you. I have preached this sermon many times about knowing what is going on in your state, and this is a prime example of that.

Any state’s Practice Act may be up for changes at any time.  And when a precedent is set in one state, it’s that much easier to get it passed in another. Practice acts are always “open” to changes, assuming any interested party can manage to get it on the legislative calendar. Here in NC, we had a detrimental change that our Board had no knowledge of  at all until it was a done deal. That’s not a good thing–and keeping secrets from the massage therapists who are affected by proposed changes in legislation is not a good thing, either. I refuse to apologize for spreading the word, or for expressing my opinion on it.

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10 Questions for Alexa Zaledonis, New Chair of the NCBTMB

Alexa Zaledonis, LMT, CPT, NCTMB, is the new Chair of the National Certification Board for Therapeutic Massage & Bodywork. She is the owner/operator of Even Keel Wellness Spa, a therapeutic massage and skin care center in Annapolis, Maryland. Even Keel employs seven full-time and several part-time employees who specialize in Thai, sports and rehabilitative massage.

A graduate of the Baltimore School of Massage, she passed the NCE in 2002 and has spent the past seven years building her practice in the community. Zaledonis is a certified Lotus Palm Thai Yoga Massage practitioner and a Certified Personal Trainer through the National Strength Professionals Association. Zaledonis currently is completing her Yoga Teacher Training (RYT200). She also teaches Thai Massage at Even Keel Institute for Continuing Education and is an NCBTMB-approved provider.

A former Certified Public Accountant, Zaledonis specialized in healthcare and nonprofit organizations for more than 15 years. She received her bachelor’s degree from Albertus Magnus College in New Haven, Connecticut.

I am NCTMB myself since 2000, and I’ve seen the good, the bad, and the ugly at the NCBTMB. They had a few rocky years and have been the target of my pen on numerous occasions…and in the past year or so, have received my accolades as well, as I feel they’ve made a big effort to right themselves. I don’t expect perfection from any person or organization, but I do expect effort, and I’m glad to report it when I see it happening. I’m glad to see Zaledonis take over the helm of the 9-member Board of Directors, and recently took the opportunity to find out more about her and her future plans for the organization. I recently seized the opportunity to ask her a few questions. My interview follows, and her answers are printed verbatim:

1. How long have you been involved with the NCB, and what previous roles have you been in there, if any?

By definition, I am not your “normal” volunteer. I joined NCB as a Board member in 2007, became Chair Elect in 2009. I had no prior volunteer experience with NCB before joining the board, outside of being a proud certificant. Volunteering prior to 2007 was not a possibility. I moved to Annapolis in 2003 and began my practice while still working part time as a CPA—there was no time for sleep, much less time to be a valuable volunteer. I believe if you can’t commit then don’t raise your hand.

2. What first led you to volunteer?

I raised my hand. I had figured out how to be a competent therapist, teach the community the value of quality massage and help other therapists to succeed in a viable career. Then, one morning, I asked myself, “What is the future for my employees, for myself, for the industry?”  I was one person helping a village. I knew that I needed to belong to a bigger village, and because national certification was always the backbone of my career as a CPA, becoming a volunteer at NCB was a natural next step for me.

3. What do you feel are the biggest challenges facing the NCBTMB today?

While massage therapy may be an ancient art, the industry in this country is young and will continue to evolve. There are incredible opportunities for our profession, but that can be a double-edged sword. What I mean is, it’s easy to lose focus without input and guidance from stakeholders. That’s why we always base what we test for and what we do programmatically on what the profession tells us is important. So the challenge is really to listen—and to always make sure that the individual therapist is heard, has a say and stays involved.

Ralph Waldo Emerson said, “Do not go where the path may lead, go instead where there is no path and leave a trail.” At NCB we are trying every day to listen, and then help lead our industry to grow in new ways. Sometimes, that requires forging new paths—like the advanced practice credential for example.

