resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
October, 2003, Vol. 03, Issue 10
We Get Letters & E-Mail
By Editorial Staff
Editor's Note: Some letters have been edited for space and clarity.
The Breast Massage Controversy Continues
Dear Massage Today:
I have been a New York state licensed massage therapist for nearly 5 years.This is the first time I have felt compelled to respond to something I have read regarding our profession. I read Mr. Korn's July editorial (www.massagetoday.com/archives/2003/07/10.html), together with his responses to questions he received regarding that editorial in the August issue (We Get Letters and E-Mail, www.massagetoday.com/archives/2003/08/17.html). I am appalled by his comments that "female massage therapists regularly get massage from therapists specifically trained in breast massage to enhance their breast health."
First of all, I receive regular massages from colleagues, and NEVER have I received a breast massage from them. Second, please show me some statistics that indicate breast massage "enhances breast health." (This sounds very much like a male chauvinistic statement.) Third, since when is breast tissue considered "muscle" and therefore subject to massage? Naturally, there is underlying muscle tissue and I have, in fact, utilized massage in this area for female clients following mastectomy. But, the breast tissue itself is NOT muscle. And lastly, NYS law prohibits breast massage - period. I have never performed massage on breast tissue and would not even suggest it to anyone - even with a "specific informed consent." I don't want to lose my license.
I might agree, slightly, if Mr. Korn were suggesting that female massage therapists, who do regular self-breast examination, have heightened palpation skills and notice irregularities more readily than the lay person, but even this statement is suspect, as any woman who practices regular self-examination knows when there is an irregularity in her own breast tissue.
Your Mr. Korn is full of bad advice and bad knowledge. I think his advice is dangerous, and I hope he doesn't practice massage in NYS.
Jody Learned, LMT
Cliff Korn responds:
This writer's concerns are exactly the type of undereducated thought processes that stimulated me to suggest that people need to avail themselves of skilled touch in the first place. I will respond point-by-point:
This writer proves a point I have always believed: A quality massage education is not tied to hours. New York has a 1,000-hour licensing requirement, and I daresay that most massage therapists with far fewer hours of schooling are well versed in this writer's shortcomings.
Lastly, the writer should go back and reread her NYS regulations where she'll find the following statement: "When massage of breast tissue is therapeutically indicated, the female patient/client must be fully informed and give consent before the therapist undrapes the breast for treatment (www.op.nysed.gov/mtguide.htm)."
So, I don't think that I am "full of bad advice and bad knowledge," and I stand by my initial recommendations.
Cliff Korn, LMT
"Have you had problems with the NCBTMB?"
Dear Massage Today Readers:
We are seeking the pros and cons of those who certify through the NCBTMB. Our experience has shown us no difference in competency or quality between those who do and do not certify; moreover, we have found NCBTMB's testing process to be untimely and not cost-efficient. We are compiling a record of problematic experiences candidates have had, and would appreciate any experiences candidates would like to share. Our hope is to one day have an examination process that will indeed credential a therapist of higher competency, whether it be through improving NCE or creating another [test]. We look forward to your feedback.
Selena Belisle, President
The following letters were not published in the print version of Massage Today.
In Support of Breast Massage
I am not a massage therapist, but I am married to one. I just read the letters to editor in the August issue (www.massagetoday.com/archives/2003/08/17.html), and I felt that I had to respond.
The breast is made up of tissue, nerves, lymph glands and the other good things that make up the rest of the body. For years I have suffered from breast congestion -- that is, tender breasts caused by lymph blockage. The breast is part of the body. Men have them too and they get theirs massaged! Women's are just a bit larger. We are told to check our breasts every month for changes; however, the breast changes day to day.
We can massage our own breasts, but the leverage acheived by someone standing over is much better. When my breasts are tender, a good breast massage relieves any lymph blockage and takes the tenderness away. As long as the touching of breasts is limited to sexual connotation, a woman will never get a good body massage. A breast is an extension of the female body -- nothing more. The mind needs to be open and trained to think of it in that matter. When a massage therapist gives a massage, he or she should maintain a professional state of mind and should be able to touch any part of a woman's body.
