resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
April, 2002, Vol. 02, Issue 04
Scope (Not the Mouthwash)
By Cliff Korn, BS, LMT, NCTMB
"Scope of Practice" is a term that, like many others, seems obvious, but means different things to different people. Strictly speaking, a scope of practice is the legal limit of practice options available to a regulated practitioner.However, in common usage, associations develop scope-of-practice guidelines for professionals in a field independent of regulation. A practitioner's scope of practice is predominantly measured by definition, and definitions change depending on who is doing the defining. Laypersons and regulators may define terms we use internal to our work differently than we do.
An example of this can be found with the term "massotherapy." From a school website comes this definition: "Massotherapy is a scientific method for treating disorders of the human body through manipulating the soft tissue, by hand or other modality, to affect relaxation, relieve pain, increase range and mobility of joints and ligaments, reduce certain types of edemas, affect blood and nutrition, improve metabolism, promote circulation, and beneficially influence the nervous system." Another school's site defines the same term as: "Massotherapy is a hands-on application that consists of a number of techniques executed on living tissue with the objective of promoting a general well-being. This type of therapy has an effect on the skin, muscles, tendons and ligaments (referred to sometimes as soft tissue) and aims for a physical as well as a psychic well-being since the last two are closely related." Yet a third defines it as the following: "Massotherapy is massage therapy or a systematic and scientific manipulation of the soft tissues of the body."
They all make the term seem pretty synonymous with "massage," don't they? My favorite choice for definitions is Webster's New World College Dictionary, Fourth Edition. My copy defines massotherapy as "a physical therapy by means of massage." My guess is that individuals looking to initiate state regulation/licensing of massage would get fewer objections from the physical therapists if they studiously avoided Webster's definition!
Individual state regulators can and do choose how they wish to define terms and scopes of practice. This can drastically affect a scope of practice from one jurisdiction to another. A classic example of this is colon hydrotherapy, which until recently was (in one state) not allowed in a licensed massage establishment, while in a different state required those performing colon hydrotherapy to also be licensed massage therapists. In another state, a practitioner of massage may treat temporomandibular joint dysfunction only if a physician has directly referred the patient in writing for such treatment. One state allows the application of non-prescription topical substances on the body within its scope of practice. This has led massage therapists there to offer facial massage, which really irritates the estheticians, who consider the word "facial" to be theirs alone.
Certainly massage therapists deal with overlapping scopes of practice all the time, but regulatory definitions, scope limitations and educational requirements make it particularly difficult within the broad umbrella of massage therapy. Many well-meaning massage boards have developed broad massage definitions so that other professions aren't able to exclude massage therapists from the conduct of emerging advances in the field. A side-effect of this is that many people get swept up in the regulations that feel like they don't fit a definition of massage. Reiki practitioners in all but the most hard-nosed jurisdictions have been able to exempt themselves from most massage definitions. Other methodologies, which frequently wish to opt out of massage regulation, are reflexology and polarity. They make strong cases for not fitting the definitions of massage in many instances, but my trusty Webster's defines reflexology as "a practice involving the use of acupressure or massage of the hands or feet to relieve pain in other parts of the body, reduce tension, etc." The International Institute of Reflexology also lists itself as approved for continuing education by both the Florida Board of Massage and the NCBTMB. Do you think a regulator or layperson reading that definition and noting those approvals would see the merit in granting reflexology an "out"?
Similar difficulty with structural integration, Bowen technique, Asian bodywork, Trager, watsu, CranioSacral Therapy, etc., stems from differences in definition. One I found humorous was Webster's definition of Rolfing. It states, "service mark for a form of painful massage intended to relieve emotional tensions by relaxing and repositioning the muscles." My guess is that the Rolf Institute's public relations team will soon be petitioning Webster's publisher for a definition change!
The differences in state-by-state definitions and scopes of practice are particularly stressing to massage therapists. As a group massage therapists tend to be a mobile lot and the ability to cross state borders relatively seamlessly should be a boon. An organization had been in place to attempt to find common ground in regulatory language. Unfortunately, the National Alliance of State Massage Therapy Boards is all but dead. It has no leadership and no plans to meet again. Perhaps there can be a grassroots effort to get it re-established.
Thoughts on scope of practice are always affected by definitions. Here are a few (from Webster's, of course!) to ruminate on when next you are discussing the benefits of accepting or rejecting regulation, embracing or delaying continuing education, or contemplating whether you are a professional or a hobbyist in massage:
My high-school biology teacher used to use a phrase that still stays with me: "Ontogeny recapitulates Phylogeny." It refers to life cycles of individual organisms affecting the life cycles of groups of organisms. When we choose to define our scopes of practice, we affect more than just ourselves. As that teacher was alluding to with his jargon, what happens to one is indicative of what happens to many!
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be published in a future issue of Massage Today. Please send all correspondence by e-mail to , or by regular mail to the address listed below:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
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