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Massage Today
August, 2004, Vol. 04, Issue 08

We Get Letters & E-Mail

By Editorial Staff

Editor's note: Some letters have been edited for clarity. Readers can respond to letters at .

"My letter is to let off a little steam"

Dear Editor:

Thank you for your magazine.

It keeps me abreast of the massage industry in my corner of the world in Boardman, Ohio. I have just gone full-time with medical massage between two offices. One is at my home and one is in a chiropractic center. The reason for my letter is to let off a little steam.

I am working hard in a small corner of the massage industry, which is auto accident patients and workers' compensation patients. It is great money per hour, but at the end of the month, I am just making my house payment and putting food on the table for my wife, 3-year-old, and my mom. I keep talking to health insurance companies and they tell me that they will pay for massage therapy (code 97124) and neuromuscular re-education (code 97112) if it is billed as the chiropractor being the provider and the massage therapist as an employee, which isn't the case.

When are massage therapists in Ohio going to be recognized as legitimate providers, so we can bill as our own businesses? Also, how do we, under the present rules, get the money from the chiropractor's pocket to my pocket (legally), since we did the work?

So many patients right now are as frustrated as I am because they need the massage therapy along with the chiropractic adjustment, but health insurance will not pay if I bill them; most patients do not have the cash to pay out-of-pocket.

John Ray Holden, LMT
Boardman, Ohio

A Few Thoughts on Massage Regulation and Education

Dear Editor:

I'm a New York state licensed massage therapist and nationally certified with approximately 400 hours of continuing education credits. I've been practicing therapeutic/medical/orthopedic/advanced massage (call it what you want, it's all therapeutic/corrective work) for 10 years. I love this work, and although I receive excellent bodywork every other week, I don't know how much longer physically I'll be able to continue in this field.

Massage therapy is a short-lived profession for most. Most graduates lucky enough to find work in the field (and I'll bet it's less than 3 percent) don't last more than three years. Either they are physically ruined or they quit because they can't make a living wage. (I'd like to see actual data of the percentage of graduates who are able to support themselves five years after graduation.)

Basic training, good or bad, is expensive. Continuing education is expensive, with cost increasing every year. Include the cost of motel rooms, travel and unpaid time off from work and CE becomes even more expensive.

Licensing or national certification does not make a good therapist, nor does anyone outside the field know or care about licensing or certification. National certification is superfluous with the implementation of state licensing. So, hang it up, for Pete's sake! There's discussion of different levels or advanced certification that may require the study of totally unrelated subjects. Who are we trying to impress, who do we think really cares? Not my clients. All they want is a good massage, and "good" is subjective; regulation up the "ying yang" won't change that.

My point is, the bodywork industry is sapping the energy and money from its foundation -- its few practicing therapists. We aren't making the money of doctors or chiropractors, and we never will, simply because they can see in half a day the number of patients that we can only physically handle all week!

I believe it's time to stop looking for credibility through regulation. Our work speaks for itself. Get rid of the ego and stop caring what the medical profession thinks of bodywork. Just do what you do best, and your clients will give you the credibility you're so in need of. Get out of the way and let it happen. And remember, even though their fields are regulated up the ying yang, you will still find no shortage of incompetent chiropractors or doctors. An incompetent doctor doesn't make them all bad, so you look elsewhere, right?

The bottom line and the point to remember is, we can't financially afford this need to prove how good we are on the basis of our "advanced certification." We are still physically limited to the number of clients we can see in a week. Regulation, advanced certification, etc., will not change it. The only ones to benefit are the continuing education instructors and the agencies enforcing it.

Kay Gustin
Troy, Pennsylvania

Dear Editor:

My adolescent punk rock mantra has evolved to that thin line between idealism and fanaticism called rational, where now I believe there is no government like less government. I'll get to my point. There is no need for HB 68 [Wyoming House Bill, regulating massage].

When I last spoke to a board member on licensing committees in 1999, there had been no wrongful cases against massage therapists. This means, nobody in the state of Wyoming has ever complained to the state that a massage therapist caused him or her harm. I respect the AMTA's self-serving establishment of national credentials in order to continue to feed "the business" to sustain itself, but supporters are neglecting two things: self-responsibility and the active consumer.

Some of us believe massage to be an art form. Some of us view our bodywork to be our artful/manual interpretation of how the body functions anatomically, emotionally, psychologically and spiritually. I feel, and apparently my clients feel, that I meet criteria in accord with their beliefs. If I don't, then they go to someone else.

Are beliefs licensed? Are artists licensed? Do you license a philosopher? If consumers rely on a state board to tell them who is qualified (and qualification equals "good") then the government and those supporting a massage therapy board encourage and support very lazy consumers.

My only encounters with "hurtful" massages were with a licensed therapist (who went and gave money to another state to bet licensed), a 1200-hour therapist. My favorite therapist had the least amount of formal education.

