CE Providers: Expenses Going Up, Income Going Down

In January of this year, I blogged Continuing Education Providers: Sink or Swim, and followed up that one with the report from the meeting convened by the NCBTMB, where profession leaders were invited to give input into the revamping of their Approved Provider program.

Last week at the wonderful annual meeting of the AFMTE, one of the presentations was by Debra Persinger, Executive Director of the FSMTB, who talked about the intention of the FSMTB to start approving continuing education. One of the burning questions from the audience was “how much is this going to cost us?”, a question without an answer as of yet, since their program is still in the planning stages. Knowing the folks at the FSMTB, I don’t expect it to be anything I would classify as exorbitant, but unless it’s free, it will still be one more expense for us to pay.

I’ve previously mentioned the states who have their own approval process–and accompanying fees to pay–for continuing education providers. With the exception of Florida, who doesn’t charge you additional money if you are already an Approved Provider under the NCBTMB, these range from a couple of hundred dollars to “you don’t want to know.”  There’s a reason why I’m not teaching in those states…it isn’t worth it to me, at this stage of my career, to lay out hundreds or even thousands of dollars, and in some cases to complete a mountain of paperwork, to teach in a location that I may visit only once.

Another unfortunate trend is all the expense associated with presenting at trade shows, spa exhibitions, and conferences.  At many of these events, not only do you not get paid to teach; in some cases you actually have to pay for the privilege. Big companies who budget thousands of dollars into their advertising plan can afford to pay a big price for a booth. With a few of the heavy hitters being the exception, the average individual provider cannot. It’s a Catch-22 of spending the big bucks to get your name out there, and then rolling the dice to see if you’re going to be able to recoup that in sales–assuming you have anything to sell. Some teachers are just that–teachers–and they’re not necessarily textbook authors or purveyors of DVDs, home study courses, etc.

I’ve been an Approved Provider since 2000, and I have organizational approval. I have a classroom at my facility in Rutherfordton, NC, where I teach myself and host other instructors. During the recession of the past three years, I’ve had to cancel classes that some of the most well-known teachers in massage were scheduled to offer. Some of them didn’t receive as much as one inquiry about the class. In addition to mailing to licensees, advertising in a number of venues, my publicizing it to my email lists and social networks and them publicizing it to their own substantial lists, it just didn’t happen.  The classes that did happen have tended to be the ones taught by more local teachers, not as well-known, and not as expensive, as some of the big names.

Some perfectly competent, long-standing, and popular teachers have suffered to the point of drastically reducing the price of classes in order to fill seats and maintain their income. One of the most well-known teachers told me a few weeks ago that his teaching income was down $70,000 last year due to the recession. I know many who have never made that kind of money in any year, and their loss has been proportionate.

All the expense associated with teaching continuing education, in my opinion, is going to have some serious fallout. Some talented, but not necessarily famous, instructors will give it up because they just can’t afford to keep on doing it. By the time you provide handouts, pay your own travel expenses, advertise your class, ship whatever books or products you might have to offer, your profit has flown out the window along with the ridiculous price of your airline ticket.

True, some well-known providers have corporate sponsorship. Those are the exception; not the rule. Corporate sponsorship usually goes to those who are already at the top. They want someone with name recognition whose picture looks good in their advertising and helps sell their products. There are only so many big corporate sponsors. Small, but quality, companies often don’t have that money to spare.

It will be interesting to see how the CE environment changes when the FSMTB gets their program up and running. Their mission is public protection, and during her talk, Persinger addressed that fact. I don’t think the Federation intends to start approving Reiki classes, although I could be wrong. I believe their intent is to approve classes that have a direct bearing on public protection, such as ethics, contraindications and the like.

The lack of income is not just an issue for CE providers. Massage schools are notorious for low pay, and therein lies one of the problems in attracting quality teachers. They may deservedly feel they’re better off doing massage for $60 an hour than teaching for $20 an hour. Most of them don’t do it for the money. They do it because they love to teach.

That’s why I do it. I don’t have a corporate sponsor. I can’t afford to go everywhere I’d like to go. I fit in as many events as I can, and sometimes I have to pass one up. I know a lot of providers in the same position. I had many people say to me last week that they would have liked to attend the AFMTE conference but just couldn’t because of finances. Even when a conference is reasonably priced (as that one was), travel, hotel, meals, missing income when you’re gone from your office, or paying someone to be there covering your office when you’re not, adds up.

