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Massage Today
July, 2004, Vol. 04, Issue 07

We Get Letters & E-Mail

By Editorial Staff

The following letters were not published in the printed edition of Massage Today. E-mail your comments to . Some letters have been edited for clarity.


In this segment:

Letters regarding Ralph Stephens' March article, "A Trade or Profession?" (www.massagetoday.com/archives/2004/03/11.html).

Letters regarding Cliff Korn's March editorial, "The Evils of Money," (www.massagetoday.com/archives/2004/03/09.html).

Letters regarding Cliff Korn's April editorial, "Of Foxes and Henhouses," (www.massagetoday.com/archives/2004/04/11.html)


"Ralph Stephens' rants are thought-provoking"

Dear Editor:

I have to admit that Ralph Stephens' rants are thought-provoking, and this installment in the March issue is no exception.

In my experience, massage is neither a trade nor a profession, but rather a vocation -- literally, a calling or even a spiritual calling. Caring human touch is the basis of massage, and is the energy that facilitates healing in all modalities. Without it, massage is just physical therapy.

The proliferation of mediocre schools is not what makes mediocre therapists, as Mr. Stephens asserts. This is a symptom, not the cause. The cause is mediocre students. (No, I don't teach massage nor run a school.) Cartoonist Gary Larson caught the essence of the problem in his cartoon strip, "The Far Side," when he showed Captain Hook in a job counseling office trying to decide whether to be a pirate or a massage therapist.

The fact is, a good student will become a good therapist even after going to a mediocre school, because he or she will make the extra effort needed. Conversely, you can send mediocre students to the best schools in the world and train them for thousands of hours, and they will still be mediocre therapists. This is true in all fields.

A 1988 Chinese study found that experienced qi gong masters emitted greater than 20 dB (100 times) more infrasonic acoustic energy from their hands than the control group. If this test or one like it could be applied to massage therapists, perhaps we could weed out mediocrity so that Mr. Stephens could sleep at night.

Warren Marsh, NCTMB
Jericho, Vermont


Dear Editor:

I'm a massage therapy student in Ohio, and will graduate around Thanksgiving, sit for the exams, and (as long as I pass) be able to stick those three important letters -- "L" for Licensed, "M" for Massage, and "T" for Therapist -- at the end of my name.

I plan to further my education after graduating by learning and adopting a large number of different modalities to be the best therapist I can. With regards to the whole Trade/Profession argument that's abounding in the massage world (and in particular this publication over the past few issues), I say "Phooey!" Let's look again at the definitions that Ralph R. Stephens gave us:

  • Trade - Somebody's particular occupation, especially one that involves a skill; the people who work in a particular area of business; and
  • Profession - An occupation that requires extensive education or specialized training; the members of a particular profession.

As far as I see it, we're both. We're skilled practitioners who work on the body for a fee (or not if you're so inclined) and require specialized training and education. In most cases, we continue to educate ourselves beyond graduating from school: we attend seminars and workshops; learn special modalities; and work with our peers to train and develop further skills.

Do allopathic doctors graduate into their professional lives without having skills? Would you want a doctor to operate on you with no surgical skills? Do architects graduate without specialized or extensive training? Would you hire an architect to build you a house if he or she didn't how to apply the laws of physics to construction?

The argument for massage to be seen as a profession instead of a trade smacks of elitism and wanting to be elevated to the mythical status that doctors, lawyers and accountants. Vice versa, wanting massage to be seen as a trade smacks of not taking pride in our continuing education, interfacing with all other facets of the medical community and building on the knowledge that already exists.

The "rub" is that educational standards and requirements differ from state to state for massage, and there's no baseline for education. There's no overall organization responsible for overseeing and regulating massage nationally. The current national examination, the NCETMB, is performed online -- theres no practical exam. How on earth, as physical professionals, can we not be tested on our palpation and manipulation skills? Some states regulate massage and provide their own examinations and licensure, while others do not. Some states don't even require a certification, never mind a license.

There needs to be a national licensure organization, just like there is for registered nurses. With a national organization at the helm, establishing a baseline for education, there would be a nationally recognized license that would allow therapists to work easily in different states (as they often find hard to do right now). Massage would also attain a level of acceptability within the medical community that it currently doesn't have; massage therapy can only benefit from such a thing.