4. What are your priorities for your term as the Chair?

We have so many great things going on, but my top priorities surround the execution of the National Certification for Advanced Practice, or the NCAP, and future specialty credentials. Also, addressing the issues of continuing education and nurturing and enhancing our school compliance program. I look forward to seeing all of our programs work hand in hand, each one helping the next one to add value to and take the industry to new heights.

5. In your From the Top letter on the website and the one that was recently mailed out to the associations and regulatory boards, you talk about revamping the Continuing Ed/Approved Provider program and vetting individual courses. One of the most serious problems at the NCB in years gone by was overwhelming inefficiency, which was the main reason for switching to the present system of audits instead of requiring each class to be vetted. How do you plan to keep that from happening again? Are you going to hire new staff?

Yes, NCB is developing a new National Approved Provider and Continuing Education program, but at this point, nothing is written in stone. We have invited thought leaders, subject matter experts, state board representatives, peer organizations, approved providers and certificants to engage in high-level discussions and participate in the Massage Approved Provider Panel. The response has been impressive.

I think people in the profession are ready to take the next logical step for Continuing Education. And that is to define, differentiate and identify the educational level of the wide variety of modalities and subjects offered. We are looking to design a user-friendly review and approval process, but the panel will help inform the best way to go about accomplishing that.

The magnitude of continuing education has grown far beyond the conventional methods of administering and maintaining a program. We have to think outside of the box. Forge a new path. We have a rough framework of ideas and have are asking subject matter experts to share their best thinking. This truly involves the entire profession.

Imagine this: what if it were possible that in its final form, the national program could consist of an array of industry-wide workgroups comprised of key stakeholders as part of the “engine” that vets CE for the entire profession. All-inclusive involvement. Now that would be groundbreaking! And at the end of the day, it’s everyone together working to move the profession forward while protecting the safety of the public. Blazing new trails.

6. The NCBTMB has taken a substantial financial hit in the past year or two, but as I reported in my annual financial series, there’s been a great job done in cutting expenses. Do you think the NCB can remain financially viable?

Laura, there is no doubt we have had to make some important strategic decisions. But we are proud of our accomplishments, and in fact, independent auditors have said that NCB has exhibited a textbook turnaround during the last two years.

The NCB Board, along with senior leadership, have worked hard to ensure that our current programs, personnel and operational concerns are sound, support one another and offer real benefits for our certificants and the profession. This is how we are building value. With Paul Lindamood as CEO and my love of financial statements, you can bet we will keep close watch on the fundamentals…and the finances!

7. There are now a couple of other organizations looking at getting into the approval of continuing education. Do you think the NCB can stay competitive in the marketplace if that happens?

Thus far, everyone seems to be showing great interest in being part of our Massage Approved Provider Panel. I don’t see this as competition. I see this as the industry putting forth their best effort on something, and that is a beautiful thing.

8. How is the NCAP progressing? I need to know since I plan to be the first one to take it!
And Laura we want test number one to have your name on it! NCB has spent more than a decade polling the profession and has witnessed the growing demand for an advanced credential. Not only that, but the medical industry is showing exceptional interest in it as well. We have spoken to numerous doctors who all support an advanced credential. This is incredibly exciting for the profession—and we are only scratching the surface.

Regarding our progress on the NCAP, a Job Task Analysis survey was sent out the latter part of 2010 and we have just received the preliminary report. NCB would like to thank all of our partners in the field from professional organizations to schools and students as well as industry media for spreading the word about the survey. We had a tremendous response.

Our next steps involve the development of test specifications, which will be sent out for public comment in March. After that, item writing will begin in earnest. It is a very comprehensive and rigorous process.

9. Your term is for a period of two years. Do you think you can accomplish all the things you want to accomplish?

Two years is not a long time. However, as I quoted Emerson earlier, I will be happy with my accomplishments if I can help to blaze a path to advance this profession, and most importantly leave trail markers clear enough for the next person to follow.

10. What’s your fondest hope for the organization going into the future?

I hope that the organization can help to bring this scenario to life:

Therapist calls prospective employer:

Ring Ring

Employer:             “Hello, Human Resources at Community General Hospital”

Therapist:             “Hello I am a Massage Therapist and was wondering if you are hiring?”