I’m hopeful that the education atmosphere is going up, along with income for those who provide it. It really doesn’t have anywhere else to go.

Report from the AFMTE Annual Meeting

I’ve just returned from the second annual meeting of the Alliance for Massage Therapy Education in Charleston, SC.  It was an excellent gathering from start to finish.

There were keynote speakers throughout the weekend, daily opportunities for those present to give input into the initiative on teacher standards the Alliance is undertaking, informative continuing education classes, group sessions, a comfortable setting, and plenty of socializing with friends and colleagues.

The first keynote address, “Creating a Culture of Teacher Excellence,” was given by Tracy A Ortelli, an education director from the nursing field who has vast experience in implementing standards of teaching excellence in that profession. She was a good choice since the same difficulties basically face any licensed profession when their educational objectives are evolving with no way to go but up. She was very engaging and had a lot of expert advice to share…including what personally jumped out at me:  “Do not assume that people learn to be teachers through on-the-job-training, or ‘trial by fire’, rather than through planned, deliberate preparation.” Timely advice for all those last year’s students who are this year’s teachers, and those who place them in those positions.

Executive Director Rick Rosen gave a report on the state of the Alliance, including the good news that attendance at this year’s meeting was up 50% from last year’s inaugural session. Rosen also shared the details of the simplified dues structure and the many new and improved benefits that are a part of Alliance membership.

Becky Blessing gave presentations on the Alliance Code of Ethics and the National Teacher Education Standards Project, and Core Competencies for Massage Therapy Teachers. I attended all three. Ben Benjamin spoke about the dynamics of effective communications. I attended a presentation on government relations led by Sally Hacking, the Queen of Government Relations (she’s actually the GR rep for the FSMTB, but she’s been doing this for 40  years for a number of entities so she’s the Queen to me) and Pete Whitridge, President of the BOD of the AFMTE.

I also attended a session on the proposed new CE approval program of the Federation led by Debra Persinger, and their new CE project coordinator Lorena Haynes, with Sally occasionally making clarifications. Among the attendees at that meeting were Alexa Zaledonis, Chair of the NCBTMB and Sue Toscano, Chair-Elect. They were a class act in that meeting and expressed their willingness to cooperate and collaborate with the FSMTB, an attitude  that would do well for all concerned to adopt. It was a lively discussion. Jan Schwartz also gave a great presentation, “The Role of Massage in Complimentary Health Care.”  Other topics for massage schools, instructors, and CE providers, including instructional design, financial aid participation for schools, increasing enrollment, and ethics in education were covered by Iris Burman and Cherie Sohnen-Moe, massage school marketing strategist Lex Filipowski, Anne Williams, Dr. Tony Mirando and Demara Stamler, and Nancy Dail.

In between all this great education, I had dinner with Sally and Ed Hacking and Jan Schwartz, enjoyed a fabulous dinner another night with Lynda Solien-Wolfe and ten other friends, and got to chat with Anne Williams and Les Sweeney, Winona Bontrager, Sandy Fritz, Ariana Vincent, Sharon Puszko, Cherie Sohnen-Moe and lots of other folks. Ruth Werner pointed out to me that she had counted nine textbook authors present. Incidentally, Ed Hacking is also 350 pages in to a book he is writing. He let me read the first chapter. I hope I’m still able to write a book when I’m 94! Ed is one smart fellow. I also taped an interview with Ryan Hoyme, the Massage Nerd, and afterward we spontaneously decided to tape a promo for the Alliance, which ended up getting shown at the meeting.  That was my first effort as a volunteer for the membership committee. Lynda Solien-Wolfe also gathered me, Bruce Baltz, Cherie, Ralph Stephens, Linda Beach, Anita Shannon and others for a roundtable interview for Performance Health and BioFreeze.

North Carolina had a big contingent present at the meeting: Gloria Coppola, Claire Marie Miller, Anita Shannon, Cynthia Loving, Nancy Toner Weinberger, and several more. Industry partners and association members, including Bon Vital, COMTA, the Massage Therapy Foundation, Mother Earth Pillows, NACCAS, Massage Register, and several others had exhibits that were well-visited.

So much happened, I feel like I haven’t covered half of it, and I could go on and on about the wonderful gathering of educators and the work and camaraderie that took place, but I’m going to cut to the chase: every educator needs to join the Alliance for Massage Therapy Education. Whether you are a school owner, program director, CE provider, or industry support partner, the Alliance is going to accomplish great things for the advancement of massage therapy education. This is an opportunity to have a voice and a partnership in many resources for that, and I encourage you not to pass it by. Jan Schwartz closed her presentation with a line I’m going to steal: “If you’re not at the table, you’re on the menu.”