In Ohio, massage therapy is a limited branch of medicine and regulated by the State of Ohio Medical Board. I'm proud of that, because massage therapy is perceived to be a healing profession, with regulation comes compliance and protection of the client base. We still suffer by not having practical testing, but I think we're better of than a number of other states.

Jason Paul McCartan
Ohio


"Cliff Korn's column...opens a needed dialogue"

Dear Editor:

I just finished reading the March 2004 edition. Congratulations on the success of this magazine. I'm writing because I agree with Cliff Korn that massage therapists are under paid because many of us love what we do and aren't good business people. But, as our profession works diligently to increase the level of public awareness to the benefits of massage therapy it is time our profession stop putting a zero or discounted value on the importance of our work.

For example, in the article "Are You Sitting on a 24-Karat Gold Mine?" (www.massagetoday.com/archives/2004/03/07.html), Colleen (Steigerwald) Holloway's ideas for increasing business is to discount a massage by 50 percent or offer two massages for the price of one. I have yet to see any other profession offer suggestions such as this, unless they are selling a commodity that is overstocked. In the world of business it is important to know your target market. If massage therapists wants to increase their businesses, they should be more proactive. But, that doesn't mean selling services at a discount. There are plenty of other things that therapists can do to keep clients, such as sending birthday cards or reminder notices. As our profession becomes more aligned with the health care field, articles on how to run a successful health care practice would be appreciated.

Linda DeGray, MA, LMT
Enfield, Connecticut


Dear Editor:

I have converted to the electronic form of Massage Today and it works great for me; the reminder in my e-mail box prompts me to read it. My only complaint is the same one I have about the paper issues: I mean to read just a couple of columns and wind up perusing the whole thing!

As always, Cliff Korn's [March 2004] column makes great sense and opens a needed dialogue. When I began massage practicing therapy in the 1970s there was a prevalence of the attitude "a massage should be as free as a hug," and for many, that outlook still has unwarranted resonance. The psychological makeup of caregivers and the prevailing attitude in the marketplace combine to create treacherous territory. Some massage consumers consciously or unconsciously expect that the therapist who enables their wellness should enable non-massage benefits as well. Although I do not practice anymore, I have acute memories of frequently hearing, "You have such a gift!" and having to ready myself to deflect attempts to receive my "gift" gratis.

I developed this rationale: My time and good name are all I truly have in life. I will give away some of the treasure of my time by doing massage, but it will be in exchange for someone else's treasure (of money or services), and will be done in a way that enhances my good name. I still donated my time to charitable enterprises and felt that was a way of adding to my good name.

Most schools are run by massage therapists who struggle with business concepts and applications. Just as one school in my old neighborhood had an entirely inadequate and absurd class in ethics ("Don't have sex with clients" and "Never break contact with your client's skin during a session"), some schools minimize or skip the very important topic of how massage works in the real-world marketplace

I hope your call for better a business foundation in massage schools brings about therapists who are better equipped to run their businesses.

Deanne Charlton
Autaugaville, Alabama

P.S.- Regarding another issue you mentioned in your column: Do you remember Andrew Weil's address to the AMTA National Convention in New Orleans back in the 90s? He said that as he left Alaska to fly to Louisiana, people there were envious of his opportunity to be among hundreds of massage therapists. On the airplane he contemplated the shift of public attitude toward the profession. At the New Orleans airport he got into a taxi and when the driver asked what he was doing in New Orleans he said he was there to give an address to a meeting of the American Massage Therapy Association.


"Massage, huh?" the cabby said. "I bet you get lucky a lot."

Dear Editor:

Regarding Cliff Korn's March 2004 editorial, I definitely agree that massage therapists need to evaluate their fees based on their levels of expertise and their local market; however, I disagree with the insinuation that a massage therapist should charge more when "more advanced skills" are necessary to provide massage to his or her clients.

My physician does not charge more to bring all his knowledge to bear in diagnosing and treating patients, nor does my chiropractor charge more for a difficult adjustment. I passionately believe that my clients come to me for all my expertise, and to charge more or less for certain techniques would violate my code of ethics. That may be part of the reason I have never had to advertise, why many of my clients have been with me for over a decade, and why my appointment book is as full as I want it to be. I also believe that a "relaxation" massage, in many instances, is as therapeutic as a massage labeled as "therapeutic." The wise therapist is the one who recognizes and honors the value of both.

