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Behind Closed Doors

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

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

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

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

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

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

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

At the recent ABMP School Issues Forum in Austin, Texas, Bob Benson stated to those in attendance that there was 100% consensus in support of this standards-setting proposal from the organizations that attended the Leadership Summit. That’s not exactly so. COMTA, FSMTB, and AFMTE all expressed concerns after the proposal was introduced in September; they are not petty concerns, and they do not appear in any way to be based on politics or turf wars.
This is bad business for two primary reasons: First, any project that has the potential to affect the entire massage therapy profession should not be designed, approved, and launched in secret. Changing the baseline numbers of entry-level education required for state licensure is a huge thing, as it will affect schools, regulators, and future students.

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

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

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

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

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

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

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MOCC Proposal: Dis-Organized Chaos

I’ve been criticizing the Maintenance of Core Competency (MOCC) proposal from the Federation of State Massage Therapy Boards since the moment it landed on my radar, and I haven’t changed my mind. I think it’s a terrible plan that doesn’t serve any good purpose other than increasing the coffers of the FSMTB. In its present form, it appears to be a blatant move to put the NCBTMB out of business.

What has been interesting to me is to see the way this thing has unfolded. Right off the bat, I had some criticism of the Task Force assembled by FSMTB that supposedly got this thing together. I say supposedly, because when I saw who was on it, my first thought was “No, they couldn’t possibly have supported that.”

So here we have Immediate Past President of AMTA, Glenath Moyle, whom I know personally and like a great deal. In spite of Moyle’s presence on the Task Force, the national office of AMTA only took a few days to come out with a statement shooting more than 20 holes in the MOCC proposal. In spite of the fact that the FSMTB chose Task Force members who were supposedly representatives of their respective organizations, that apparently didn’t work too well in this case.

AMTA has never allowed an individual officer to speak for the entire organization without their board’s approval; their blanket slam of the proposal seems to indicate that they never saw the proposal prior to publication, much less given the opportunity to sign off on it. I wholeheartedly support AMTA’s condemnation of this far-fetched plan, but I didn’t like to see Ms. Moyle in a position of looking like she had egg on her face. That could have been prevented if this process had been carried out in a more transparent manner.

Then we have Pete Whitridge and Cherie Sohnen-Moe, President and Board Member, respectively, of the Alliance for Massage Therapy Education. Since both of these leaders are well-known continuing education providers, and represent an organization that is largely composed of CE providers and massage schools that sponsor CE, I was shocked at their support of this plan. I felt at the time, and still feel, that if the membership of the AFMTE had been polled about this plan, the consensus would be a big fat NO.

The theory that this plan will not take away business from CE providers is BS of the highest order. Since the proposal calls for newly-created education modules that the FSMTB will put on their website to be the ONLY course work required for state license renewal – with all other CE related to “professional development” becoming optional – it doesn’t take a rocket scientist to figure that out.

The AFMTE issued a statement last week,that frankly, I feel should have been included in the proposal itself. I might have felt better about the whole thing if this was part of the original proposal. The AFMTE has suggested that they support the FSMTB contracting with the NCBTMB to administer the process of approving CE courses and providers, as that is beyond the resources and scope of most state massage therapy boards. The NCBTMB was excluded from the MOCC Task Force, which is petty politics to me. This plan affects them in a major way and they should have been included. They have expressed their willingness to work with the FSMTB, and frankly it’s the Federation that has prevented it from happening.

That doesn’t look good to me. When the NCBTMB convened a meeting of diverse stakeholders last year for the purpose of getting input into revamping their programs, they invited the FSMTB to participate. Their exclusion from the MOCC process is, I’m sure, based on the Federation’s party line, “the NCBTMB isn’t regulatory.” Big freaking deal. That is true, but they exist and for 20 years have administered the only national approval process for CE providers. AMTA, ABMP and AFMTE are not regulatory organizations and they were invited to serve on this Task Force. There were people on the Task Force from states that don’t even have any CE requirements to begin with. That dog don’t hunt, as we say in the South.