Come to the table. Visit the Alliance website at www.afmte.org and join today.

Meeting in the Middle

One of my fondest dreams is coming true! For several years I’ve been preaching the sermon on my blog that I wanted our national massage organizations to play nice together and it is happening! Earlier today I got the news that all seven of our major organizations will come together for a summit meeting in St. Louis on Sept 13-14. St. Louis is centrally located, and it’s neutral ground. None of the groups involved are headquartered there.

The Alliance for Massage Therapy Education (AFMTE), American Massage Therapy Association (AMTA), Association Bodywork & Massage Professionals (ABMP), Commission on Massage Therapy Accreditation (COMTA), Federation of State Massage Therapy Boards (FSMTB), Massage Therapy Foundation (MTF), and National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) will be coming together, according to the press release.

Earlier this year, I was fortunate to be included in the meeting hosted by the NCBTMB in Chicago, which was attended by all the organizations, except for the AFMTE. During that meeting, several people (including me) talked about the need for all the organizations to come together for the good of the profession. Bob Benson, Chairman of ABMP, stepped up to the plate as he often does and said that he would assume the responsibility for seeing to it that it happened. All the representatives of the attending organizations agreed that they would participate if such a meeting was convened.

According to the press release, the purpose is “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. Each participating organization is contributing to creation of the specific agenda, which will be finalized at the beginning of the St. Louis meeting.”

All the organizations will be sharing equally in the cost of the meeting. Unfortunately, I won’t get to attend this meeting, but I understand the reason why. The press release further states that in order to promote candor in the meeting, neither the press nor the public will be allowed to attend, and there will be a joint press release issued after the meeting.

I’m sure this will be a lively meeting. Every one of these organizations has their own turf, and some of them are competitors. But I have long said that there’s room in the sandbox for everybody, and I firmly believe that.  Pete Whitridge, President, and Rick Rosen, Executive Director, will be representing the AFMTE; Glenath Moyle, President,  and Shelly Johnson, Executive Director, will be representing AMTA; Bob Benson, Chairman, and Les Sweeney, President, will be representing ABMP; Randy Swenson, Commissioner, and Kate Zulaski, Executive Director, will be representing COMTA; Debra Persinger, Executive Director, and Kathy Jensen, Vice President, will be representing FSMTB; Ruth Werner, President, and Shelly Johnson, Executive Director, will be representing the Massage Therapy Foundation, and Paul Lindamood, CEO, and Alexa Zaledonis, Board Chair, will be representing the NCBTMB.

These are all smart people. They all care deeply about the massage profession. They don’t always see eye to eye, and they may never see eye to eye, but this is a big step forward to me. I look forward to seeing what comes out of it, and I hope it will be good for everyone concerned.  When people come together for the purpose of problem solving, and leave their egos at the door, that’s a wonderful thing, and I hope that will be the spirit this is approached in. Kudos to them all for agreeing to it. I hope my fellow massage therapists will join me in holding good intentions for the highest good at this gathering and for these leaders to go in peace.

‘Tis the Season

No, I’m not talking about Christmas…although the retail world seems to force it down our throats earlier every year, it’s not quite time for that. I’m talking about politics, particularly the politics of massage.

I’ve had a good little hiatus this summer from reporting on all the political happenings, but it’s that time of year when state legislatures start reconvening, the lobbyists come back from vacation, and things start cranking up. And then there’s a trifecta of organizational goings-on: next week, the AFMTE will meet, then in October the annual meeting of the FSMTB and the week after that, AMTA National Convention.

You can keep up with what’s going on in your state by several means. AMTA’s legislative update page is available for viewing by anyone, not just members. ABMP notifies their membership about any legislative matters of concern in their state. Your state board’s website should list any pending rule or practice act changes. And bear in mind that due to the nuances of the way government operates, a legislative change concerning massage may not be listed as such on your state’s legislative website. Legislative changes are often listed under the heading of the major name of the bill, like SB 102, Expansion of Highway Department–with some regulation concerning massage attached to it, so it’s a good idea to visit your state’s site and type in “massage” in the search engine periodically when the legislature is in session.

