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Massage Today
October, 2005, Vol. 05, Issue 10

We Get Letters and E-mail

By Editorial Staff

Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be edited for space and clarity, and published in a future issue or online.

Please send all correspondence by e-mail to or regular mail to:

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

"Quality training is imperative, but certifications don't ensure that people are more caring and compassionate"

Dear Editor:

I read with interest "The Medical Massage Issue" of Massage Today. The lead article ["Medical Massage: Facts, Fiction and Frustration] presents a useful overview of the subject and asks many important questions.

I have been giving massage for many years in medical settings, including hospices, hospitals, skilled nursing facilities and homecare. I also train massage therapists in an approach to massage that is safe, effective and appropriate for use with the elderly, the ill and those dealing with chronic and acute medical challenges.

I see the ramifications of the subject as I engage with health professionals and administrators working in medical settings. I see the ramifications as I work with elderly and ill clients in homecare and medical settings. What do massage therapists really need to know to work in a medical setting? Do we need to diagnose people? No. Do we need to fix them? No. Can we offer touch that is helpful, even transformative? Yes. But to do this, requires a different kind of awareness and training than what most of those espousing "medical massage" are offering. It does involve a thorough understanding of anatomy and physiology, but it also involves communication skills and the ability to connect with the wholeness of another human being with genuine respect and compassion.

We can work in our legal scope of practice and be effective, caring practitioners. Quality training is imperative, but certifications don't ensure that people are more caring and compassionate.

Mary Rose
Longmont, Colorado

More Feedback on the "Facts, Fiction and Frustration" of Medical Massage

Dear Editor:

Just a note to tell you the article you wrote in the latest issue of the paper is excellent. I, myself, am finding all this talk a bit confusing - to the point that I even called the New York State Licensing Board to find out what their official stance was.

I learned a lot from your article. It made things a lot clearer. Thank you. Please continue to be an objective voice in this industry; we really need one - especially when the meaning of "which" word, or words, used to describe the treatment becomes such an issue. Again, thanks.

Debra Vida
Schenectady, New York

Shouldn't We Be All We Can Be?

Dear Editor:

I just read Cliff Korn's July editorial ["Using Medical Massage, July 2005:]. I couldn't agree more, or to be more accurate, I could agree more if we added a few other things to the picture. I attended the Swedish Institute back in the early '80s. One-third of our in-school curriculum was devoted to medical massage, and covered pathology and technique. We did our first massages on the public in the clinic as part of our medical massage training, not before. When I attended the Swedish Institute, my fiancé was in chiropractic school. He was very impressed by the curriculum and compared it to a pre-med course. It was rigorous, but it also was rewarding and enlightening. I have used this information extensively during my 21-year practice, and I also teach a continuing education course in pathology for massage therapists at a local community college. Should I be required to take a new course and join an organization to be entitled to file for insurance reimbursement? To say I am a bit put out by the recommendation of David Luther or any organization that comes along hoping to lay claim to this area of practice or that claims to certify people in medical massage after a brief training is putting it mildly.

I agree there is money to be made, and this is a big motive for organizations and so-called certifications. But, I also feel there are some involved in this movement who genuinely are interested in raising the level of massage competency. And on that issue, I wholeheartedly concur, but my question is this: Why do so many schools ignore this area as part of their normal curriculum? Why don't the licensing boards demand this kind of competency from the word "go," instead of relying on people to motivate themselves to receive this training?

When I came to Florida, I taught massage and pathology in one of the massage schools here. That was my awakening to how different the massage training could be from one state to another. At one point, students in a different school protested having to learn pathology since it was not on the licensing exam! I think those protesting students did themselves a big disservice - the same disservice the state and national boards do them by not requiring this education in the first place. Even if someone goes to school intending to give only relaxing massage, they can and will encounter many pathologies and issues they may feel inadequate to address. Even if a person desires only to use their intuition, practice healing touch or any other modality, he/she could, on more than one occasion, find basic school training in medical massage a useful and necessary tool for appropriate treatment or for referring to other health care practitioners.

Shouldn't we be all we can be before we take specialized and divergent paths? The students in my CEU course are grateful to receive this information, no matter what their area of specialized practice. I hope that more people will become actively involved in attempts to raise the standard of education in the massage schools, so all massage therapists can be fully recognized as health professionals without the need for additional training.

