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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.

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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.

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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.

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10 Questions for Alexa Zaledonis, New Chair of the NCBTMB

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

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

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

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

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

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

2. What first led you to volunteer?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Therapist calls prospective employer:

Ring Ring

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

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

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

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

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

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

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Report from the Federation of Associations of Regulatory Boards

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

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

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

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

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

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

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

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NCBTMB Revamping Approved Provider Program

Alexa Zaledonis, the new Chair of the National Certification Board for Therapeutic Massage & Bodywork, is starting off her term with a bang. In a joint statement issued today with Paul Lindamood, Executive Director, Zaledonis states that the NCBTMB is about to undertake a major initiative to improve the CE Approved Provider program. The statement acknowledges that this evolution is necessitated by the fact that there are now over 1700 providers, and that what worked in the beginning is not necessarily going to serve the purpose in the future. The folks at the NCBTMB are aware that times are changing, and it’s time for a Spring cleaning.

The statement says in part:

We also anticipate a move toward comprehensive course-by-course review and auditing of all AP offerings. NCBTMB has reviewed the processes in place, as well as the needs of the profession, and the conclusions suggest:

  • a review of course content against a more robust set of criteria for every class is imminent
  • the requirement for a specific set of teaching qualifications is compelling
  • a stratified system of course designations is fast approaching to differentiate entry-level and advanced CE

In the old paradigm, once an instructor was approved as a provider, additional classes could be added to the list of offerings without the individual class being vetted for content. Unfortunately, some people have taken advantage of that to bend the rules.

According to the Approved Provider Reference Guide, appropriate continuing education is meant to go beyond what is expected of an entry-level therapist who has 500 hours of education.

Inappropriate content includes, but is not limited to, classes that are about diagnosing clinical conditions, implementing allopathic medical or surgical procedures, physically invasive procedures such as ear candling or colonics, techniques that incorporate osteopathic/chiropractic procedures such as ballistic thrusting and joint manipulations, procedures that require additional licensure or certification such as physical therapy, Pilates instructor training, personal training, etc.; any class that is about how to prescribe herbs, nutritional supplements, and/or pharmaceuticals; any class about how to perform hypnosis, aesthetic facials, electrical stimulation, ultrasound, or acupuncture, and any class that is about psychological counseling, or psychic, clairvoyance, telepathic, astrology, religious or spiritual practices. There is also a prohibition of any class that is based on a product that the student is expected to buy, which some providers have also ignored.

The NCBTMB has sent out letters inviting participation on a Massage Approved Provider Panel to the leadership of the professional membership organizations, regulatory boards, providers, certificants, and leaders of the profession. I think this is a great initiative, and since it’s meant to improve the CE/AP program that serves almost every state, I certainly hope that politics are put aside here for the greater good of the profession. It’s the right thing to do.

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Continuing Education Providers: Sink or Swim

Every time I turn around, it seems that something is on the horizon that affects CE providers–and the therapists who are obligated to get CE in order to maintain their license.  The latest salvo has been fired from the state of Maryland, where legislation is afoot with big changes in the CE environment. According to the Maryland Chapter of AMTA, the proposed regulations mean that NCBTMB-Approved Providers can no longer offer classes in Maryland unless they have been pre-approved by the Maryland Board of Chiropractic and Massage Therapy Examiners at least 90 days in advance; CE offered by community colleges and online classes will be subject to the same rules, and providers will have to pay $25 per course unit for approval. CE hours earned at AMTA conferences won’t fly unless they have been pre-approved and the fees paid. This is going to be voted on this coming week and the MD Chapter has been making a big effort to drum up enough support to kill the changes. If you haven’t weighed in yet, you’ve got until the 18th of January to call your legislators and protest. Every time something like this happens, I get a lot of email from people asking me what they can do about it. The short answer is do it right now–don’t wait until the bill is passed to complain. You can send your comments and questions to vallonej@dhmh.state.md.us

As a provider myself, there are certain states I’ve never visited because of the hoops you have to jump through. New York, as I reported last year, requires a fat fee of $900 to be a provider, and a New York-licensed massage therapist has to perform the hands-on portion of any CE training. I don’t pretend to hold myself in the same class as Erik Dalton or Ben Benjamin, but it does seem strange to me that someone with a PhD can’t perform the hands-on portion of their own class unless they have gotten themselves licensed in NY.