Paula Z. Hamelik, LMT
Miami, Florida


Dear Editor:

I have over 15-plus years in this business and can relate to this article. It was not long ago when folks said, "customer service in the health care field" when asked what I did for a living. NOT FOR FREE is what I take serious issue with in this article! I value myself as an incredible human with an ability to effect lives and not a work drone in a mundane field of body "fluffing." I disagree that most massage therapists/bodyworkers devalue themselves or are afraid of money or even success. Extreme cases are in all professions; for the purposes of this letter, set those aside.

In my experience it's those clients/patients that need us the very most that canot afford it. If payment had been demanded for all of our services and I taught my students to demand payment, that would be wrong! Yet, I would be monetarily thousands of dollars richer in cash. Yet, at what ultimate price would I have had to pay for such?

This is a healing-art profession; we are neither hairdressers nor car mechanics -- both wonderful fields, yet not the same. We are the tools that enable others to "heal" themselves in a triad of ways: body, spirit, mind. It is my divine gift to be able to work in this field. The inability to "share" or "give" free touch is more of an issue than the worthiness of the receipt of payment for it.

I have worked and felt, at times, like I had lost my ethical soul in several extremely high-end Houston "conveyor belt" spas, that charge clients an hourly rate for 50 to 55 minutes, give them some herbal tea and a promise for a brighter day. Really, the most ethical thing to do is to assist clients in a longer session that tackles the problem; explain the reasons for them to be aware of how to modify their actions/behavior to enhance each day of their life; or, in many cases, refer them to a specialist, such as a chiropractor or medical doctor -- not focus on "washing instructions for that fancy terry robe" that came with their spa visit or sell them some "magic cream" to make it all go away till next time; moreover, in my experience it's the "spa employers" that treat each therapist like a lower-class citizen and not appreciate the "gift" they have as a part of their intuition. That really knocks down even the healthiest spirit of a therapist.

Do not get me wrong, my hourly rates are higher than the average massage therapist, and justly so, due to my years of experience and education. As the sole-proprietor of my business, every day is a profit or loss. Just put it into perrspective of life: every moment is priceless; use each one for the "higher good," and abundance is yours! I practice bodywork to create such happiness and peace for others in our world.

What do we receive in compensation for these "freebies?" It's called "Karma," and each day it comes back to me, so make a mental note in your check register. Each day of my life, I am thankful and privileged to "touch others" for my bounty of health, family and prosperity.

I will never regret my "free" hours of "touching the lives" of the terminally ill hospital patients and families, AIDS clients, breast cancer survivors, war veterans, nursing home residents, newborn babies or burned children, animals and laid-off Enron employees. These bodies riddled with disease, disfigured through physical or emotional trauma and tortured by neglect are the most valuable of my clients.

Most importantly, it is a privilege to be there for them, and I never, never told a soul or promoted these "good deeds" for monetary gain from them or other clients. It is my gift to receive them into my life as a reminder of my own abundance in all aspects.

So who is receiving more? Think on that. I am thankful that my check register is filled with notes in black ink and sometime numbers in red. It's not the measure of the bottom line...behold the "Brass ring" that I hold.

Sheri Wood-Rogers RMT, MTI
Houston, Texas


More From the North Carolina Board of Massage and Bodywork Therapy

The following letter is in response to Cliff Korn's April 2004 editorial concerning rule changes to the massage licensing law in North Carolina (www.massagetoday.com/archives/2004/04/11.html).

Read a letter from the North Carolina Board of Massage and Bodywork Therapy's legal counsel in the June 2004 issue at www.massagetoday.com/archives/2004/06/12.html, and Mr. Korn's comments regarding the letter in his June 2004 editorial at www.massagetoday.com/archives/2004/06/09.html.

Dear Editor:

As the former Vice-Chair of the North Carolina Board of Massage and Bodywork Therapy (Board) and former chair of the board's School Approval Committee, I am responding to your editorial in the April issue of Massage Today. From my perspective, the article is inflammatory, inaccurate, and poorly researched. That you would receive information from an "individual" who suggested you "take a peek at the rules" and then choose to publish an article without bothering to confirm or verify facts demonstrates irresponsible journalism. I question what agenda and whose agenda you are attempting to convey to your readers.

