resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
In a previous column, I discussed the history and definition of evidence-based practice (EBP), and expressed concerns with how the concept has been narrowly construed by some academics and payers.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
Medical Payola (Part 2)
Not only has Medtronic made billions selling expensive screws and hardware for highly controversial spine fusions, but a Senate investigation also found Medtronic felt compelled to write and edit medical journal articles attributed to outside physicians that downplayed the risks of the company's best-selling bone graft, Infuse.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Spinal-Cord Injuries: Saying No to Steroids
With steroids, epidural and otherwise, in the news lately for their overuse when treating back pain (and their danger when tainted by fungal meningitis), it was high time for a policy change, and we've got one, from the Congress of Neurological Surgeons and the American Association of Neurological Surgeons.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Calcium Supplements and Mortality
When the National Institutes of Health's AARP Diet and Health Study reported that men who took calcium supplements had a higher risk of dying from cardiovascular disease compared those who didn't, it was the third large cohort in six months with alarming findings regarding calcium supplements.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Wisconsin Exam in the Spotlight
You've passed your national boards with flying colors, including Part IV, the practical examination, at a combined cost of more than $3,000.
Exercises for Back Pain: Low-Compression Training Program
This program is intended for two groups of people: 1) those who want to engage in resistance exercises for the major regions of their body without developing back pain in the process; and 2) those who already have back pain and want to do resistance exercises, but consistently re-irritate their back when trying to do so.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
History Repeating Itself in Wisconsin?
Thirteen years ago, the Wisconsin Chiropractic Association (WCA) "agreed to settle Federal Trade Commission allegations that [the association] orchestrated a conspiracy among WCA members to increase prices for chiropractic services and to boycott third-party payers to obtain higher reimbursement rates."
Let's face it – patient evaluation takes time. Unless you are really into the diagnostic evaluation game, you probably have found the formal exam protocol tedious if not downright annoying.
Chiropractic Research: A Moral Issue
This year I've had the opportunity to go to three great chiropractic research conferences; the ACC-RAC, the Fédération Internationale de Chiropratique du Sport (FICS) Congress and the World Federation of Chiropractic Congress.
Business Building: What's Your Strategy?
I know some in our profession love to debate about whether or not spinal curvatures change as a result of our chiropractic adjustment, but I have a question that hits a little more close to the belt than that: Are chiropractors capable of change?
News in Brief
Cancer Treatment Centers of America Continues Support of Chiropractic; ACBOH Announces 2013 Practical, Written Exam Dates; PCORI Approves Funding for Research on Spinal Stenosis; Macquarie University to Cease Offering Chiropractic Program.
Repeating Bone-Density Tests
The U.S. Preventive Services Task Force recommends that women older than age 65 undergo bone-density testing. However, organizations in general have not stated when repeat bone-density testing should be done.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
Covering Chiropractic as a Profession, Not a Single Service
Recently Dynamic Chiropractic published a front-page article about various state essential health benefits and referred to Oregon and four other states not currently providing chiropractic as a covered benefit.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Telecommuting and Technology: Ergonomic and Worker's Comp Considerations
As our world becomes more and more reliant on technology, equipment becomes more dependable and we become increasingly more comfortable with e-mail, the fax machine, the Internet and the smartphone, it is becoming easier and easier to work away from the office.
The Pallof Press for Core Stability Evaluation
Many people become injured because of instability, weakness and poor neural-sequencing patterns in the core. Lack of bracing and support from the inner core cylinder during coronal and transverse movements makes the body vulnerable to compensation injuries.
July, 2012, Vol. 12, Issue 07
Moving Massage Therapy Toward a Brighter Future
By Ralph Stephens, BS, LMT, NCTMB
Exciting things are happening in our profession of massage. I am more positive about the profession's future than I have been in many years. We are being included in the development of the new Integrative Healthcare Paradigm largely through the work of the Academic Consortium for Complementary and Alternative Healthcare (ACCAHC – "The Consortium").The Massage Therapy Foundation is representing massage at international research conferences and promoting massage research. Both of these organizations deserve our support. Many of our stakeholder organizations are stepping up and moving us toward being accepted as a real profession. I want to share more of the good things that are happening with you and point out some problems that will hold us back from reaching our potential, while making some constructive suggestions. In the spirit of full disclosure, while I am on the Board of Directors of the Alliance for Massage Therapy Education, I am not speaking for the Board. All opinions in this column are my own.