If you want to be a provider in the state of Texas, you must get yourself pre-approved, reapply and pay a $200 fee every two years. I just looked at their list and there are 549 providers currently approved there. That’s a tidy chunk of change for their board.

Florida also has their own process. I got their approval last year, and while it didn’t cost me any money, I did find their process a little confusing to go through. I actually sent them $250 because I thought I had to after muddling through their directions for applying. My money was refunded.

The Chair and Vice Chair of the North Carolina Board of Massage & Bodywork Therapy reported upon their return from attending the Federation of State Massage Therapy Boards meeting in 2010 that the Federation was investigating the possibility of approving continuing education. Recently, the Alliance for Massage Therapy Education has also been making noises about national teacher standards as well. Alexa Zaledonis, the new Chair of the National Certification Board for Therapeutic Massage & Bodywork, has also put up a statement on the NCB website that they are about to undertake new initiatives in the CE provider program.

The opportunity for continuing education here in North Carolina is so competitive, it’s almost overwhelming. We have about 8000 active licensees, and 145  CE providers who live in the state…that doesn’t count the folks who are traveling in from elsewhere to teach. If you only count the ones who actually live here, that breaks down to 55 students per provider per renewal period, so if you’re wondering why it seems to get tougher to attract students, basically it’s because there’s a CE provider on every corner. While some students will seek you out because of what you teach or who you are, there are hundreds of others who are just looking for the closest class so they don’t have to travel, or the cheapest class they can get due to their finances, or they’ve procrastinated so that they just take the first thing that comes along when it’s time (or past time) to renew.

I love teaching. It isn’t my primary source of income, but it’s important to me to get that interaction. I feel energized after I’ve spent the day in a class with a bunch of people who actually care about learning something.

The CE river is rolling along, the water is getting pretty muddy, and we’re all going to have to sink or swim.



ADDENDUM: After I finished this blog, MK Brennan brought to my attention the following post from the MD Board:At its General Session Meeting of 1/13/2011, the Board of Chiropractic & Massage Therapy Examiners announced that it would forthwith withdraw from the rulemaking proposal Chapter 16 (Recordkeeping) and Chapter 20 (Continuing Education) pending further review and study. Both of these chapters were contested in comments received to date. This means that Chapters 16 and 20 will not be processed further in the current rulemaking proposal.

When further review and study of Chapters 16 and 20 is scheduled, details shall be posted on this website and in the Maryland Register.

That is the best demonstration of what can happen when MTs rise up and take ACTION! Legislators are forced to LISTEN! Kudos to Maryland Chapter of AMTA and all the MTs who protested this move!



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The Financial Health of Our Organizations: NCBTMB

This is the second year that I have written a series on the financial status of the non-profit organizations associated with the massage therapy profession. I am not an accountant or a financial expert. All the information in my blogs on this subject is available for public viewing on www.guidestar.org, which is a clearinghouse of information on non-profit organizations.

There’s good news, and there’s bad news. The bad news is that like some of our other non-profit organizations, the National Certification Board for Therapeutic Massage & Bodywork has taken a substantial financial hit during the past reporting year. In this particular instance, it can’t be blamed entirely on the recession; the MBLEx has taken a big chunk of change out of the exam revenues of the NCBTMB–over one million dollars in the past year alone.

Income from the sale of the mailing list decreased by over $30,000, which may also be indicative of the financial status of other businesses and organizations who have previously purchased the list. There’s always a trickle-down effect during a recession.