Knowledge is power, people, so the best thing you can do for yourself and your profession is to keep yourself informed. I can’t keep up with every move that’s being made or every piece of legislation. I appreciate the heck out of it when people send me information about what’s going on in their states, because my network is a big one and at least I can help get the word out that people need to take some sort of action. I just can’t keep up with every move that’s being made or every piece of legislation. Blogging is only my hobby…I have a real job to attend to 🙂

Peace & Prosperity!

The World Massage Festival: A Great Time!

Champ and I got home from the World Massage Festival this morning, and while I’m tired, I must say it’s that good, satisfying kind of tired, the kind you feel when you’ve really had a great time. We certainly did!

This year’s Festival was held on the beautiful campus of Western Carolina University in Cullowhee, NC, and as usual, it was like a family reunion! We got there on Wednesday, in time for me to take Ruth Werner‘s class on Teaching Research Literacy. That night, about 20 or so of us who were helping with the Festival went out to dinner together. Everyone sang Happy Birthday to Champ (his 59th). We sat around for a couple of hours just catching up.

Thursday, I spent the day helping with registrations while Champ helped people set up in the vendor hall. There were about 80+ vendors present and by the end of the weekend, quite a few of them had sold all their product and signed on for next year in Las Vegas. Lots of goodies were given away…and I even got some extras. AMTA National VP Nancy Porambo won a diamond charm bracelet and she gifted it to me (thank you, Nancy!). Champ is famous for winning raffles and he won a nice set of essential oils. Lynda Solien-Wolfe was there representing Performance Health/Biofreeze and she was giving away the goods everywhere! I love that company and all their products…I’ve been selling Biofreeze since day 1 at my office and it’s a best-seller.

Thursday night there was an awards ceremony. I was not expecting to get an award, and I was really worn out from working registration all day and I almost didn’t go. I’m glad I dragged myself there, because I received the Government Relations award. Of all the kudos I’ve ever gotten in my life, I have to say that one pleases me the most. I would have dressed up for the occasion if I had known I was going to have to go on stage, and I was slightly embarrassed to be getting an award in a pair of jeans and t-shirt…but hey, it was a special t-shirt that Cindy Michaels embroidered just for me! ABMP was recognized as the Association of the Year for the third year in a row. Ryan Hoyme, Pat Donahue, Darcy Neibur, Mike Hinkle Jr, and Vivian Madison-Mahoney and her husband John were also honored, and Ruth accepted an award for the Massage Therapy Foundation. I’m probably forgetting someone! Mike Hinkle and James Waslaski handed out the awards.

Friday morning I taught a class in Using Research to Market Your Massage Therapy Practice. Friday night, the amazing Lori Stegner entertained a big crowd, first as Patsy Cline and then as Tina Turner. I roped my favorite and very talented cousin Todd Rollins into playing a set with me in between Lori’s performances and then after the show, we led a jam session. Ruth Werner started things off by singing some Beatles’ tunes. Ralph Stephens had his washboard so we played a few bluegrass songs, too. Several other attendees got up and sang…kind of a live karaoke! We had a blast.

I spent Saturday in the vendor hall visiting with all kinds of people and doing massage in the Sweet Serenity booth. Sweet Serenity is a project started by Darcy Neibur to raise money for charity. The proceeds from this event went to the Shriner’s Burn Center and we raised $800. I not only gave, I received, and I got a great reflexology session from Travis Alligood. He saved the day for me.

Saturday night, I was inducted into the Massage Therapy Hall of Fame along with my fellow North Carolinian Gloria Coppola, Leslie Young Giase, Editor of Massage & Bodywork Magazine, Richard Rossiter, Joseph Goldman, David Lauterstein, Michael McGillicuddy, and other hard-working souls. The ceremony was opened with a beautiful prayer from Medicine Woman Jenny Ray. Champ and I hung out with Jenny and her teaching partner Janelle Lakman every evening when we got back to the residence hall…we probably kept the whole place up with our story-telling and laughing.

Sunday was not only the high point of the Festival for me, I would have to say it was one of the high points of my entire massage career. I took a class in Thai on the Table from Mukti Michael Buck. It was the best hands-on class I have ever attended, and I have attended hundreds of hours of continuing education. Mukti is undoubtedly the most charismatic teacher on the planet. The bodywork was sensational. The whole class was in such a state of gratitude at the end of it, we were one big melting pot of thankfulness and grace. I would recommend it to anyone.

