resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
June, 2001, Vol. 01, Issue 06
With Legislative Intent
By Keith Eric Grant, PhD, NCTMB
I take on this month's topic with the "slight" hesitancy characteristic of following my two sons into an unheated swimming pool in winter. There are few issues that can polarize massage practitioners as quickly as that of licensing and regulation. Not coincidentally, there are also few issues that could benefit from dialog and critical reflection as much as this one.
Massage is a profession seeking credibility, a useful scope of practice, and freedom from the vagaries of local regulations. We habitually seek such goals within the realms of state occupational regulation (OR). Such regulation has been the most successful strategy for wresting control of massage from local agencies. However, local laws may apply even in states with licensing, unless the state's statute specifically forbids this.
In many states, the practice of medicine is defined so broadly that there is no unclaimed area of health care practice.8 Under such definitions, only professions that have their scope of practice carved out by a licensing law are free from the potential of prosecution. An alternative approach, recently taken in Minnesota and under consideration in California (SB577), is to redefine the business and professions code to specifically allow the unlicensed practice of noninvasive complementary methods.
The Legislative Intent of Occupational Regulation
For most states, the motivation for OR is to protect the public from harm that is recognizable and not remote. Without likely harm, there are fundamental rights for a person to be free to choose a profession.5,7 Motivations of legitimizing or recognizing the credibility of a profession are notably missing from state statutes defining the purpose of OR. So the key question becomes, what is the likelihood of harm occurring at a level of practice that licensing would prevent?
In 1997, the Georgia Occupational Regulation Review Council concluded that there was minimal potential for harm from massage.3 Recently, the British Columbia Health Professions Council concluded that there were no massage practices that warranted being declared as restricted acts.1 These conclusions, coupled with extremely low liability insurance rates, indicate that harm from massage is remote. Massage licensure would have rough sledding in states with sunrise (review) acts.5,7 and such states, like Florida, that currently regulate massage, would be much less likely to do so if the regulation were newly proposed.2 The assumption that unlicensed massage results in client harm is a dog that won't hunt.
Standards and Quality
Licensure is often promoted on issues of standards and quality, yet when closely examined, these are far from clear. When quality is measured by client satisfaction and availability of service, the relationship between licensure and quality is often weak.4,5,8
Measures of quality based on hours of education have been driven more by eligibility requirements for federal financial aid9 than by the need for specific training. In contrast, massage school owner Ramona Moody6 provides one of the few starting points that is based on examining the training needed to achieve minimum competence:
I participated in a task force initiated by the BPPVE [Bureau for Private Postsecondary and Vocational Education], which legislates massage schools among others. The purpose of the task force was to decide what the absolute minimum requirements should be for massage training. The massage schools, owners who participated in the task force decided that rather than develop a curriculum for the 250 hours suggested by the Bureau representatives as a minimum, we would discuss what knowledge we feel the students really need, and how many classroom hours it realistically takes to impart that knowledge. It was a really interesting discussion, carried out over several meetings, and the conclusion we came to was that it takes about 200-300 hours in the classroom to impart to students the minimum education we felt they really need in the marketplace. This included more than one massage modality, along with health and safety, anatomy and physiology, business practices and ethics, as well as communication skills. We felt this would make the student competitive in the marketplace, as well as no danger to the public.
Similar to massage, piloting a plane requires both kinesthetic skills and technical knowledge. Piloting, however, is much less forgiving of incompetence. The FAA requires 250 hours of flight experience to issue a single-engine commercial pilot certification.10 Coupling this FAA requirement with Moody's observations, it seems clear that minimal training requirements for massage are being significantly overestimated. It is incongruent to advocate integrity for the profession of massage when we have not assured the integrity of our own claims for licensing. If we are truly committed to improving the delivery of massage services, we need to take account not just the hours, but the modern teaching concepts and the social fabric for increasing the availability of massage.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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