The good news is that recertification revenues actually rose by over $187,000; it’s good to know that I’m not the only one who values my National Certification enough to keep it up.

I also have to applaud the NCB for the way they have cut expenses. Their belt-tightening is nothing short of impressive. When revenues go down, expenses should go down (albeit not at the expense of customer service), and apparently not all our organizations get that concept, as I have pointed out on a previous blog or two. I think the general public relates well to that…when you earn less money, you have to spend less money.

Compensation to officers, directors, trustees and key employees was decreased by $418,000. Other salaries and wages were decreased by almost $160,000. Legal fees were down by more than $321,000. Advertising and promotional fees, office expenses, conference and convention expenses, printing expenses and other expenses decreased. Altogether, the NCBTMB cut expenses more than 2.4 million dollars from the previous year.

Paul Lindamood, CEO, drew a salary of $230k. Board members are also compensated at the NCBTMB; Chair Neal Delaporta is listed as devoting an average of 17 hours per week to the NCB and was compensated $55,000 for that service. Other Board members received anywhere from $3000 to over $13,000 for their part-time service. Former COO Laura Edgar Culver received more than $128,000.

Lindamood had personally stated to me earlier this year that the organization was doing everything possible to cut expenses, and I am happy to see that has in fact been done. Assets have increased and liabilities have decreased.

When the economy goes down, charitable contributions go down. I am particularly glad to report that in spite of the harsh financial hit the NCBTMB has taken, they still managed to donate $10,000 to the Massage Therapy Foundation. I think that shows commitment to the good of this profession. They could have easily said “we can’t afford it this year,” but they didn’t. Kudos to them.

I hope the recession is winding down for everyone, all the small business owners, all those who work in our profession and support industries, and our non-profit organizations as well.

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New Board Members at NCBTMB

The certificants have spoken: the new Board members have been elected at the NCBTMB. I have shamelessly lifted their bios from the NCBTMB website and their own websites.

Michele Baker, LMT, NCTMB, CVA of Jackson, MS has been serving as Treasurer. She was reelected for a four-year term.

Michele Baker is owner/operator of To Your Health! Therapeutic Massage Associates, an exclusive, referrals-only outcall service in the deep South. Her practice offers Swedish massage, pregnancy massage, reflexology treatments, deep tissue, neuromuscular therapy, aromatherapy, Reiki and ear candling. For the past five years, she has also taught at two schools of therapeutic massage and mentored dozens of therapists.

In 2008, Baker was awarded a Certification in Volunteer Administration (CVA), the only international professional certification in the field of volunteer resources management.

Baker received a bachelor’s degree from University of Arkansas and graduated at the top of her class from the Mississippi School of Therapeutic Massage.

Baker divides her time between massage therapy, volunteering and growing her new business, Treasures of Egypt Tours, LLC.  When not traveling internationally or teaching massage, she spends her time baking and working on a reference manual of massage and healthcare treatments for common ailments.

Judy Silcock from Idaho was elected for a four-year term. Judy has been serving as a volunteer with the NCBTMB since 1999. That’s important, because she has seen the best of the best and the worst of the worst during her tenure on various committees there. She knows the history and has experience that I feel is important.

Idaho is an unregulated state. Many therapists there have National Certification because it sets them apart as professionals. Judy is also very interested in seeing regulation come to Idaho, is working towards that effort, and I feel she will play a balanced roll between the regulatory faction and the certification faction. Judy would like to see Idaho accept both the MBLEx and the NCB exams, a philosophy that I personally support. Judy got started on her career in massage therapy back in 1969, so I think she’s seen it all by this point in time and has a lot to bring to the table. I supported her as a candidate.

Bruce Baltz, whom I also supported, was elected to serve a three-year term.