Employer:             “Well your timing couldn’t be better. We are always looking for qualified                                 people. Tell me about yourself.”

Therapist:             “I am a Licensed and Certified Massage Therapist. I hold a National                                 Certification in Advanced Practice, am working toward a specialty in                             Medical Massage and have a list of qualified continuing education I can                         share with you.”

Employer:             “Your credentials sound great. We only hire Licensed and Nationally Certified Therapists. Why don’t you send over a resume and we can set up a time to talk.”

You gotta think big Laura. Thanks for giving me the chance to be a part of your blog.

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Competency vs. Hours

I have long desired to see the standards for massage therapy education raised in my state and across the nation. Here in North Carolina, the requirement is only 500 hours. That varies in the US, from the unregulated states that have no requirements at all, to the 1000 hours required by New York, Nebraska, and Puerto Rico. The rest fall somewhere in between.

Our neighbors to the north in Canada have a few provinces that are unregulated, but those that are regulated have a much higher hour requirement than the norm here in the US. However, in looking over their documents pertaining to their regulations, I see that it is not really about the number of hours; it is about the basic competencies that they have set forth for an entry-level massage therapist, and I must say that I find it quite impressive. You can read those here.

I imagine that the higher number of hours is merely a by-product of the competencies that are required. It would take a lot more than 500 hours to pack all those competencies in. And I couldn’t find any fault with any of them. It actually bears a lot of similarities to our recent document, the Massage Therapy Body of Knowledge. That’s not a perfect document; it’s just a start on defining what an entry-level therapist should know here. I’ve heard a good many complaints about it. In fairness to the dedicated volunteers who gave of their time and expertise to work on it, they offered a long period for comments from the profession, and I was personally appalled at how few they got. I think they got about 600 or so, and about 50 of them were mine. It was also very telling to me that when our Board sent out a survey to the approximately 40  school owners and program directors recently about raising the standards, only 7 of them bothered to reply. There is a big lack of interest in raising the bar.

The complacency here is staggering, and people just tend to complain after the fact instead of offering input on the front end. It’s the same thing I’ve seen over and over again when it comes to detrimental legislation in our profession; a few dedicated people will contact their legislators before something awful gets passed into law, and the rest will just gripe about it after it happens. That’s another blog, and one that I’ve written several times.

I’ve actually been pushing for our Board to raise educational standards, which like anything a public board is considering gets passed along to a committee for study. It is unfortunate that we could not find any concrete evidence that requiring more hours leads to better test scores. Then again, is that what it’s all about? The ability to pass a test? In our paradigm, yes, it is. We are lacking here in measuring competency in any other way.

I am the author of a popular book on how to pass the exams that are required here, and for over ten years I’ve been teaching a test-prep class as well as tutoring students privately. Let me tell you what I’ve observed. There are some people who can’t pass a test. Does it mean they can’t give a good massage? Not at all. They might be perfectly capable of putting me to sleep on the table or helping my aching back. And on the other hand, we’ve got the people who happen to be good test-takers and who are good at regurgitating information, who couldn’t give a decent massage if their life depended on it. They just don’t have what it takes. The ability to pass a test doesn’t make you competent, in my humble opinion. It just demonstrates that you know a certain amount of information.

When I was reading the Canadian document, I was more than a little envious of it. I kept comparing it to what I learned in massage school, and thinking, “Wow, I wish I had been taught that at the beginning.” In the dozen years since I went to massage school, I have managed to learn most of it through continuing education, self-study, and on-the-job experience. I’m the resourceful type and a go-getter, and I’ve had a modicum of success in spite of not knowing these competencies right out of the gate. I’ve learned a lot of them through the school of hard knocks. There’s no doubt I could have avoided some of those hard knocks if I had known these things at the outset of my career.

As a provider of continuing education, I’ve often been distressed and appalled when people call me up and say something like, “I need 6 hours, do you have any classes that long?” They don’t give a rip if the subject matter interests them or not. I’ve also been informed that “I don’t know why I have to get continuing education, I already know everything I need to know.”  They are clueless.