Shellie Enteen
Delray Beach, Florida

The current state of the massage profession

Dear Editor:

The ongoing finger pointing, turf wars and vitriolic factionalism are a sad reflection of the current state of the massage profession. Is it that we ourselves cannot see the forest for the trees? Until the time when massage therapy becomes a health sciences degreed profession, through accredited universities (with nationalized standards of curriculum content), the lack of recognition by chiropractors, medical and insurance structure will only continue to exist.

If it were possible to pursue a college degree in massage therapy, no one would have the monopoly on defining what constitutes medical massage. That would be up to the therapist themselves, regarding which areas of specialized study they chose to pursue, and how much of an advanced degree they wished to achieve. Much like the nursing profession, which has a two-year, four-year and advanced degree curriculum.

Instead of cursing the darkness, why not light a candle? Standardized curriculum content through a college course of health sciences is truly the only way for the massage profession to move forward and remain competitive in the world today.

Why are we wasting time arguing with each other when we could be doing so much to move our profession into the next millennium? In Eastern European countries, massage therapy is a five-year course of study, and the therapists who achieve a college diploma in massage therapy are recognized as health sciences professionals. In Canada, massage therapists are required to have completed 3000 hours of curriculum before recognition as an accepted provider through their insurance structure. The sad fact is, that here in the states, there is no ubiquitous standard for course curriculum content for massage therapy. And while there are some states with more stringent standards of curriculum content for massage practitioners, other states are unregulated.

And while there are certainly some massage schools that responsibly teach a comprehensive course of study, many others are basically diploma mills, more concerned with cash than curriculum. And this is also pertinent to continuing education, in such issues as were represented in your recent medical massage issue ("When will we get a clue," "who should use the title medical massage therapist" and "open letter/founder or fraud.")

Clearly it is time to restructure the foundation of massage education, to clarify what we are and what we are not. And in order to be recognized as health sciences professionals, we need to have a college degree in massage therapy. In this way, and only in this way, can our profession move forward, and not only in the halls of higher medicine, but also for the collective integrity of the profession...which in real terms, means being able to successfully bill insurance providers for medically prescribed massage therapy.

Don't bite my finger, look where I'm pointing.

Joe Graday
Las Vegas

Response to the "Interesting" Letter From David Luther

Dear Editor:

I found the recent letter to the massage profession from David Luther about himself and the organizations with which he is associated interesting, to say the least. At the end of the article, he made some comments about me and certain allegations I had made in a previous issue of Massage Today regarding members of the Advisory Board of the Medical Massage National Certification Board (MMNCB). In his letter, he refers to "stacks of e-mails" that refute these allegations. Since that time, I have communicated with Mr. Luther as well as Lori Rolen, the executive director of the MMNCB. I stated that I would be happy to correct any error I had made in these allegations if they were not true. While I have not heard back from the MMNCB, one of the three advisory board members I was referring to did contact me and reported being aware of the listing as an advisory board member. However, requests for additional clarification about the advisory board's responsibilities were unanswered.

Whitney Lowe
Sisters, Oregon

"Can't we just admit there are different levels of skill in this profession?"

Dear Editor:

I have just read David Luther's open letter and the accompanying articles in Massage Today. I have been hearing this grumble grow to a roar, wondering where it was headed and why. I must add my 2 cents worth.

I have been a massage therapist for many years now and have taken many, many workshops, including one from David Luther. Excepting Timothy Agnew, David Luther is the only presenter I have contacted post-workshop who has returned my call or e-mail. David has gotten on the phone with me within 24 hours in two cases in particular when I had problems with insurance claims. He listened, gave me my best options, offered to help in any way possible, and never even suggested he be reimbursed for the time he spent with me. (In both cases I was fully reimbursed, by the way.) David's workshop was one of the least expensive and one of the most helpful for someone trying to work with injured patients and be reimbursed fairly for that work.

If there was a fault with his workshop, it was that every participant in the workshop was very nicely educated on how to be reimbursed from insurance companies. Unfortunately, not all of these therapists were qualified to do injury care. From his article, I understand he is trying to rectify this error by trying to insure that only qualified, educated therapists participate in this goal-oriented injury care system, for the well-being of the patient and the profession itself.

David Luther has found a way to earn decent money doing something he is very adept at teaching. I would hope that everyone who makes great financial gains would give back freely as much as David Luther appears to.