As the NCBTMB has announced their intent to sunset the existing National Certification program in favor of a post-graduate Board Certification credential, it is obvious that they are phasing themselves out of the entry-level market. At this point, they are not letting go of offering their National Certification Exams for state licensure purposes. However, that use of the cert exams is on a steady path of decline, as the MBLEx is now being used by the overwhelming majority of massage school grads. I think with some negotiation with the FSMTB, they would let it go altogether. The thing is, cooperation is only possible when both parties come to the table. The FSMTB isn’t playing nice.

There will need to be some skilled facilitation to get these organizations to look beyond their own interests, and to work together to achieve broad-based solutions. We need a single national approval program for continuing education, and our field will truly advance when there is just one entry-level exam for state licensure (instead of the current crop of five).

Every professional organization should take a lesson from some of the past troubles at the NCBTMB: all it takes is to get one or two people with a personal agenda in a position of power, and the fallout is detrimental to the organization and the profession on the whole. Board members have the responsibility of checks and balances. To those who sit on their hands and blindly follow the leader, I say get up or get off.

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Cheers and Jeers

I confess to being too lazy to be in depth with my blog this week. It’s Easter Sunday, and quite frankly I need a day of rest, so I’m just handing out a few cheers and jeers. There is usually a swirling sewer of legislation going on somewhere, and I’m sure today is no exception. AMTA keeps their finger on the pulse; you can read the latest here. ABMP also reports legislative updates; you can read them here under News and Information.

Cheers to Idaho for becoming the 44th state in the nation to license massage therapists. Beginning July 1 2013, all therapists will be required to have a license. There will be a two-year grandfathering period for therapists who meet certain qualifications. You can read the entire practice act here.

Cheers to COMTA (Commission on Massage Therapy Accreditation) for their improved website and their new online learning resources. Schools who are seeking accreditation, or thinking about doing so, can access a number of informational courses about the process. I started as a site reviewer for COMTA last year, and will be doing several site visits for them in the next few months. Seeking COMTA accreditation is a voluntary process that is rigorous–and sends a clear message for any school that you are doing more than you have to do.  I would encourage any school owner who wants to uphold standards of excellence to consider seeking COMTA accreditation. Part of the process is a very thorough self-study….it forces the question of “What could we be doing better?” The organization will bend over backwards in order to help you meet your goals.

Jeers to Lifetime television for The Client List, which debuts tonight. Cheers to ABMP and AMTA for contacting the producers of the show, for all the good that did, which was exactly none. Lifetime’s response is that they do not intend to show massage therapists in a bad light. If portraying a massage therapist as a prostitute isn’t casting a bad light on massage therapy, then I don’t know what is.

Jeers to the Federation of State Massage Therapy Boards for their recent proposal on Maintenance of Core Competencies.

Cheers to AMTA for shooting more than 20 holes in it.

Cheers to the Massage Therapy Foundation for their new and improved website.

Cheers to the NCBTMB for their new plan of action. It isn’t perfect but it’s a big step in the right direction.

That’s it from me this week. Even Laura Allen falls down on the job, and today’s the day. If you’d like to add a cheer or a jeer, feel free to do so in the comments. Everyone have a blessed Easter and a peaceful and prosperous week.

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Inquiring Minds Want to Know

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

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

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

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

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

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

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

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

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NCBTMB: New Plans for the Future

The National Certification Board for Therapeutic Massage & Bodywork has announced several bold new initiatives for moving the organization ahead. It’s no secret that the NCBTMB has had their ups and downs. The immediate past CEO, Paul Lindamood, had a lot to do with bringing them back from the brink of financial disaster that was caused partially by the MBLEx cutting drastically into their exam income, and partially by a previous administration that seemed hell-bent on bankrupting the organization. In a press release dated March 14, the organization outlined their new directions:

— Beginning in the first quarter of 2013, NCBTMB will end its existing National Certification credential, and will replace it with a new Board Certification credential. This will require passing the new Board Certification exam, which has Eligibility Requirements of 750 hours of education, 250 hours of hands on work experience and passing of a background check. Additional qualifications may be added, based on feedback from the profession. This will elevate the value of “certification” to a true post-graduate credential as opposed to the entry-level status it has held since its inception.