Sunday night, we wrapped up with a Facebook Friends party at O’Malley’s, an Irish pub (my kind of place, you know!) It was very well attended and we had a great time visiting with old friends, making new ones, and meeting FB friends in person for the first time.

The staff at WCU bent over backwards for us. The campus is gorgeous, the food in the cafeteria was good, the residence hall we stayed in was top-notch, and the staff and students were all as friendly as they could be. True Southern hospitality.

The Massage Therapy Alliance of America also seated its first Board of Directors. Pat Donahue is at the helm as President and her husband, Joe Ferguson, is 1st VP. Pat and Joe each have more than 40 years of experience in the massage profession. I’m excited to see them there! Tina Rivera is the 2nd VP. Darcy Neibur is the Treasurer; Leslie Lopez is the Secretary, and the Members at Large are Lynn Shell and Carrie Thompson. Thanks to all for serving.

Throughout the week, I saw so many friends it was like old home week…I wish I had more time that I could have visited with them all. I did get a few minutes to speak with the crew from the NCBTMB, the FSMTB, our state chapter of AMTA, and so many more. M.K. Brennan was there from the American Polarity Therapy Association. There were so many of my favorite folks in attendance…Michael McGillicuddy, the Massage Nerd, Sharon Puszko…I just couldn’t get around to everybody!

Mike and Cindy Hinkle are to be commended for all their hard work…Mike gets the big ideas and Cindy pulls it together. He knows what a jewel she is! We were joking last night at dinner and Cindy told Mike he couldn’t get any more ideas until after August…she needs a rest! It was a great time and I’m looking forward to next year in Las Vegas. Hope to see you there!

A Matter of Opinion

Last week, the AFMTE released a position paper authored by Executive Director Rick Rosen, “Alliance Offers New Vision for National Certification.”

The AFMTE also recently announced that it is partnering with the FSMTB in their initiative to begin approving continuing education.

Both of these have attracted quite a bit of discussion on the various social media sites. And like any discussion, people agree, disagree, and agree to disagree.  I’m glad to say there hasn’t been any mudslinging of the nature that goes on at times in some of these venues. I think these discussions are useful and informative.  They sometimes bring to light a lot of misconceptions that people have about which entity does what, and how they do it.

I encourage everyone to read Rosen’s paper in its entirety, but to make a long story short, it is a plea to the NCBTMB to reorganize, and get out of the continuing education business and the entry-level exam business. The FSMTB has been stating the opinion since their founding 5 years ago that NCBTMB exams are inappropriate for licensing purposes, and encouraging the states to drop those exams and use the MBLEx exclusively. That hasn’t happened.  If the map on the FSMTB is current, 33 member boards are using the MBLEx. If the map on the NCBTMB website is current, 38 states are still accepting their exams, meaning the majority of states are accepting both, and offering their licensees a choice. The AFMTE is also supportive of the Federation’s stance, as is AMTA and ABMP. Still, the facts show that either the 38 states are doing the wrong thing, or else they are exercising their undeniable right to conduct their business the way they want to.

I haven’t been in this profession nearly as long as Rosen or some of the other players here. I became a massage therapist in 1999, and it seems like I joined at a time when everything was just really starting to swirl. I was in the first wave of licensees in North Carolina.  Mr. Rosen actually has license #00001…first person licensed in our state. He has seen and been instrumental in a lot of things happening. I would never try to minimize the contributions he has made to this field. I won’t criticize his career, his integrity, or his belief that he is suggesting something for the good of the profession on the whole.

My criticism is this, and it isn’t directed entirely at him; it’s directed at the concept of any organization trying to mandate to another organization how to run their affairs. We get enough of that from the feds, don’t we?

I believe that the FSMTB and their mission of public protection is a great thing. The member boards come together for the purpose of discussing common problems and looking for workable solutions. Anytime people sit at the table together to try to solve a problem, that’s wonderful to me. I also believe that the AFMTE was started with the noble intent of acting as the voice, advocate, and resource for massage schools and educators. What I don’t believe is that either one of them can unilaterally force the NCBTMB to change their way of conducting business, nor do I think they should have that right.

The FSMTB is developing a model practice act, in addition to developing a CE approval program. They can and do suggest to the member boards that their exam is the appropriate exam, their CE approval (will be) is the appropriate approval, their model practice act (will be) the premier example of an appropriate act, and so forth.  It’s part of the quest to streamline things  in a uniform fashion and promote portability.