On the subject of "medical" massage therapy and insurance reimbursement, I have personally seen patients who had been seeing another therapist for up to two years for their injury with no end in sight (whiplash) and in another case a patient was sent to me for a work injury after having seen another therapist who never had them get undressed and reported to me never having been palpated into his muscle, only on the surface of his shirt. (Interestingly, when I asked if he had received deep tissue work, he responded in the affirmative!)

Can't we just admit there are different levels of skill in this profession, just as there are in every other profession?

Debra Roof
Bangor, Maine

"Choose your battles wisely"

Dear Editor:

This is in response to David Luther's "open letter." Mr. Luther, sir, you are completely full of yourself. First of all, how dare you condemn professional colleagues for conducting their business in a way that you yourself admitted to doing? Clearly your initial training couldn't have been that extensive if your physical therapist friends had to "dummy down" their information in order for you to understand it. I find it very interesting that 18 years into your career, you were having difficulty holding conversations with other healthcare professionals. I find it even more interesting that between your encounters with those two physical therapists, you didn't seem to find it necessary to crack open a book. Had you done so, you probably wouldn't have had to struggle so much the second time around. Which leads me to my next question: exactly when and where did you receive the additional training that makes you more qualified than others?

Massage therapy schools, and therapists themselves, are not the same across the board. I don't know in which state you were trained, but I do know that in New York state, without classes in orthopedic assessment, pathology, protocols, medical terminology, medical ethics and documentation, there's no way any of us would be able to pass the state boards. So, I'll ask you again, Mr. Luther, where did you receive your additional training?

I agree with you that 100 hours is not all that much and that books and seminars, although useful tools, cannot take the place of hands-on training. But if a therapist is able to gain an understanding of what they're working with through those means, then who's to say they're not qualified? What matters most are the results. If the client is making progress and he or she is satisfied with the work, what difference does it make how many hours of training the massage therapist has had, as long as it's within state guidelines? Everyone has to start somewhere. The first two conditions I worked on as a student were fibromyalgia and pes planus. All the information I had about those two conditions I learned from books and lectures alone. Does that mean I wasn't qualified to treat those conditions? My instructors didn't seem to think so, nor did my respective clients or their doctors.

Now you're going to say your letter was directed to those "who have found a way to make a quick buck." Knowing what you know about insurance companies, how can you possibly make a statement like that? Insurance payoffs are anything but quick. As a matter of fact, I know many massage therapists who have ceased dealing with insurance companies because they were tired of dealing with all the red tape.

I recently graduated from the Swedish Institute College of Health Sciences, where I received 1,226 hours of intensive training. Do I think I could pass your medical massage licensing exam? I'm sure of it. However, after paying $300 for the New York state exam and $200 for the NCETMB, I really don't feel I should have to. My education, my work, speaks for itself.

My advice to you, Mr. Luther: Choose your battles wisely. Personally, my concern over the respectability of our profession lies more with the men and women offering sexual favors to their clients than it does with fledgling massage therapists billing insurance companies. As for massage therapists who perform chair massage "not necessarily [being] qualified" to work on a person who was in a car accident a week ago, need I remind you that in the acute state of injury, the client shouldn't be receiving massage from anyone.

Rachel Schneider Beam
Queens, New York

Divisiveness and Misguided Priorities

Dear Editor:

Sadly, regulation, national certification and defining what constitutes medical massage may well be the three most divisive issues in our profession. This divisiveness does not appear motivated by a desire to increase the availability of affordable massage therapy that can help the general public minimize perceived stress and manage or resolve medically diagnosed pathology.

When our industry leaders decide to truly help the average practitioner earn a reasonable annual income by serving the public (instead of appearing to be lobbying for compulsory financial support of their favored organizations) they will:

  1. Credibly define what massage practitioners do that is complementary to and uniquely different from mainstream medical services provided by orthopedists, physical therapists, occupational therapists and their aides.
  2. Stop lobbying to legally require more than 120-150 hours of massage education for practitioners who wish to provide basic stress management massage to people free of medically diagnosed pathology.
  3. Stop lobbying to legally certify "medical" massage practitioners and prevent insurance payment to other massage practitioners until such time as the massage therapy community and the medical mainstream are equally convinced that specific massage techniques and protocols are generally safe and effective in treating specified pathologies.
  4. Begin routinely pressuring law enforcement officials to act against those who label themselves as massage therapists while advertising what clearly appears to be a sexual service.

Noel Norwick, MBA & Massage Instructor
Santa Monica, California


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