— In the summer of 2012, NCBTMB will launch a new online portal where all interaction with NCBTMB can be accomplished. including applications for all exams, recertification, approved providers, school reviews and payment for all NCBTMB services and products will be accomplished through this new portal. This will streamline their operations and cut down on the amount of time involved for all concerned.

— Beginning in the summer of 2012, NCBTMB’s continuing education approval program will also require courses to be vetted, along with CE providers. Providers will be required to submit their qualifications to teach each course. Previously, once a provider was approved, they could add on courses at will, which has caused some problems with people teaching subjects they are not truly qualified for. There has been some abuse as well concerning inappropriate course content, such as people creating a course just to sell a product they’ve invented. I attended last year’s meeting held by the NCBTMB for the purpose of gathering input and suggestions on how to improve the CE program, and vetting individual courses was at the top of the wish list. It’s good to see them listening and taking suggestions.

— Effective immediately, the current online practice exam is discontinued. In the summer of 2012, NCBTMB will launch a new online education resource offering thousands of questions to help candidates test their knowledge of many specific areas of practice. The old practice exam only had 65 questions, so this is a vast improvement for testing candidates.

— Licensing Exam. The NCETM and NCETMB, currently accepted for licensure in thirty-nine states, will be retained. The exam may now be taken at any time prior to graduation; however, formal notification will be released only upon proof of graduation from a minimum 500-hour massage therapy program. State licensing requirements are dictated by the individual states.  Since most of the existing massage licensing boards in the US have now joined the Federation of State Massage Therapy Boards, and the official line from that organization is to urge all states to exclusively adopt the MBLEx for licensing, this particular move keeps the waters a little muddy.

Since the creation of the Federation of State Massage Therapy Boards and the exploding popularity of the MBLEx, the NCBTMB has found themselves in a difficult position, and not just financially. For about 15 years or so, the exams from the NCBTMB were the sole path to licensure almost everywhere, except in a few states that had their own exam. In states that had no licensure, National Certification has been used as a credential to set educated and legitimate massage therapists apart from the “massage parlor” workers.

With only a few states left that aren’t regulated, most of which are working towards adopting regulations, the MBLEx will probably be used as the licensing exam if and when it does happen. The MBLEx is an entry-level licensing exam. By the NCBTMB’s own admission, the NESL exam they have used for licensing is the same exam they have used for certification–the only difference being the name of it– that has up to this point been a somewhat confusing state of affairs. The NCBTMB is currently seeking item writers and planning to beef up the new exam, so we’ll see which way that goes. In light of the new requirements for National Certification, I think it would make sense now for them to get out of the entry-level licensing game altogether and let the new credential truly mean an increase in value to those who seek a higher credential.

In a paper he authored in May 2011, The Optimal Role of National Certification in the Field of Massage Therapy, Rick Rosen, the co-founder and former Executive Director of the Alliance for Massage Therapy Education, stated the following:

….national certification at the entry level has been rendered unnecessary and redundant as a first credentialing step. To advance the field of massage therapy towards full professional status, NCBTMB must relinquish the task of entry-level credentialing to state licensing boards via the MBLEx. In place of its existing program, NCBTMB has an excellent opportunity to upgrade and repurpose what has been called “national certification” to a graduate-level credential. Decoupling certification from licensure would bring NCBTMB back to its original mission as the provider of a truly voluntary program that allows experienced practitioners to distinguish themselves through testing and demonstration of continued competence. That’s what certification was designed for.