One of my North Carolina colleagues stated on a forum this week that his poll showed that people were very satisfied with the 500 hours, and of course, a lot of people are. Going beyond that requires money and effort, and many people don’t want to spend any more money or effort than they can get by with. I’m personally not interested in just getting by.

Education is never wasted, and hopefully, I still learn something new every day.That’s my goal, anyway.  My education didn’t end at 500 hours. It hasn’t reached 3000 yet, but I intend for it to, and I still won’t know everything there is to know.

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Pay in Massage Therapy: What’s for Real?

I just finished reading AMTA’s 2011 Massage Profession Research Report. It’s 66 pages of information that was created from several surveys conducted by AMTA and supplemented by government statistics.

The report covers many topics, including consumer demographics, information about massage schools and their students, where massage is fitting into the general scheme of health care in the US, and statistics on the practitioners themselves.

According to AMTA’s report, during 2010 the average massage therapist worked slightly less than 20 hours per week and made $41.00 per hour including gratuities. That was down from 2009, when the average therapist reportedly worked 20.4 hours per week and made 44.90.

In looking around for verification and figures to compare these to, I checked out the Massage Metrics by ABMP, and also referred to the AMA Health Care Careers Directory for 2009-2010 and the Bureau of Labor Statistics (BLS). The BLS has faulty statistics as far as I’m concerned, because they are based on a therapist working 40-hour weeks year round, which is usually not the case. Their formula shows the median pay to be $16.78 per hour. Many therapists only work part-time, sometimes keeping other jobs that provide them with needed benefits. The AMA publication cites therapists who do more like 15 hours of massage per week and make between $15,000-30,000.

I also conducted an informal survey recently of the 1200+ massage therapists who are on my Facebook page. I asked how much money self-employed therapists charge for massage, and asked for their location, and was not surprised to see how much variance there is from place to place. I got everything from $35 in rural areas to $120 in some of the bigger cities. However, you have to remember that’s the gross, and doesn’t take into account that the self-employed have overhead that can really cut into that. By the time one pays for space, advertising, telephone, utilities, laundry, and supplies, actual take-home income is probably half that, if not less.

As far as those who work for someone else, I personally know of a licensed massage therapist who makes less than $9.00 an hour working for a chiropractor. Another acquaintance who works in a ritzy day spa in Cape Cod during the summer makes as much as $2000 a week in take-home pay, but when she’s in North Carolina in the wintertime, has worked in day spas here for as little as $12 an hour plus tips. My own staff members are paid between $30-45 an hour depending on the work they do and how long they’ve been here, and I constantly hear from therapists who work elsewhere that I am the best-paying employer in our small town.

I believe all the above organizations did the best they could in compiling these reports. I also think they are all somewhat skewed (and in fairness, AMTA does quote a 3% + or – confidence level) by several things. No survey can possibly take in every massage therapist in the US. There are still unregulated states, and any therapist who isn’t a member of a professional organization or unrecognized by a licensing or certification board isn’t going to be included in any surveys. And people tend not to answer surveys; according to www.quora.com, a statistics site, a 3% return is about average on e-mail market studies. 10% is magnanimous. According to the laws of statistics, you can get an accurate sample from a little as a 1% response rate, but I think most of us have a hard time thinking that what happens with 1% applies to the rest of us.

When it comes to pay in massage therapy, what’s for real? It’s hard to say.

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Daylight’s Burning

I hit the floor early every morning, so early that I’m usually on my second cup of coffee by 5 am. “Daylight’s burning,” my Granny used to say…meaning get up and get at it. It’s been my lifelong habit. I’m pretty worthless after 9 pm.

