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

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

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

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

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

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

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

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

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Comment by Gordon J. Wallis on March 31, 2011 at 3:06pm: I've been a massage therapist for 25 years now...Too me, all this licensing, credentials, and so on..Mean absolutely nothing..Except that the person is good at taking exams. I find them more of a pain in the ass then anything. I work in a day spa now..A really nice day spa. The other day a new client came in to see me...Somebody had bought her a gift certificate for a massage and pedicure..I work with maybe 15 other therapists, and she just happened to get scheduled with me. After I brought her into the massage room she told me she that she has been suffering with neck and shoulder pain for six years, and she just wanted relaxation massage. She has been involved with Chiropractors, Medical Doctors and massage therapists for years. Her last attempt to relieve her problem was six months of Chiropractic. She just quit on her own, sense it wasn't helping her at all. To make a long story short..I cured her in 80 seconds..She had several HUGE trigger points in the area of distress.. Right rhomboid, rt upper trap, one of the extensors in the middle of her neck, and a really bad one where the pecs and deltoid meet on the right side. I simply released those trigger points..Easy...She was amazed...her pain was gone..Full range of motion..A very happy women.. Chiropractic??? Therapeutic massage? She saw medical doctors too.. All those people are credentialed,, Licensed, nationally certified and everything else. Im not licensed, or nationally certified....I could be, if I wanted to memorize all that crap and pay a bunch of money... Also the average career span for a massage therapist in this country is only six years...A high percentage of those people end up quitting because of repetitive strain injuries. Considering the fact that there is no better therapy for repetitive strain injuries then massage therapy...Makes one wonder what and how massage is being taught ?? Unless things change, I see licensing and certifications in this massage industry leading the way to incompetence.

Comment by Laura Allen on March 15, 2011 at 2:24pm: ME will probably snap some of them up...that's a good point and will probably be a good place for them to go get their feet wet. And you're right, SOME vets have no schooling at all. There are usually people in every state who have been grandfathered in.

As I said, since "supervision" hasn't been defined, until it is defined that could mean a once a week phone call to check in. So a non-licensed person isn't obligated to charge what their supervising therapist does unless that does get defined as being in their premises. They can be out there doing massage for 20 bucks. Since the "supervision" is what's being considered right now, now is the time for them to spell that out in their practice act.

We're all evolving, hopefully :)

Comment by Lisa on March 15, 2011 at 8:47am: While I understand what you're saying Laura, I still don't see how it's possible that unlicensed MTs would charge less than licensed ones since the unlicensed MTs will have to work under some who IS licensed. All I can see happening is Massage Envy using this to scout more graduating MTs with the lure of helping them gain licensure. For some it'll be what they need to keep moving forward in their career. For other's it won't matter. Prices of massages won't go down because of this legislature, it will just help places like ME stay in business. (now whether that's a good thing or not is another post) :)

And in as much as I understand a veteran MT being infuriated with this, SOME veteran MTs didn't have to have nearly as much schooling up front as the ones coming through now. don't we all have to be a little flexible when it comes to massage evolving?

As for the legislation not being completely specific to the who's, what's, where's and how's...is this legislation written in stone? Can it not be worked through so some of these things CAN be addressed? Can that not happen even after it's passed (if it passes)? In as much as we like to see rules and regulations being thought out from the get go...many times it takes trial and error to get legislation right.

Comment by Laura Allen on March 15, 2011 at 4:10am: The main issue I see with this Lisa, is that the FL Board has not defined "supervision." Boards get in deep ka-ka when they don't spell these things out. They haven't defined in their practice act whether that means that the supervising therapist is on the premises or not. And even though that seems like splitting hairs, all it takes is one test case to cause a ruckus.They should have stated a clear definition of that before moving forward with this.

The licensees in FL I have heard from have a legitimate concern that this will drive down the price of massage with the unlicensed people charging less that licensed therapists. And since this is coming along way after FL first implemented licensure, it is also infuriating some of the folks who had to do things in order--they couldn't practice until THEY were licensed, so they now hate to see other people getting to do it.

Comment by Lisa on March 14, 2011 at 1:32pm

Hi Laura. I posted this on a similar thread regarding the FL legislation:

I didn't read the whole thing but from a glance I don't see what the problem is. it's a TEMPORARY license with requirements to meet in order to obtain. You still have to be a graduate of an accredited school. I think it makes sense.

If I recall correctly, in CT they had "sponsors" that enabled an MT fresh out of school, to work under an establishment while they began the process of state/national testing. It was a great idea. It allowed those that don't have a ton of money and whom have already forked out a ton of money for schooling, to start working right away.

If you don't have money, how are you suppose to test? This gives people a way of working and making money TO take the tests.

I really don't see an issue with the FL legislation. However as for the New Hampshire legislation, I'm completely in agreement with you. I don't understand how that can even be considered a "cost cutting" solution. Are there THAT many LMTs in that state that require so much man hour? ;) You would think the additional cost of the license would bring money in if there's THAT many to need to cut cost. But then again, I've never been very good with finances. :)

and the UTAH thing makes me irrate!! declaring massage to be purely recreational is just an insult to the amount of hours and continuing education we have to have to do what we do!!