Well, it’s great that NCBTMB has finally listened to what Rosen and other leaders in the field have been suggesting for a number of years.

I spoke with CEO Mike Williams and Board Chair Alexa Zaledonis last week to get a few questions answered, namely what has happened to the much-touted plan for an advanced certification. Williams and Zaledonis stated to me that the NCBTMB has cast aside their former plan for the N-CAP (Nationally Certified Advanced Practitioner) exam, based on negative feedback from the profession. I had personally been in favor of the N-CAP; however, I think the new credential is ultimately a much better solution. Another of Rosen’s statements, “Our field would benefit significantly from having a “generalist” credential that is available to massage therapists who have achieved a designated level of professional experience and continuing education beyond their foundational training,” seems to bear that out.

I don’t believe true licensing portability is ever going to happen in my lifetime. I am not sitting around holding my breath waiting for our organizations to all get together and sing Kum Ba Yah, although that would be nice. Turf wars are not a pretty sight, and the one between the NCBTMB and the FSMTB is no exception.  Both organizations have something to contribute, and they just need to get clear on what that is and to conduct themselves in a transparent and professional manner and in the spirit of what is good for the profession on the whole, not just what is financially lucrative for one organization. The recent MOCC proposal from the FSMTB that I have been reporting on recently would be financially lucrative for them, and that’s the only good thing I can say about it. To ignore the organization that has administered most of the continuing education for massage therapists in the country for the past 20 years is a political move that is, in my opinion, aimed at taking more money from the NCBTMB in the hopes of eventually crippling them altogether.

I remember the dark days when I had to report on the shenanigans of some of the previous leaders of the NCBTMB, and the Federation seems to be forcing me to do the same to them with some of their recent actions. I was gratified last week to see AMTA shoot down the MOCC proposal on more than 20 points, while ABMP President Les Sweeney spoke out in favor of it. It will be interesting to see if they have a response to this new plan from the NCBTMB.

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MOCC-ERY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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A Disgrace in Iowa

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

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

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

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

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

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

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

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

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Legislative Hullabaloos in WV and TN

As usual, the opinions on my blog are my opinions and not to be construed as the opinions of anyone else.

I  haven’t had much to say on the legislative front for a few months…when the legislators go home for the summer, not much is happening; then there tend to be shorter sessions in the fall before they take a break for the holidays and not much happens then, either. Well, the break is over, and how.

I received a press release from the NCBTMB yesterday announcing what amounts to a win for them in the state of WV. Here it is:

The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) is pleased to share the news that Nationally Certified Massage Therapists in West Virginia will continue to have their services covered by the Public Employees Insurance Agency (PEIA). Initially, the PEIA Finance Board considered discontinuing massage therapy coverage altogether as a cost-savings measure, but with input from NCBTMB, the American Massage Therapy Association (AMTA) and practicing therapists, it will still cover active employees and non-Medicare retirees who visit massage therapists with national certification.

The new financial plan goes into effect July 1, 2012. Certified therapists must also carry $2 million in malpractice insurance as well as follow treatment guidelines of the AMTA.

“NCBTMB commends the Public Employees Insurance Agency for providing their employees with access to nationally certified massage therapists who commit to a code of ethics, standards of practice and pass a national credentialing exam,” said NCBTMB CEO Mike Williams. “We see this as a win-win situation for both PEIA employees and Nationally Certified Massage Therapists in the state of West Virginia.”

“PEIA has an obligation to state employees to cover necessary medical treatments, but also an obligation to the state of West Virginia to be fiscally responsible,” stated PEIA Executive Director Ted Cheatham. “We stand behind the PEIA Finance Board and its decision to only accept massage therapy claims from therapists who meet the new criteria.”