I’ve been feeling more than a little paranoid lately. As my schedule gets busier and there are more demands on my time, I find myself constantly looking at the appointment book on the desk at the office, the calendar on my computer, and the calendar I carry around, and hoping I’m not forgetting anything. Yes, I have been one of the last people on the planet without a smartphone, but I just ordered one a minute ago. It’ll be here in a couple of days. So I will be carrying around an electronic calendar, but I’ll still be checking it against the appointment book at the office, where I also record my activities for the benefit of my staff, who might wonder where I’m gone and when I’ll be back. I also record Chamber meetings, local events I’m attending and so forth in the appointment book, because staff members are sometimes involved or might want to be. I will also have to keep the Google calendar, because it is shared with the other members of the North Carolina Board or Massage & Bodywork Therapy, so that we can all keep up with committee meetings and the tasks that we have all been assigned to do and we are supposed to check in on it when we’ve completed our assignments. It’s a balancing act and I keep worrying about missing something.

I get to my office at 7:30. I handle the housekeeping chores, like cleaning the bathrooms, catching up any laundry left over from the night before, vacuuming and making sure all the trash cans are empty. People sometimes act shocked to hear that I still scrub the toilet at my office…well, if I didn’t do it, I’d be paying someone to do it, and I have the cleaning there down to a fine science of about 15 minutes a day. I’d have a hard time finding someone who only wants to work 15 minutes a day. When I’m there, I’m also the receptionist. I file all the insurance. I answer the phone. I schedule appointments and check clients in and out. When I’m on the road teaching, I pay someone to do the job…and frankly, nobody does it better than I do. It’s my business. It’s hard to find someone who will care about your place as much as you do and take care of it in exactly the same way. When I get back from a trip, I have to keep myself in check not to be too critical about how things were taken care of while I was gone. I know the clients got good service, I don’t have to worry about that part of it, but as for the mundane tasks of running the business, I will be pouncing on everything with my eagle eye, noticing that the blinds are dusty, or that the office helper entered a cash transaction as a credit card on the daily log or that the insurance was filed incorrectly and got kicked back.

In between all this, I try to keep abreast of the legislative and regulation activities going on that relate to massage, write my blog and work on the articles I am writing for the various magazines. For the past six years, I’ve also almost continually had a book in progress that needs my attention, too. I check in on my FB and youtube channels and make posts or upload new videos. In accordance with my own advice, I spend at least 30 minutes a day on marketing activities for my business…working up new ads, sending out the email newsletter, updating my website, calling clients, sending out birthday cards, or whatever it is I’m focused on that day.

Out of the estimated 50-60 times a day or more that the phone rings at the office, at least a half-dozen of them will be someone who wants me to answer questions about the massage board, continuing education requirements, or what they should do about some ethical dilemma they’ve found themselves in. Or I’m asked to do some project for someone, that in the end turns out to be a total waste of my time because they didn’t like the way I handled it. My e-mail is the same way, as are the messages in my FB inbox. I listened to Michael Reynold’s great e-mail ninja presentation this week, and implemented the “requires action” folder, and it is already stuffed full.

I’m participating in a lot of webinars and live events, which I’m grateful to be doing, but along with those also comes the accompanying responsibility of publicity. In addition to just getting ready to teach my own classes, there are radio interviews and video commercials to make, and of course the organizers would like those posted every day. I have to look back on my FB page and Twitter to make sure I’m giving everyone equal time. I also have this paranoia about not appearing to be fair and impartial, and I don’t want to give one event more coverage than another. I also try to help my friends in the massage profession advertise their events, and I worry about that…did I post Gloria and forget to post Felicia, or was it the other way around? I’m always checking back to see, and I’m afraid when other things take precedence, I feel bad when it doesn’t happen at all, especially if they’re helping me, which they usually do.

Like everyone else, I also have a household to maintain, laundry to do, meals to cook, a spouse to spend time with, bills to pay…I am childless, and those people who are parents have my admiration for doing all I do and more.

In the past ten days, my husband’s best friend died at the age of 61, another friend survived crashing his private plane although he did sustain some serious injuries, one of my brothers flipped his truck on black ice and thank God didn’t get hurt but it was still scary, and yesterday the wife of one of the musicians I play with on Sunday nights passed away, also at the age of 61.