I support active consumers. A consumer who wants to ask me what qualifies me to manipulate the soft tissue on their body is an active consumer. They are free to determine what is best for them. If I don't meet there qualifications, that is O.K. My job as a "free" person is to accept and respect other people's choices. Don't create or limit my choices as a therapist or a consumer. I believe in self-responsibility, in this case, regarding education.

First and foremost, Wyoming does not have any massage schools. If boards are instituted, this means that someone will have to leave their own home in Wyoming to pursue an out-of-state education. Not everybody is as financially able as others to just pick up and leave to pursue an education. I think education evolves from many avenues (like your family, your time alive). Should an artist not be allowed to practice art because they can't afford to leave their state at the convenience of the board? Does previous education, if any, hold any merit with 600-800 hour massage therapy "school" (I say company).

Mine didn't. [I have] a degree with five years of anatomy in art and five years of schooling in psychology and art therapy. I was a practitioner in the mental health field for six years. I don't think massage companies embrace psychology at all in their curriculum or as much as they should, but that is the path that they created. My state allowed me mine. I got to choose the times I left my state to educate myself. I got to choose what I wanted to study, based on finance, interest and time, and what I think is relevant to my art.

A major complaint I have heard from several therapists is that they had to learn things that did not interest them in regard to massage philosophy in order to fulfill course requirement hours. I would never be able to sit through anywhere from 10 to 100 hours on something that I had no interest or belief in. I would rather spend my time and money choosing what I study because it interests me and, hopefully, my client. Sadly, several therapists have acknowledged that they have resented my routes of education because I did not spend as much money and did not have to leave the state for a year or so in order to meet their "company" requirements.

On the contrary, I spent $60,000 to attend a private art school because (and although I am proud of my school and education) I learned that it was a business. I don't think that if someone wants to move some paint around on a canvas, that they have to take my same path, as I also learned that spending more money and time did not make me a better artist. I learned 15 years ago that I do not, especially in today's information age, have to spend $10,000 to re-educate myself.

When I chose my art of massage, I was privileged to live in a state that allowed me to choose my avenues of education, to police my own education, to research information that I am interested in. My employers also have had their right to choose me to work for them based on what they think qualified me. Employers, consumers, "therapists", all active in self-education, self-responsibility, pro- and anti- "more government".

Dana Gatt, CMT, EP (Educated Person)

Dear Editor:

There has been much coverage in recent issues of Massage Today, as well as other massage trade journals, that insurance companies are moving toward limiting or eliminating coverage of massage therapy (when performed by massage therapists) even when prescribed by a doctor, but continuing to cover massage therapy as "physical medicine" (when performed by a physical therapist, physiotherapist, osteopath, chiropractor, etc.). And with precedence set by a state prohibiting CranioSacral Therapy (CST), the potential ramifications for regulatory limiting of massage therapists' scope of practice are dire and real.

And why do you think this is occurring? It is very likely that it is due to a couple of factors, one being that there is no standardized curriculum in America for massage therapy; it varies greatly from school to school, and from state to state. In some states (New York), schools teach a curriculum of 1,400 hours (with 1,200 required for licensing), and other states like Nevada, where schools teach a curriculum of somewhere between 500 or 800 hours, and only certain counties are regulated (requiring 500 hours for licensure), while the other rural areas, which comprise the majority of the state, remain completely unregulated, with no licensing requirements whatsoever.

And while there are certainly good schools which responsibly teach a comprehensive curriculum, there is certainly no shortage of "diploma mills" which are primarily concerned with creating profit revenue; this results in a great number of minimally trained people who refer to themselves as massage therapists.

Until the time when a college degree in massage therapy (associate's, bachelor's or master's) can be earned at accredited universities, after the successful completion of a prescribed course of study that follows nationalized standards for content, the massage profession will not receive the same respect from the medical profession, from insurance companies, and/or from lawmakers, that is commanded by other degreed health science professions.

It is obvious that NCTMB certification has done nothing to change this, nor have license regulation requirements made any difference. Joining a professional association, and being responsible enough to shell out for liability insurance doesn't make any difference. And it doesn't matter if one has enough display certificates from fancy CEU workshops or "advanced certifications" to wallpaper an entire office, it won't change things. And no amount of self-righteous indignation on the part of our profession will change things either.

It's time to drag the massage profession kicking and screaming into the third millennium. Wake up, people. If we want to be respected as health science professionals, let's move to create higher and consistent standards for ourselves. It happened for the nursing profession about a hundred years ago, and it's about damn time it happened for the massage profession. In some parts of Easter Europe, a degree in massage studies is earned after five years of college. As the saying goes, "the fates lead those that go willingly, and drag them that don't." It's obvious that simply maintaining the status quo is not a viable option. Our profession must move forward if it is to truly survive. And that means requiring national standards of curriculum content, and the successful completion of a college degree in massage studies from an accredited university.

Joe Graday, NCTMB
Las Vegas, Nevada


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