Disclaimer: I am Nationally Certified myself and have been since 2000. I am not obligated to maintain that; I just do because I want to. When I got licensed, it was also the only option available, as it was in most states for many years, saving those few that have their own exam. As any of my long-time readers know, I’ve had my ups and downs with the NCBTMB, criticized them many times, and applauded them when I thought they deserved it. I am also a  member of AMTA, and due to having  multiple coverage on different policies I have as a business owner and employer, I personally have $12 million of liability insurance. If I lived in WV, I’d be good to go.

My first thought on this was that it will be challenged immediately by the Federation of State Massage Therapy Boards.  I’d  bet the farm on it. West Virginia is a member state of the Federation. The Federation, and thus the member states, own the MBLEx (Massage & Bodywork Licensing Exam) which is accepted by the state of WV, as is the NCB exam. Therapists in that state have a choice of which exam to take in order to get licensed.

This move by the legislature would seem to be an endorsement of the National Certification Exam, as well as an endorsement of AMTA, since one of the other requirements for being able to file insurance is adherence to AMTA treatment guidelines. They don’t come right out and say you have to be a member of AMTA; just that you have to be following their guidelines. It also requires therapists who want to participate in the state employees’ insurance program to have a minimum of $2 million worth of liability insurance.

I personally file a lot of insurance in my own office, and it’s a standard practice for insurance companies not to deal with you unless you carry liability insurance, so no big deal on that front. AMTA’s treatment guidelines are on their website, accessible to the masses, including people who are not their members, so that’s really no big deal either.

What is a big deal here, at least to me, is that even though the state says that passing either exam is adequate for a massage therapist to receive a license, it is now saying that only one of them is adequate for therapists who wish to file state employees’ insurance. To me, that is sending a confusing message to students who haven’t yet taken an exam, as well as to the practicing therapists who chose to take the MBLEx, ignorant of the fact that this new law would be coming down the pike, and even to the massage-consuming public. It’s a statement that basically says “If you’ve taken the MBLEx instead of the National Certification Exam, then you’re good and qualified enough to work on the public, except for the state employees, and you have to be Nationally Certified to work on them and file their insurance.”  It is really stating that one licensee is better than another.

Is there going to be any fallout from this? Absolutely, in my opinion. The Federation, since its inception, has encouraged all member states to use the MBLEx exclusively for licensing purposes, while still stating that certification has its own value as a credential, but maintaining that it should no longer be used as a licensing exam. Since WV has opted not to follow that suggestion, and has kept both exams, massage schools and instructors in WV will now be falling short if they don’t inform their students of this legislation, and will basically be saying “You can take two different exams. If you want to file insurance, take the NCBTMB exam. If you don’t care about that, you can take the MBLEx.”  So two therapists can have the exact same 500 hours of  education that the state requires, and the exact same license that the state issues, but the one who took the MBLEx won’t have the privilege of filing insurance on state employees. The logic here is escaping me. There is one caveat: WV is currently not requiring any continuing education of massage therapists; however, maintaining National Certification requires 48 hours of  continuing education every four years. Still, I don’t think that’s a big factor. As long as you passed the NCB exam last week, you could be accepting the state employee’s insurance, before you’ve ever had a single hour of continuing ed, so I don’t see how that really fits into the picture.

I don’t think this is over, and I’ll try to keep you updated.

WV isn’t the only place where trouble is brewing this week. Therapists in TN are up against HB 2387 SB/2249, which would take the regulation of massage therapy out from under the health care professions and move it to the Department of Commerce and Insurance. That is almost bizarre that it has anything to do with the department that governs insurance–because most insurance companies will not pay for any health care services unless they are provided by a person who is in a licensed health care profession. This move would basically state that therapists are not health care providers. The Department of Commerce and Insurance regulates trades, not professions. For all intents and purposes, this is a statement to massage therapists that “you are practicing a trade, not a health care profession.”