First, let me state that I am not a current recipient of your publication. I was given the article when I attended the Spring conference of the North Carolina Chapter of AMTA (AMTA-NC) held recently in New Bern on March 26-28. Copies of your editorial along with copies of the draft of proposed rule changes by the board were provided to the chapter membership. I was concerned that your editorial comments were presented as factual, along with comments by the leadership of this organization, about the negative impact of these rule changes on the practice of massage in the state. Your editorial was touted as proof of this fact.

This was the first time I had attended an AMTA-NC conference. As the program director for the Therapeutic Massage Program at Pitt Community College in Greenville, NC, I had taken a group of my students to the conference as a way to introduce them to a "professional organization." Imagine the surprise of new students to see an article on the North Carolina Board of Massage and Bodywork Therapy presented in such a negative light, especially when their instructor was a former member. They were confused about what to think. It left them with negative impressions of the North Carolina board, before they had any experience with this regulatory agency.

I would agree with your statement in paragraph 4, of your editorial: you did provide a "brief analysis." I would also add from my opinion it was inadequate. For your information, North Carolina is the only state with massage regulations that do not have another state governmental agency administering some part of the licensing process for schools of massage and bodywork therapy. This responsibility used to be the domain of the North Carolina Department of Community Colleges (NCCCS).

When the North Carolina Massage and Bodywork Practice Act (our massage law) was written, it was assumed by the authors that the NCCCS would continue the licensing of massage and bodywork schools and the massage board would approve school curricula and instructional staff. After the Practice Act was passed, and the board was appointed, it was discovered that, due to state regulations, the NCCCS no longer had the statutory authority to license massage and bodywork therapy schools.

For the board, this meant it had to bear the full responsibility for creating and administering a comprehensive school approval process. As a former member of this agency, I can attest to the fact that the board had never imagined that it would be forced into the regulation arena without adequate funding or staff to administer such a program. As you may know, approving a school on paper is not the same as verifying compliance with all standards. As a result of this, the board formed a School Approval Committee, which I chaired.

For your information and enlightenment, there were no "former school owners" on this committee. Besides myself, the committee was made up of the board's public member (an attorney who is the current board chair, and who has taught in the state university system), and another therapist member of the board with years of practical and teaching experience. We all have advanced degrees. As a foundation for our research, we examined educational standards from the NCCCS, Commission on Massage Therapy Accreditation (COMTA), and the Accrediting Council for Continuing Education and Training (ACCET), as well as other state regulations. At that time I was maintaining my own private practice. I cannot speak for the other members of my committee, but I spent countless hours researching these processes and during that time reduced my practice to four days per week so that I could provide a service to my profession and contribute to the professionalism in the field.

Furthermore to insinuate that a "proprietary school owner" spearheaded the increase in school fees to drive small schools and the community colleges out of the massage education business is just plain irresponsible and complete nonsense. The fees that the board has collected to administer the program are about 25 percent of the actual costs. Without funding from the legislature, (which is precluded under our Practice Act) or another agency to administer the licensing process, the funding would have to come from the regulated group: the schools themselves.

There are several other issues in your article that I would like to address:

1) Concerning the issue of documentation of staff/teacher credentials: You state "If a faculty member gets hit by a bus the day before school starts, this rule would make it illegal to hire a completely qualified individual to meet the start of the school program."

This statement demonstrates a fundamental lack of knowledge of the recruitment processes that state agencies and approved programs are required to meet. For my program to hire an instructor, we must follow a process, which is required by law and includes steps, such as advertisement of the position in the public media, verification of credentials of the applicant, an interview of the applicant by the search committee, and approval and recommendation for hire by the search committee. I can assure you this process takes longer than one day. But it ensures that only the most qualified candidates are selected for the position.

All approved programs must comply with well-documented, required recruitment and hiring requirements for instructional and key administrative staff. If one of my instructional staff was unable to teach due to an emergency, the rest of the faculty would assume the teaching load until that person was able to assume his or her duties. As a former chair of the Board's School Approval Committee, I suggest to you that, if all the schools were compliant in notifying the board of changes in key administrative staff and faculty, there would be no need for the board's proposed rule change to require "preclearance" of new hires. The problem in this field is that a small few disdain the regulation process, which makes it difficult for those of us that comply. The irresponsibility of a small group of schools creates the need for more specific regulation, so that public protection will be maintained.

