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Massage Today
September, 2005, Vol. 05, Issue 09

Bad Dog and Good Dog Let Out

By Ralph Stephens, BS, LMT, NCBTMB

I have championed the term "medical massage" for several years. I think it's the best term to separate specific, therapeutic, outcome-based massage from relaxation massage (and certainly from adult entertainment).

Medical massage clearly is neither relaxation nor entertainment. This easily is understood by the public and the medical profession. Unlike some, I don't think medical massage must be done in allopathic-controlled situations. I don't think it should require a diagnosis by a physician, and it doesn't need to be done under the supervision of one. Of course, it could be done in that setting, and it's fine if it is, but it should not have to be. We are first-door providers. Medical massage doesn't have to be paid for by an insurance company, but it could be. What makes a massage medical is not who pays for it or who authorizes it, but that the therapist, using advanced massage skills and techniques, is attempting to reduce the musculoskeletal complaint(s) of the patient.

Bad Dog

The popularity of the term medical massage has grown very rapidly and it's only to be expected that over-eager people will try to gain control of it. Sadly, the first attempt has been made. David Luther and his association, the United States Medical Massage Association (USMMA), have sued State Farm Insurance. I have no problem with suing insurance companies, and his main goal - to prevent downcoding of claims submitted by massage therapists - is an honorable one. However, in the process, he has tried to get a judge to define, "Who is a medical massage therapist?" He told the judge it would be a member of his organization. Now granted, our profession does have trouble defining itself, but the last thing we need is to have some politically appointed lawyer/judge defining us based on an entrepreneur's bottom line. The USMMA doesn't have enough members to fill the demand Luther is trying to capture and control. His actions will more likely deny care to those who need it, instead of providing it. This is heavy karma to take on, in my opinion. Would you want to have to join some association just to be able to call the work you do "medical massage," or to be able to bill for it under that term, or under the codes for manual therapy and massage therapy?

I suspect the USMMA will face a huge backlash, not a huge surge in membership because of this action. I use history as my basis for that statement. How much good did it do the AMTA to write itself into laws, effectively giving it monopolies in some cities or states? It brought about lawsuits, bad public relations and resentment. The gain was short lived; the loss ongoing. Fortunately, the AMTA has learned this lesson the hard way and dropped the strategy. The USMMA will have to learn it, too. Associations are like governments - they both must be watched constantly. Their very nature is to acquire power and control by stealing it from the individual.

My biggest concern is that this will create a huge backlash against the term "medical massage" and we will lose the best term we have to reach both the public and our allopathic colleagues. I hope we don't let the action of an individual, an association or a judge cause us to throw the baby out with the bathwater. This event reminds me of an old fable about a beggar finding a magic lamp and letting the genie out. The genie granted one wish and the beggar wished for all the money in the world. He got it, only to find that the rest of the world, now absent money, had developed new exchange systems for value. All of the beggar's newfound money was worthless. Trying to gain a monopoly on medical massage will result in the same effect. A new term will be coined and the profession will move on. I only hope this can be resolved without losing the term, or the potential it provides our profession to help humanity.

Good Dog

I always believe in giving credit where credit is due. ABMP has stepped up to the plate to significantly fund and support the formation of a federation of state regulatory boards for massage therapy. This is huge and ABMP deserves respect, admiration and kudos for this visionary project.

Professional regulation is done at the state level, which is good. However, this requires that each state have its own law and its own board. There are no formal channels for these boards to communicate with each other. Due to the lack of leadership and consistency from the association that has passed the hodge-podge of laws for massage therapy we now have, it's becoming more and more difficult for a therapist to move from one state to another or for continuing education providers to present nationally. There is no mechanism in place to work on reciprocity, a uniform code of ethics, disciplinary procedures, education standards and a host of other issues. On two previous occasions, the formation of such an organization has been attempted. However, it was an effort by volunteers, most of whom were already overcommitted, and there was no funding or administrative support available; thus, both attempts failed. Since then, more states have become regulated, with laws written by well-meaning people who have little, if any, regulatory expertise and little guidance. So, the situation has become even worse.

Almost every other regulated profession has a federation of regulatory boards working on issues of mutual concern. Nurses, chiropractors, social workers, etc., all have organizations that provide interstate communication for their boards. I know how necessary it is that our profession develop such an organization, as I was on the Iowa Board of Massage Therapy Examiners for eight years. It's in the best interest of the profession and the public that this federation, or whatever it comes to be called, be established - and that it be successful.

A very competent group of people are working on this project and they deserve to be supported and encouraged. Thanks ABMP, and all the volunteers participating in this landmark effort. May your efforts be rewarded with acceptance and success. Lead on!

Summertime done come and gone; my, oh my. Hope yours was a good one. See you this fall!

Click here for more information about Ralph Stephens, BS, LMT, NCBTMB.


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