Quite a few states have been on cost-cutting missions during the past few years of recession, combining public boards and even going so far as to disband altogether–or threatening to–but this cannot be construed as one of those cost-cutting missions. Tennessee’s massage board is self-supporting through licensing fees. They do not cost the taxpayers any money.This is not tied to financial impact on the state in any way. In fact, I’m not sure what it’s tied to or what the logic is behind it, other than a slap in the face to the massage therapy profession.

I urge all TN massage therapists to immediately  contact your legislators. Don’t wait until it’s a done deal to express your opinion.

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It Was a Very Good Year

As I look back over 2011, it was a very good year. For the 8th year in a row, since I first opened my business, I am going to finish the year with a growth in sales and in my bottom line. That’s rather miraculous, considering the unemployment rate in my county has been between 14-16% for most of the year. Many businesses have closed. The foreclosure notices in the paper have far outweighed the job listings for the past couple of years. And still, we have thrived, and we had zero staff turnover. I’m very grateful to be blessed with such wonderful staff members and clients.

This year started out with a bang when we made a trip to Miami to participate in the Massage School Makeover organized by Angie Patrick of Massage Warehouse. What started as a little project of Angie’s snowballed into one of the most magnanimous displays of generosity throughout the massage world. The Educating Hands school ended up with over $80,000 worth of equipment and supplies donated by industry partners. As they were moving into a brand-new building at the time, it was just a fresh start for their well-respected school. It was a joy to participate in it and to see so many of my friends from the profession at the festivities. I also got to visit my youngest brother on that trip, and got to see a dear friend who used to live here in NC that I  hadn’t seen for several years. That one was bittersweet since her husband, who was also a friend and former business partner with Champ, had passed away suddenly a few months before, but it was a wonderful visit.

I was honored at the American Massage Conference this year as the Massage Therapist of the Year…and that wasn’t even the highlight of the conference. Getting up to play a few tunes with Errol N Schroeder at the dinner dance was the high point for me. I had a blast! Scott Dartnall and the rest of those Canadians came out of the gate running and made their first American event a resounding success.

Then the World Massage Festival came along and I was inducted into the Massage Therapy Hall of Fame, which I appreciated, but I was also awarded there for Government Relations, which I’d have to say meant even more to me. I’m no Sally Hacking–whom I greatly admire and who has been working in GR for several decades–I’m not able to go all over the country attending legislative sessions and even if I could, I certainly lack her expertise and experience; the award was for my efforts to keep the masses informed of what’s going on through my blog and social media. My politics aren’t popular with everyone, and that’s okay. I feel good about it if I am able to jolt even one person out of complacency to take up the fight against detrimental legislation. I got to play some music at that one, too. The Hinkles are just some of the nicest people in massage and I always enjoy the World Massage Festival, which I refer to as the Woodstock of massage. Leave your coat and tie at home, and just come and have a great time! The 2012 event will be in Las Vegas.

My annual trip to Ireland was one of the high points of the year. It always is. I enjoy teaching the students at the Obus School of Healing Therapies, hanging out with my Irish friends, visiting a few pubs 🙂 and in general, just breathing the Irish air.

I traveled a lot this year. I was invited by the NCBTMB to come to Chicago for a meeting with a lot of industry leaders to offer input on how they can improve the Approved Provider program. I in particular appreciated that meeting, because that’s where the seed was planted for the Massage Therapy Profession Leadership Summit that took place a few months ago, where for the first time, all of our national leaders came together for the common good. It was attended by the executive management and board chairs from the AFMTE, FSMTB, AMTA, ABMP, COMTA, NCBTMB, and the MTF. Speaking of the Massage Therapy Foundation, it was another red-letter day for me to be included on Rise and Shine, a CD of wonderful music donated by massage therapists to raise money for the Foundation. If you don’t have your copy yet, get on the ball! I am very honored to be in the company of such great musicians. It is truly a great compilation.

