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Massage Today
April, 2003, Vol. 03, Issue 04

Shades of Gray

By Cliff Korn, BS, LMT, NCTMB

This is a unique time in the history of massage therapy in the United States. It would be nice if we could speak with one voice in this time of opportunity, but it appears we can't even use the same language.

It also appears that many of our own are clinging to the bulwarks of the Tower of Babel, shouting louder and louder in their own language, and getting more and more frustrated that they aren't being heard.

Nationwide, massage regulation is being considered at a frequency we haven't seen for many years. California; Georgia; Massachusetts; Arizona; Indiana; Kentucky; Michigan; and Pennsylvania are just some of the unregulated states currently looking at various forms of regulation/licensing. Massage regulation has always been a volatile and contentious subject among massage therapists. The sides break into two general camps: one that wants no part of anyone controlling the ability to practice individual forms of massage or bodywork, and the other that hopes to create a playing field that has minimum standards and limits the ability of some to enter the field.

Nowhere is the argument louder, or the battle lines drawn more clearly, than in California, which is currently an interesting mix of regulatory cacophony. Some California governmental entities regulate massage therapy as a health care field; others regulate massage therapy with ordinances suggesting massage therapists are prostitutes. Some parts of California require a minimum of 1,000 hours of education and passage of an accredited competency examination; others require nothing more than completion of a weekend workshop.

California arguably has the most massage therapists per capita of any of the 50 states. The raw numbers alone make California's actions watershed events. This time period is particularly unique in that California is in a position like none other: to be an example to other states in regard to appropriate levels of regulatory oversight. Those on the extreme edges of both arguments see the regulation issue in black and white terms only. If one listens to these individuals, it seems more likely that California will be a laughingstock than a leader. California is no different than any other governmental entity in that the determination of issues come in many shades of gray, and the sooner those carrying the banner of either "edge" compromise or get shunted to the parking lot, the better the massage situation will be for practitioners and the public.

I continue to see and hear the divergent arguments for and against state licensure. The issues that seem to be causing the most people to grab one another's throats include:

(a) the requirement for local regulation that necessitates high business licensing fees, blood tests for sexually transmitted diseases and fingerprinting;

(b) the requirement for multiple business licenses if one wishes to work in multiple communities;

(c) "high standards" that represent someone else's ideas of initiation into the profession;

(d) the perceived inability for graduated, "easy entry" into the field;

(e) the perceived money-grubbing of large schools and associations who provide or require substantial hours of study for entry to the field;

(f) the perception that massage boards are ineffective and protect the criminal and the incompetent;

(g) the frustration that massage regulation doesn't solve every ill known to the profession;

(h) the frustration that there is little proof a licensing law eliminates prostitution operating under the guise of massage;

(i) the frustration that sufficient knowledge to practice safely has never been determined;

(j) the feeling of vulnerability that comes without a protected scope of practice;

(k) the implementation of standards when there is no agreed-upon set of standards;

(l) the fear that if we do not regulate ourselves, others will regulate us;

(m) the fear that without our own licensing our profession will be eaten away by physical therapists, chiropractors and prostitutes (for differing reasons!);

(n) the fear that entry-level minimums are really designed as "population control" to keep people out of the profession;

(o) the perception that entry-level licensing eligibility criteria and testing will slam the door on those who possess the spatial and nonverbal skills of massage, but not the verbal-linguistic memorization and test-taking skills;

(p) the fear that regulation will further polarize full-time and part-time practitioners;

(q) the need to protect the public from harm;

(r) the lack of substantial public evidence that massage causes public harm;

(s) etc., etc., etc.

I think it's time to stop bickering. The "I'll never agree to that unless . . ." attitude keeps polarizing the process. From my desk, it's starting to look a lot like the classic right-wing versus left-wing struggle. The right-wing, reactionary forces are clamoring for a market-driven solution only, while the left-wing "big-government" group feels that layers of bureaucratic restrictions on practice will solve the public's social ills. Both positions are just plain silly. I find it humorous how many massage therapists with liberal political leanings are fighting the big-government approach to massage, and how many massage therapists with conservative leanings are taking a stance opposed to a free-market economy. (Massage therapy is not without irony!) It's time to step up to the plate and muzzle those fringe players unwilling to move from their pre-conceived ideas. Remember your mother telling you, "Never say never"? She was right! It's time to start compromising, so the greatest good is realized. It's time to keep the dialogue open, honest and professional. In my opinion, the most important issue facing the profession today is the ability to practice in different parts of the country. This concept was once called "reciprocity," but is now more frequently called "portability."

California has an opportunity to establish operating conditions the rest of the country can emulate to maximize portability. It can accomplish that by establishing massage regulation so correct and comprehensive that almost everyone appreciates its fairness and ability to meet diverse needs, while allowing the "substantially equivalent" clauses in other state laws to apply; or they can develop a regulatory posture based upon the lowest common denominator, and try to convince the 31 licensed states they should do the same with their existing regulations. My guess is that time would be more valuably spent attempting the former; the latter seems a tough row to hoe. California has the opportunity to embrace shades of gray, rather than the black and white. The whole profession is watching with anticipation!

Thanks for listening!

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:

Massage Today
P.O. Box 4139
Huntington Beach, CA 92605

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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