However, suggestion is the key word. The member states aren’t bound by any legalities to do what the FSMTB offers in the way of suggestions. If they want to keep the NCBTMB exams, they can. If they want to keep their own practice act, they can. If they want to keep NCBTMB approved providers or continue to approve their own, they can. They all have the right to conduct their business as they see fit within the law.

There is certainly room for improvement, on the practice act front, in particular, when you see all the variance that’s out there between the states. Keith Eric Grant has summarized that. You can access it here.

The bottom line, to me, is that all of these entities, including the NCBTMB, also have the right to conduct their business as they see fit. Unless and until there is a federal law governing massage, the individual entities can continue to do whatever they do however they want to do it. The FSMTB and the AFMTE could spend days pointing out past shortcomings of the NCBTMB, but it wasn’t “the NCBTMB” as an entity that had the shortcomings. It was the human beings running the organization.

As the FSMTB is only 5 years old, and the AFMTE less than half that, neither of these organizations have been in business long enough to have been plagued with the personnel problems, inefficiency problems, financial problems and so forth that happened in the past at the NCBTMB. Board members come and go. Executive directors come and go. Priorities of boards and organization come and go. Even organizations come and go. Last week I learned from Dr. Kory Ward-Cook, CEO of the NCCAOM, that there was previously a Federation of State Acupuncture Boards that fell apart.

AMTA and ABMP have their own missions and their leadership has their own opinions. As do we all. And any organization, just like any individual, has the right to run their business as they please, as long as they are not breaking the law. The NCBTMB is not breaking any laws by continuing to conduct their business as they see fit. The other organizations are not breaking any laws by conducting their business as they see fit. They all have that right. You don’t have to like it. I don’t have to like it. One organization doesn’t have to like what the other organization is doing. But until the federal government steps in and says, “you must do this,” they can all do as they dang well please. If any of them don’t do well enough at whatever it is they choose to do, they won’t survive.

Everybody has their own opinion on what’s good (or not good) for this profession, what’s good for licensing, what’s good for certification, what’s good for teacher standards, what’s good for education, what’s good for continuing education. There are just as many opinions on all of that as there are opinions on what kind of massage oil you ought to use.  Everyone is entitled to that. And everyone is entitled to conduct their business the way they choose to, as long as it’s within the law.

The AFMTE posted on LinkedIn that they had posted Rosen’s position paper directly to the NCBTMB. I suggest that if the folks at the NCBTMB are interested in hearing more about it or discussing it that they will get in touch. And if they don’t, then I suggest that the AFMTE, and in fact all organizations, concentrate on being good at what they set out to do for their organization, and leave the NCBTMB to do as their board and their leadership sees fit. Their Board is elected by their certificants, and their ED serves at the pleasure of their board.  They may well thrive and survive by doing things their own way, or they may fail altogether.

Either way, I think the burden to make it or break it is on them, just like the burden that is on all the organizations, and on any of us as practitioners and business people. And any insinuation of the NCBTMB being “uncooperative” is an opinion, not a fact. I can tell you how to run your business, you can decline to take my advice, and I will not refer to you as uncooperative. I will assume that you are exercising your right to conduct your business in the manner that you see fit, whether it suits me or not.

That’s just my opinion.

Report from the NCBTMB Approved Provider/CE Meeting

I just got back from Chicago, where I participated in the Massage Approved Provider Panel convened by the NCBTMB. I have to say it was one of the best meetings I have ever attended. Everybody left their egos and their agendas at the door…not one single moment of tension or dissension occurred, in spite of the fact that competing entities were represented.

I spent the weekend sitting next to Bill Brown, Deputy Director of the AMTA. I’ve heard through the grapevine that Bill has wanted to strangle me a few times over my blog, and I’m glad he got the opportunity to know me a little better. I might have managed to convince him that I have a few redeeming qualities and I’m not just the crazy blogger he thought I was.

Cynthia Ribeiro, President-Elect of AMTA, was also present, and what a class act she is. I had supported Cynthia during the AMTA election, and there’s no doubt in my mind that was the right move. She is one fine lady who has made many contributions to our profession, and had a lot to contribute to the task at hand this week.

Bob Benson, Chairman of ABMP and Anne Williams, Director of Education for ABMP were there. Bob brought his considerable business acumen to the meeting. I’ve worked with Anne before and she’s just a go-getter who shares my philosophy of “make it happen.” She has a great sense of humor, too. There was a lot of laughing this week, which is always a great ice-breaker and good for the cohesiveness of the group.