The Alliance for Massage Therapy Education meeting in Charleston was one of the best events I’ve ever attended. The annual national convention of AMTA in Portland was probably the best one I’ve ever attended, and I’ve been going to those for quite a few years. Kudos to the Oregon Chapter and to President Glenath Moyle for putting on a heck of a good time in such a lovely city. I also got to make my first trip to New Orleans on behalf of the North Carolina Board of Massage & Bodywork Therapy, and it was a blast. I completed five years of service to that board this year, and while I miss the wonderful staff and friends I made at the board, I don’t miss that five-hour haul to Raleigh or having to participate in disciplinary hearings. I got to make my first trip to Los Angeles to attend the Federation of State Massage Therapy Boards meeting, which was as usual, informative and a good time visiting with so many other board members from across the country.

Without dragging out my calendar, I can’t recall every place I got to teach in this year, but they were all fun and filled with beautiful people. One of the high points–literally–was the Take it to the Top Summit put on by Vivian Madison-Mahoney over in Gatlinburg, TN. The hotel was at the top of a mountain, we were on the 14th floor, and the view was just beautiful. That was one of the best education conferences ever, and Vivian and her husband John certainly know how to throw a great event. A lot of my buds were there–Lynda Solien-Wolfe, Michael McGillicuddy, Irene Diamond,  Mike Hinkle and his wife Cindy and a lot more, and a good time was just had by all. I got to play some music at that one, too. Vivian loaned me her limited edition Martin for the occasion since I came without a guitar. It was great.

I made my first site visit as a peer reviewer for COMTA a couple of months ago. I went to New Bedford, MA to review a community college massage program. It was a good learning experience for me, and the other reviewers were great companions. We had a good time. Our hotel was across from the harbor and a good seafood restaurant, so it was a good time.

I had some great classes at the office this year. Marjorie Brook came down from NY to teach a Scar Tissue Release seminar, and she was accompanied by my friend Allissa Haines. We had a good time visiting with them. Christine Courtney and her husband Colum came over from Ireland for Christine’s classes in Indian Head Massage and Traditional Chinese Medicine, and we always look forward to their visit as well.

On a personal level, lest I just sound like an effervescent fool who never has a bad moment, we’ve had some. My husband’s best friend Brent Stephens passed away this year…he was suffering, so it was a blessing for him to go, but it was still a great loss to both of us. Another dear friend died suddenly this year. Donna Metcalf was the picture of health when I saw her last, and three weeks later, she was gone…an unfortunate case of going to the hospital for a simple procedure that went very wrong. Donna was a force of nature, one of those women who dressed in sparkly clothes and a feather boa, and just lit up every room she ever entered. Her death was a shock. It was also a reinforcement that you ought to live every day like it’s your last. It just might be.

I’ve had some family trauma and drama this year…hasn’t everybody? But I’m pleased to say it seems to be on the upswing. My constant prayer is that those family members who need to forgive each other will just get on with it. One year at Christmas when there were some family divisions, my husband said “Well, we could have two dinners.” He was referring to the people who weren’t speaking to each other and the “I won’t be there if they’ll be there” situation, and my reply was “Hell no, we will not have two dinners. They can sit down and break bread with each other or they can go to McDonald’s.” My fond hope is that they’ll all come to the table. The people we resent feel good. Carrying around resentment is, as someone said, like drinking poison and waiting for the other person to die. It isn’t hurting anyone except the person carrying it around.

One of the last great things to happen this year was my husband Champ passing the MBLEx. He is currently waiting for his North Carolina massage license to arrive. Champ is a builder by trade, and the economy here has been a sudden death to his business. There are so many foreclosed properties here, no one needs to build anything. You can buy a house that was on the market three years ago for a million bucks for less than $200,000. You can buy a perfectly livable house for less than $30,000. In fact, if you only need a small one with one or two bedrooms,  you can find some for less than $20,000. Still, I feel optimistic that things are looking up. Facebook has recently built a new data center in our town, and a couple of other manufacturing businesses have come in on their coattails. Hopefully, the economy is going to turn around and the residents in my county will see their circumstances improve. I certainly hope so.