None of us have the guarantee of drawing the next breath. So what if I don’t get everything done that’s on my to-do list everyday…I can’t take it to the grave and in the general scheme of things, the world isn’t going to come to an end if I don’t post a blog or make a new video. At the end of the day, all I really want is to think I did the best I could. Daylight’s burning, and I’m pedaling as fast as I can.

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Report from the Federation of Associations of Regulatory Boards

This past weekend, I attended the annual FARB conference in New Orleans.  FARB, the Federation of Associations of Regulatory Boards was formed in 1974. Members come together for the sharing of information; public boards of all types are welcome to join, as are industry supporters such as testing companies that provide exams to the membership and the law firms that represent the Boards.  The Federation of State Massage Therapy Boards (FSMTB) is a member, as is the North Carolina Board of Massage & Bodywork Therapy, and it was on our Board’s behalf that I attended.

The conference was quite enlightening. It was my first time attending this particular meeting, and the panel included speakers from various boards, everything from medical boards to social work, optometry, and even mortuary boards. Debra Persinger, Executive Director of the FSMTB, was one of the dozen or so panelists.The primary topic of discussion was the various problems facing public boards today and how those can be addressed. It seems that no matter what kind of board was represented, we all have the same problems: unethical behavior from licensees, problems with public perception about what a board actually does, problems with education and exam breaches, lawsuits, interference from lobbyists, and a lack of transparency, among other things.

The first speaker was Meghan Twohey, a reporter from the Chicago Tribune, who for a year or more has been reporting on problems surrounding the medical profession in IL. She has repeatedly been denied access to medical board records surrounding physicians who have been accused of rape and sexual assault–and who have not been disciplined–they’re still out there practicing on the public. It really brought to light how professions with powerful lobbies can close ranks around their members and continue to abuse the public trust.

Persinger spoke about various problems with massage and bodywork exams, including one association who is still giving handwritten exams in public libraries with no security measures at all in place. A representative from Pearson Vue, who administers the exams for both the MBLEx and the National Certification Exams, explained that Pearson Vue is now using something called Palm Vein technology to identify candidates at their test centers. It is reportedly much more reliable than fingerprints and should eliminate the problem of proxy test-takers who use fake ids to take a test on behalf of someone who can’t pass it.

Quite a bit of legal advice was dispensed by attorney Dale Atkinson, who represents FARB, the FSMTB, and numerous boards and agencies all over the country. Among his advice to boards, that got my attention because as a board member myself I have seen it happen: never accept voluntary surrender of a license but to instead insist upon a consent order.  He also advised boards not to be afraid to permanently deny an applicant, something that in five years I have never seen happen. We have refused to license people based on their criminal record, but they are usually told they can reapply in X number of years, usually 1-5 years. The logic, which makes perfect sense, is that some people will never be suitable candidates to place their hands on the vulnerable public. Boards have had a tendency not to permanently deny anyone for fear of litigation, such as being accused of prejudice and subjected to a discrimination lawsuit.

The same issue has affected schools, according to several educators from public institutions who spoke. Admissions departments in public universities who have a limited number of places in an educational program can and do refuse applications based on academic merit and other reasons. According to Dorinda Noble, an educator and member of the Texas Department of Social Work Examiners, one of the major issues facing licensing boards today is the proliferation of for-profit career schools who don’t turn anybody down–if you have the tuition, you’re in whether you are unsuitable to the profession or not, and if you don’t have it, they’ll bend over backwards to get it for you, in the form of crippling student loans. Incidentally, I thought Ms. Noble was the most informative and engaging speaker of the conference.

I have often preached the sermon of the need for massage therapists to stay informed and to be involved in their profession in the interest of 1) knowing the law (how can you abide by it if you don’t know what it is?) and 2) rising up together to prevent legislation that is detrimental to us. It doesn’t do any good to complain after the fact. My attendance just reinforced that. All in all, it was very informative, and from my perspective of being one who has a vested interest in the regulation of massage therapy, I’m glad I went.

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