The facilitator, Drew Lebby, provided exactly the right balance of keeping things moving, listening, and explaining. We had breakout groups and larger discussions and the whole meeting just had a great flow. Having been in meetings with some very boring facilitators in the past, I thought he was wonderful and I would highly recommend him to groups who are looking for a great facilitator. He has 35 years of experience at it and it shows.

I heartily applaud the Federation of State Massage Therapy Boards for sending Kathy Jensen, VP of the FSMTB, and kudos to the NCBTMB for inviting the Federation to participate. Since the MBLEx has taken a huge chunk of the NCBTMB’s exam market share, and the Federation has also recently announced plans to jump into the CE approval arena, I can think of past administrations at the NCBTMB that would have spent the time sniping about the Federation as competition instead of inviting them to attend, all the more reason why I appreciate their willingness to play in the same sandbox. That theme was reiterated by Ribeiro and several others this week–this isn’t about your organization, or my organization, or who’s the biggest or the best–it’s about massage and increasing the quality of massage education.

COMTA was also represented by Commissioner Randy Swenson. Several state board members were in attendance, as were approved providers and a couple of nationally certified massage therapists.

The AFMTE was not represented, although they were invited to participate, and as a founding member of that organization I personally found their refusal to attend distressing. This meeting was about education, and in my opinion, they should have been there. I contacted Rick Rosen to give him the opportunity to explain their absence, and his response was that since the AFMTE has decided to partner with the FSMTB in developing their CE program, he felt it would blur the issue and divert their focus to attend.

Nice try, Rick, but since the Federation was invited, and in fact chose to participate in the meeting, I don’t buy it. The mere term “Alliance” suggests that you are representing education, and not just one faction of it. The Alliance could have made some great contributions to the meeting and you missed out on a good opportunity to do so. Rosen is of the opinion that the Federation should replace the NCBTMB and the individual states who do their own approvals as the only provider/CE approval entity. We’ll just have to agree to disagree on that issue.

No one has been a more vocal critic of the NCBTMB than I have in the past, and I have defended the right of the FSMTB to offer their competing exam, as I don’t believe that any entity is entitled to a monopoly. I will go further and say that I don’t believe any entity is entitled to a monopoly in any arena, so I am not in support of the Federation having a monopoly on continuing education. They have the undeniable right to jump into the market if they choose, and the marketplace will decide. I am personally not going to be dictated to of which entity I have to throw my CE approval business to unless my state makes it a law that I have to choose one or the other. I’m not going to hold my breath waiting for that to happen.

There are 42 member boards in the Federation and so far, although many states have voted to accept the MBLEx, and some have adopted it exclusively, many others have refused to throw out the NCB exams, and continue to give their licensees a choice in which exam to take. I believe the same thing will happen when it comes to continuing education. Some states will go with the FSMTB CE program, and others will continue to allow providers to make their own choice. It’s the American way. Furthermore, in many places legislative changes will be required in order to switch from one to another or add another approval entity, and we all know that legislation most often moves at the speed of molasses. That is also the American way.

There were a number of problems identified with the NCBTMB’s current system. For one thing, some providers have taken advantage of the fact that once they received approval, they could add on classes at will. Some have ignored the fact that there is a prohibition on classes that are based on a product they sell. Some have ignored the fact that there is a prohibition against classes based on religion and/or spiritual practices. Some have ignored the fact that they need to be genuinely qualified to teach in their subject area.

Bruce Baltz, an NCBTMB Board member, mentioned people who teach NMT techniques suddenly throwing in a class in lymphatic drainage needing to be looked at carefully…sorry, but your attendance at a weekend workshop does not qualify you to suddenly start teaching it yourself. The people who have been guilty of these offenses are going to have a little awakening when some of the changes to the program are implemented.

The suggestions for solutions were great and it was interesting to see that when we broke up into small groups to do problem solving, most of the groups were on the same page. Some of the suggestions included requiring providers to submit videos of their classes, a much stricter and more frequent auditing process, an improved evaluation process where students can go online anonymously and evaluate teachers and class content, a required online class for teachers themselves to improve instructor competence…lots of good ideas that the NCBTMB is going to consider and decide which ones to implement.

Every organization and individual at the meeting expressed a genuine interest in assisting the NCBTMB in this endeavor. Even better, they all agreed that all the organizations, not just a choice few, need to come together once or twice a year for the good of the profession. Bob Benson stepped up to the plate on that front and good for him for doing so…AMTA and ABMP can take a few swipes at each other, but in the final analysis, there is room in the sandbox and he knows it.