If we trust our doctors to touch our breasts and be professional, then a professional massage therapist should also be allowed to touch breasts in a therapeutic setting. Massage is for the wellness of the body, and the breasts are part of the body!
A Difference of Opinion
Cim Roesener of Kansas should relax (We Get Letters and E-mail Online, www.massagetoday.com/archives/2003/09/12.html).
Roesener wrote about the "mistake" that "excessive limitations on massage therapy's scope-of-practice [was] being imposed by the state legislature," charging that SB 225 passed in Kansas with ineffectual monitoring and opposition from massage therapy associations.
I'm guessing Roesener has misread the bill and is unaware of the legal context for massage in Kansas that prevailed before the bill was even written, and continues today. The purpose of SB 225 as far as massage therapy is concerned was to liberalize the law, not make it more strict. The bill merely takes the words of the existing Kansas exemption, now in the healing arts licensing law (§65-2872), and applies it to physical therapy. Here is the exemption language in Kansas' healing arts legislation, which matches the quote Roesener lifted from SB 225:
"(f) Persons who massage for the purpose of relaxation, muscle conditioning, or figure improvement, provided no drugs are used and such persons do not hold themselves out to be physicians or healers."
There's nothing new in it, regardless of how limited one might think the imputed scope of practice is. Instead of wondering about professional associations not lobbying against this exemption, massage therapists should actually see this as a small step forward.
For quite a long time, Kansas has been the original "freedom-of-access" state, at least as far as exempting massage therapy goes. Still, SB 225 reminds us that freedom-of-access laws as passed in Minnesota and California are not doing enough of a favor for massage therapy if they only provide exemption from one or two laws that require physicians to be licensed.
Massage therapy needs to be exempted from physical therapy; chiropractic; naturopathic; acupuncture; and even cosmetology laws. None of that will handle the problem of exemption from local county and city parlor laws, however. So in the end, perhaps Roesener and I do think favorably about state licensure. Most massage therapists see it is the cleanest means of providing freedom of access to a broad scope of massage therapy, for both levels of government.
John Fred Spack
"A 'regulated profession' is the basis for the public's assurance of quality-of-practice"
I am a Registered Massage Therapist licensed in British Columbia and Ontario, Canada, and am American. I read with concern the clause in the new Arizona legislation that refers to sexual impropriety (July issue, www.massagetoday.com/archives/2003/07/01.html), which [prohibits] massage therapists [from committing such acts], then continues on to detail inappropriate sexual behavior. I understand both sides of the concern.
On the one hand, it should not need mentioning because of the ethics [massage therapists] uphold; on the other hand, there is a need to let the public know they are protected and when the line has been crossed. However, there is a sneaky insinuation in the law that massage therapists are really NOT safe or at least not to be fully trusted. In Canada, we went through this, too.
When I entered the profession in 1983, I would get a telephone call every couple of weeks asking, "how the girls are." After all my training and the difficulties of starting up a new practice, it made me disgusted and frustrated. It is different now, twenty years later. We have a College of Massage Therapists (board of massage therapy) in British Columbia and Ontario legislated by the government, whose mandate is to protect the public. The very fact we are a "regulated profession" is the basis for the public's assurance of quality-of-practice and legal recourse for malpractice of any kind. The bylaws mention "sexual abuse" by name, along with a list of other potential legal and ethical violations. In other words, this is just one of many ways in which the public is protected.
Such wording and legislation exists in other regulated professions as well. In BC, there is no "dirty laundry list" of illegal sexual acts needed to define sexual abuse. There is zero tolerance for sexual abuse; however, there is a way of phrasing the law that is sufficient to protect the public without being an embarrassment to the profession. And, bottom line: it works.
A regulated college or board is a necessary growing stage in any health profession. Self-regulation that is monitored by the government (not to be self-serving) can be a benefit to both the profession and the public. Being American, I understand the distaste for "over-regulation." On the whole, I would say that there can be balance between freedom and discipline, as there always must be.
May you find your balance unique to your American situation.
David Dressler, BA, RMT
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