Bruce, founder of SpiriPhysical® Inc., is a licensed massage therapist in New York and Florida and an internationally recognized educator with over twenty-eight years experience in the fitness and bodywork industry. Bruce has developed Deep Tissue Healing; “The Art of Stone Massage” in 1999 and more recently has been teaching Active Isolated Stretching (AIS): The Spa Method approved by Aaron Mattes. He has been serving on the CE Committee at the NCBTMB since 2007. He is on board with my desire for seeing the organization offer advanced specialty certifications, and I know he will work towards that. He also has managerial experience, which I consider a plus for this position.

Rhonda D. Reif, MBA;LMT;RM;NCTMB of Iowa was elected to serve a one-year term. She is a Holistic Health Practitioner. She is the owner of the Stress Management Center (a private practice), Holistic Horizons (a school of the Healing Arts), and Fier & Sol Seminars. She currently conducts workshops and classes on Holistic Healing Modalities and the Healing Arts.

These folks officially take office on Jan.1, along with the new chair, Alexa Zaledonis.

Alexa Zaledonis is the owner/operator of Even Keel Wellness Spa, a therapeutic massage and skin care center in Annapolis, Maryland. Even Keel employs seven full-time and several part-time employees who specialize in Thai, sports and rehabilitative massage.

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

A former Certified Public Accountant (a skill I am happy to see the chair of the NCBTMB possess), Zaledonis specialized in healthcare and nonprofit organizations for more than 15 years. She received her bachelor’s degree from Albertus Magnus College in New Haven, Connecticut.

Congratulations and good luck to all the new Board members.  It is my wish for them all that they follow their conscience and their heart; that they refuse to blindly follow the leader; and that they do their best to help lead the NCBTMB into a new period of growth and sustainability.

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The 3 R’s: Research, Regulation, and Raising Standards

Yesterday, I had shared on my FB a post from Ruth Werner, President of the Massage Therapy Foundation, entitled “Who Needs Research Literacy?“. I commented on that that all massage schools need to ramp it up and start including research literacy as part of their core curriculum.

That garnered a comment from a fellow massage therapist that schools wouldn’t start teaching it unless there was a regulatory requirement that they do. I hope that isn’t true.

I think the MTF has been doing a great job of spreading the word in the massage community. And there are so many industry supporters as well. The MTF transcends politics, as I have said before. The AMTA, ABMP, and NCBTMB all contribute. Massage Warehouse, Massage Envy, Biofreeze, and others have done a lot to raise money and raise awareness. I blab about it a lot myself on my blog and to my networks.

Research literacy does not imply that we expect massage schools to start teaching advanced statistics or turn out the next Tiffany Field. According to Ruth’s post, research literacy means being able to:

1. Find a pertinent article

2. Read and understand it

3. Critically evaluate its credibility

4. Apply findings to practice

5. And if you’re really paying attention, come up with some more questions to ask about it…

Why would any school wait for regulation to force the issue of raising standards, in the interest of improving the education of students, which in this case could potentially have such effects as raising the credibility and profile of massage therapy in general, not to mention giving their therapists a leg up in their career? Physicians are impressed by research. Research benefits clients; any time a therapist has more knowledge of a condition they’re presented with, that applies directly to their practice in the planning of treatment and client education.

Research literacy can increase the marketability and prosperity of the massage therapist. I’ve been offering a CE class in “Using Research to Market Your Massage Therapy Practice” recently, and the prevailing comment from students is “I never thought about using research until now.” My class surveys show that hardly anyone attending my classes had been introduced to research literacy in massage school.

My colleague said verbal admonitions and challenges wouldn’t spur schools to pick up the cause of teaching research literacy, and I hope to prove him wrong. I urge you right now, if you’re a school owner or director, to start including it in your program, and don’t wait for regulation that may never come. It isn’t about regulation; it is about you voluntarily raising the standards in your corner of the world.

The Massage Therapy Foundation has help available. If you are with a school and you’re interested in the Teaching Research Literacy program, click here: http://www.massagetherapyfoundation.org/teach.html