resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
January, 2008, Vol. 08, Issue 01
Recent History of California State Massage Regulation
By Beverly May
In late 1991, the California chapter of American Massage Therapy Association (AMTA-CA) organized the California Coalition on Somatic Practices. This informal group, representing massage and somatic associations, individuals and school owners, developed a 40-page informational packet and survey on questions of professional identity and regulation. In 1995, almost 20,000 surveys were sent throughout the state. At that time, just over a majority of massage therapists supported state regulation. Non-massage somatic practitioners, who are not subject to local vice laws, mostly did not want to be regulated.
Six years later, AMTA-CA surveyed our members specifically regarding massage regulation. All the massage and somatic organizations that might be affected were offered copies of the survey. Only the Association of Bodywork and Massage Professionals (ABMP) did a concurrent survey.
With fairly strong support from our members for a state law to pre-empt local vice regulations, AMTA-CA began to explore feasibility. ABMP, with a large California membership, was told that we would not proceed if they were in opposition, and we encouraged their participation. Our intent was that non-massage, somatic specialties be exempt, as is fairly standard in the newer state licensing laws now in existence.
We began with a fairly broad principle - if there is going to be regulation, one state regulation is preferable to multiple and vastly differing vice ordinances. It has been our experience after at least three decades of working on repeal or reform of local ordinances, that very little progress is possible at that level. Both AMTA-CA and ABMP were in agreement regarding provisions such as full grandfathering and pre-emption of these local ordinances.
Only AMTA-CA committed to hiring a lobbyist. We prepared to introduce a bill in the 2003-2004 legislative session. Although it was extremely optimistic, we expected to mobilize supporters and work with opponents and other stakeholders.
Then, San Diego assemblywoman Christine Kehoe agreed to author the bill. Under the pressure of meeting the bill-filing deadline, communication broke down and caused some initial chaos.
We expected a "spot bill," worded as "an intent to study the need for regulation," allowing us time to work on the actual wording. Instead, the assemblywoman's staff cut and pasted sections from AMTA and ABMP Model State Codes that we had sent, along with sections of bills pending in other states. The result was a bill that no one liked pieced together in order to keep the bill active.
Many states, including California, require submission of a Sunrise survey documenting the need for state regulation. Typically, it's based on potential harm to the public by the unregulated profession. There is little proof that massage practitioners actually do much physical harm.
The Sunrise survey introduced in 2003 took the position that massage is not causing any significant physical injury, but that the public would be better served by state regulation rather than the patchwork of local regulations. We believe the public is harmed emotionally and financially by the current situation - as individuals, as well as in the costs borne by communities in their mostly futile efforts to prevent the use of massage as a front by the sex industry. The costs of state regulation would be borne by the pooled fees of all licensees. The 30,000 or so California massage therapists also are harmed by being subject to varied and expensive local requirements, paying for criminal investigations and permit fees in multiple cities.
At the same time, a committee representing AMTA-CA, ABMP and massage schools formed to discuss revisions to the bill, producing a version that we felt could begin the process of negotiation with other stakeholders including local officials, employers, other schools and other professions.
In November 2003, AMTA-CA agreed to pull the bill from consideration as there was still too much work to do to prepare for upcoming Sunrise hearings. Fast-forward to the 2005-2006 session when finding an author was not easy. Gov. Schwarzenegger had just come to power with plans to do away with over half the boards regulating professions, and a serious budget crisis was taking attention from legislators. Our best option was a promise from then Senator Figueroa, Chair of the Senate Business and Professions Committee (as well as the joint committee, which would hear our Sunrise application) to come up with something if we passed the hearing. Her option was to author a bill with no sponsoring organization, but with AMTA and ABMP both providing the type of support that sponsors generally do. However, rather than a license law, Figueroa insisted on the odd California model of a private agency created by the legislature to issue certifications and regulate certificants - unlike the previous licensing bill, this would be a title act, allowing those not certifying to work under other titles.
With lobbyists for both AMTA-CA and ABMP working together, S.B.421 died in the very final hours of the session due to opposition mostly by the California Chiropractic Association (CCA), and to a lesser degree, the Physical Therapy Association, over scope of practice issues.
During the most recent session, Senator Oropeza authored S.B.731, using the language from S.B.421, with AMTA-CA as the sponsoring organization. ABMP was in support and both groups worked very hard to address the concerns that defeated the prior bill. The CCA formally supported it after the massage associations agreed to remove the definition (scope of practice) of massage. Typically, title acts don't need definitions, unlike practice (license) acts, which regulate both the practice as defined and the titles used. S.B.731 also died in the final hours. Despite having the votes to pass, it got caught up in strange politics which caused numerous bills to be bundled and held back.
For the second year of this session, it looks like we can take a "gutted bill" - one that still is active, and insert our language. We have a powerful author and likely will co-sponsor with ABMP. If all goes well, it would be a bill that has passed the first house and is in the second committee of the second house (where S.B.731 stalled). It will have a new number this next year.
California is a very large and diverse state. With more than 200 schools teaching massage at all levels of training and vastly differing requirements throughout the state, the profession itself has unique regional needs and perspectives. The state is not very supportive of new state regulations. We feel this optional title act is a reasonable solution. Those who prefer to work under their local massage ordinances, or in areas having none, can continue to do so. The bill has tiers of 250 and 500 hours, with the lower tier phasing out after five years. Those certified by the board will be exempt from the need for local massage permits and cities must recognize them in zoning and fees as they do other professions. By doing so, massage therapists in California finally can avoid regulations prepared for vice control.
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