All in all, I thought it was a wonderful gathering of some of the best and brightest, with the intent of creating a positive outcome, and I was honored to have been included. Paul Lindamood and his team did a great job in organizing the gathering and assembling the best people they could get. And hey, any meeting that includes keeping chocolate on the table at all times does it for me.

My Organization is Better Than Your Organization

The massage profession has a plethora of organizations these days.

AMTA (American Massage Therapy Association) is a non-profit organization that has some executive staff at the top, a board elected by the members, and a hearty band of tireless volunteers that keep the wheels turning. AMTA has about 57,000 members.

ABMP (Associated Massage & Bodywork Professionals) is a for-profit concern, and frankly I’m just sick and tired of hearing that fact stated as a criticism. What is inherently wrong with making a profit? I want to make one in my massage therapy practice, don’t you? ABMP has around 77,000 members.

The NCBTMB (National Certification Board for Therapeutic Massage & Bodywork) , for 17 years, was virtually the exclusive provider of certification exams that were used for licensing in many states, and the approval body for continuing education providers. A few states had/have their own exam. About 90,000 massage therapists are nationally certified. The NCBTMB also has a board elected by their certificants.

Then along came the FSMTB (Federation of State Massage Therapy Boards) with the MBLEx test as a route to licensure, which many of the 40 or so member states have adopted. The Federation also recently announced plans to get into the business of approving continuing education, and they are creating a model practice act. They also have a board, which their state delegates elect.

The new kid on the block is the AFMTE (Alliance for Massage Therapy Education), which aims to advance the quality of education and develop a model of teacher standards. The Alliance has announced that they would be collaborating with the FSMTB on the continuing education project. They still have their first board seated; that’s how new they are.

We’ve also got COMTA (Commission on Massage Therapy Accreditation) in the business of giving accreditation to schools and programs who meet their standards of excellence. Getting COMTA approval is voluntary, expensive and time-consuming. There are only 100 or so that have earned it.

The majority of states now regulate massage, some by their own self-supporting massage board, some lumped in with nursing boards or other health boards. I am often asked by therapists what their state board does for them. Other than issuing their license and in some states licensing schools, the answer is not much. A public board serves the purpose of public protection. Some do a better job than others. State board members are appointed by politicians. The average board is usually composed of a few dedicated people, often includes one or two clueless slackers, and a rebel redneck like me. I’m sure my board is glad I’m at the end of my service. My blog makes them nervous.

I’m a member of both AMTA and ABMP. I’m a member of FSMTB by virtue of my seat on the North Carolina Board, which I will be vacating later this month after five years. I have been a past delegate to the Federation. I am a founding member of the AFMTE. I’ve been nationally certified for over ten years, and an approved CE provider under the NCBTMB as well. I am soon to go on my first site visit for COMTA. I attended their reviewer training after I wrote a few derogatory blogs about them and they invited me to attend. Positive change usually happens from within, doesn’t it?

I have a stake in all these organizations so I’ll pat them on the back when I think they deserve it, and I don’t mind calling them out when I think they deserve it. I have the same attitude with them that I have with other massage therapists who act competitive instead of collegial. This isn’t a contest. If one organization has to fail in order for another to succeed, that’s just a big shame as far as I’m concerned. When one organization slams another and presents half-truths and posturing, it starts to look like a playground fight–better call that a turf war, I guess–and it’s not attractive in the least.

None of these organizations would exist without their constituents–the massage therapists. And none of them can represent all of the people all of the time. They’ve all made moves that didn’t suit me at one time or another, and what ticked me off may have made other MTs perfectly happy, or vice versa. And the therapist who isn’t represented by any of them probably couldn’t care less what they do or how they act. In fact, many of their own members couldn’t care less what they do or how they act. When it comes to the professional associations, many therapists just join for the insurance and have no interest in the political fray at all–until something detrimental happens that affects their license or access to education.

If you don’t like a piece of proposed legislation, contact your legislators to tell them. And if you don’t like the direction your professional organization is taking, contact them to tell them. Get yourself in there as a board member or volunteer and change it from within. Cancel your membership, or switch organizations.  Money still talks. It’s akin to voting…if you don’t exercise that right, then don’t gripe about the outcome. Go to your state board’s meeting and sign up for public comment. You have a voice. It’s only effective if you use it.

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.

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.