2) You have criticized the board for not using the same style of language that the National Certification Board of Therapeutic Massage and Bodywork (NCBTMB) used in developing its Standards of Practice.

Your criticism indicates that the circumstance and type of practice should determine its applicability. This type of language, while applicable to a voluntary certification agency, is not applicable to the rule-making process required by the North Carolina Rules Review Commission (the state agency that oversees our rule making process).

You have implied that some sort of evil intent exists on the part of the board for not using this language. This could not be further from the truth. When I served on the board, our first set of school rules was returned to us for being too vague. These rules were lifted almost verbatim from the rules governing the NCCCS, so the board was surprised when they were rejected. It was learned that specific language governing occupational practices must be contained either in the statutes, or in the rules in order for licensees to understand how to uphold the law. In the above case, detailed school regulations were documented in the law and did not have to be restated in the rule making process. Using terms such as "if applicable", or "appropriate" does not meet the legal needs of a governing body in North Carolina.

3) Concerning massage therapy as a regulated profession and the administrative practices of the board: What is not common knowledge to you or to "the individual" who was your inside source, is that the number of serious complaints received by the board about both practitioners and schools is legion.

The investigative and disciplinary processes required by these violations consume much of the board's resources. I have been shocked about the quantity and nature of ethical problems in this profession; perhaps this is naiveté on my part. I do not know of any other regulated profession that would not report ethical violations. On that note, I asked my supervisor -- the Department Chair of the Occupational Therapy and Massage Therapy Department -- what the response of the NC Occupational Therapy Board would be if she allowed her license to expire while continuing teaching or practicing her profession. She told me her license to practice would be revoked. Her colleagues who knew of the offense but declined to report it would be disciplined.

Yet, in the massage field we have people who continue to practice (or teach) without a license and who are protected by therapists in the field because they do not want to "tattletale" on their friends. Allowing and protecting unprofessional behavior is a detriment to the integrity of this profession.

For your information, the National Certification Board's own "Standards of Practice" provide in Standard II, Legal and Ethical Requirements, that a "certificant shall (d) report to the proper authorities any alleged violations of the law by other certificants; (f) report to NCBTMB any criminal convictions regarding him/herself and other certificants; (g) report to NCBTMB pending litigation and resulting resolution related to his/her professional practice and the professional practice of other certificants."

Also NCBTMB certificants are obligated "to report unethical behavior and violations of the Code of Ethics and Standards of Practice that are performed by other NCBTMB certificants, to the NCBTMB and other appropriate professional associations and regulatory bodies governing the massage and bodywork therapy profession." I would hardly consider it draconian to protect one's own profession from improper practices.

Rules revision is an administrative process defined by North Carolina law. It is a process that requires proposed changes to be published so that the constituency affected will have an opportunity to comment. When I was a member of the board, information received by constituents was seriously considered. I fail to understand how a requirement for informed consent or documentation of work performed can be considered a "requirement of therapist to spend an extra 30 minutes" as is being alleged by the AMTA-NC, or how it shapes the profession into a "clinical perspective" as you reported.

As a former board member, I can assure you that I have become very tired of having elected officers of AMTA state during board meetings how much they have appreciated all the hard work that has been done by the board -- and then hear how the story they present to members of the profession and legislative bodies is how the North Carolina Board of Massage and Bodywork Therapy and its regulatory program are a "laughingstock" or a "joke." This strikes me as disingenuous.

Finally, if you can judge the administrative capability of the board on "a brief analysis" of proposed rule changes, and come to the conclusion that it is poorly administered, it is my opinion that you must be anointed by a higher authority, particularly since, to the best of my knowledge, you have had no contact with the board. You owe the board the opportunity to present its response.

You have engaged in the worst kind of yellow journalism by not fully investigating your subject. Before you allow your paper to again be used as a forum for a political agenda, I would suggest you attempt to investigate the facts.

Candace C. Frye, MA, LMBT
Greenville, North Carolina

 

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