Another great thing this year was what I have been referring to as The Grand Purge. I have been on a mission the past couple of months to clean out my house and my office. I keep watching the old video clip on youtube of George Carlin and his rant about “Stuff.” I have too much Stuff. Or rather, I had too much Stuff. A lot of it is gone…I’ve donated things, sold things, thrown out some things, burned some things…I’m getting rid of my Stuff. Stuff is like an albatross around your neck. My attitude is if I haven’t used it in a year, I’m not going to use it in another year.  I figured if I was going to move, and wouldn’t want to take it with me, then I don’t really need it. So goodbye, Stuff. It’s been very liberating.

I’ll remember this year. A lot of good things happened. A few bad things happened. That’s the way life goes. But all in all, it was a very good year.

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Rick Rosen: A Job Well Done

Rick Rosen, MA, LMBT, Founder and Executive Director of the Alliance for Massage Therapy Education, announced last week that he will be stepping down from that position effective November 30.

In his letter to Alliance members, Rosen stated that he is returning to his full-time duties at the Body Therapy Institute in Siler City, NC. He founded the school in 1983 and has co-owned and co-directed it with his wife, Carey Smith, for the past 20 years. Their beautiful school and 150-acre property is for sale, and they intend to move permanently to their new abode on the Big Island of Hawaii whenever it’s sold.

Rosen has been a massage therapist since 1978. There are very few people in this profession who could claim anywhere near the amount of hours he has spent volunteering his time, and working for the evolution of massage therapy – both on the legislative and educational fronts.

I first met Rosen in 2000 when he was a founding member and the first chair of the North Carolina Board of Massage & Bodywork Therapy, a position he held from 1999-2003. He was very instrumental in getting massage regulated in our state and in assisting the Board’s legal counsel in drafting the administrative rules and statutes. As a former Board member myself (2006-2011), I appreciate fully the countless hours of unpaid work, and imagine that to be so much more for a start-up Board.

Rosen has always had a fondness for getting in on the ground floor and helping to lay the foundation for the future success of organizations. He also served as the first Executive Director of the Federation of State Massage Therapy Boards (2005-2006), and wrote the Request for Proposal that led to the development of the MBLEx as the licensing exam of choice.

In 2009, Rosen hand-picked some seasoned educators to help launch the Alliance for Massage Therapy Education. Under his leadership, the AFMTE has made its mark as the stakeholder for education among the professional organizations. Recently, the ACCAHC Board of Directors invited the Alliance to join its Council of Colleges and Schools as the designated education representative for the massage therapy field, further solidifying the Alliance’s role. Not bad for an organization only two years old.

Rosen’s school was the first to offer professional training for massage therapists in the Carolinas, and the first to offer post-graduate training. BTI was also the first school in the Carolinas to receive accreditation from the Commission on Massage Therapy Accreditation. He has presented massage education all over the country and in West Africa. He has been a professional member of AMTA since 1983, helped form the AMTA-NC Chapter, and was Chapter President from 1985-1987. He has authored a number of white papers, and was a contributing author to TEACHING MASSAGE: Fundamental Principles in Adult Education for Massage Program Instructors, published in 2008 by Lippincott Williams & Wilkins.

Rosen’s pioneering contributions to this field over the past three decades have been many, and often unsung. In fact, I contacted him and requested a copy of his resume before I wrote this – and I could write a book about all the things he’s done in the arenas of bodywork, education and government relations that I had no idea about.

I gave a list of “kudos” and “thumps on the head” in a recent blog, and I had included a kudo to Rosen for starting the AFMTE. I’ll repeat that here, along with an additional word of thanks for all he has contributed to the massage therapy profession. It’s been a job well done.

Rosen shared with me that he is leaving the door open to future teaching, writing and consulting projects that can continue to advance the field. I’m curious to see what he gets into next!