So, let's start about a year ago when the youngest stakeholder organization in our profession, the Alliance for Massage Therapy Education (Alliance) published a position paper recommending a change in focus for the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The paper proposed that NCBTMB let go of its entry-level certification and testing program and replace it with a voluntary post-graduate certification credential that would follow mandatory state licensure. This new and upgraded program was suggested as an alternative to the so-called "advanced" certification program that NCBTMB was promoting. For its part, the Alliance took a lot of heat for having the audacity to "tell other organizations what to do."
Then, in mid-March, NCBTMB took us all by surprise by announcing that lo and behold, it will sunset the National Certification program in 2013, and replace it with a new post-graduate credential called Board Certification (with specialty certifications to follow). Kudos to NCB's leadership for finally being able to break out of an operating model that was heading off the cliff, but also kudos to the Alliance for planting the seeds and advocating a bold position for the future welfare of the whole profession.
Time for Teacher Standards
Separate from all of that, the Alliance has proposed the single most important step needed in the advancement of our profession – the development of standards for massage teachers. The National Teacher Education Standards Project (TESP) is a five-phase plan that will establish core competencies for massage therapy teachers, along with model teacher-training curricula, training resources and ultimately, certification programs. Phase one of the TESP, The Core Competencies for Massage Therapy Teachers, has just been released for public comment and input.
Once again, the Alliance is ahead of the curve in putting forth a project of this nature. It is an ambitious, long-term effort, estimated to take five to ten years. The goal of this effort is to create a culture of teaching excellence in our field with the downstream result of therapists being able to deliver a better massage to the public.
The nursing profession went through a similar process many years ago and there are additional excellent model(s) to draw from. The massage profession must begin the training of our teacher corps, turning them into true educators, rather than simply therapists with a textbook publisher's lesson plan in hand. Just because a therapist can give a good massage does not mean they have the knowledge, skills and attitudes (KSA's) to effectively teach beginning massage therapists. It will take time, but it will be worth it. If you are a massage educator and want to be on the cutting edge of massage education, check out the Alliance website www.afmte.org to become involved in this process. In a national survey conducted by the Alliance, 80.4% of respondents agreed that competency-based teacher training standards are needed in the massage profession. Only 6.8% disagreed. The time has come.
Massage students are only as good as the quality of instruction they receive. Better instructors make better therapists. The only way to elevate our profession to the status it deserves, and that most of you desire it to have, is to improve the knowledge and skill level of our teachers. If you are a massage instructor, view this as an opportunity to improve your teaching skills. We can all get even better than we are now – right? The standards will be phased in over time in a supportive way. Our entire industry needs to support this endeavor, as nothing else can do more to get the public higher quality massage than developing and implementing a teacher standards program. Just as we are what we eat, a profession is what its practitioners have been taught.
The Storm Clouds
However, the two largest stakeholders – our major membership organizations – have set out on a wayward mission to standardize the hours required for licensure and to come up with a learning objectives map for entry-level massage programs, the "ELAP." PLEASE – don't just do something!
The number of hours required for licensure are currently completely meaningless quantities. They are dartboard numbers that have been picked out of convenience to school operators or for accessing Federal Student Aid. Standardizing the country on an arbitrary number of clock hours will not magically improve competency or portability. There is simply no data that shows the public is getting a safer massage from graduates of a 1000-hour program as opposed to a 500-hour program. One thousand poorly taught hours will not produce a better therapist than 500 poorly taught hours. In fact, it may produce a worse therapist with more substandard habits and lack of awareness, burned out and broke. The number of clock hours that will eventually be nailed to the wall by the ELAP, if it is allowed to proceed, as the "evidence-based" standard will be completely meaningless if we cannot assure that at least 90% of entry-level program graduates can give a massage of satisfactory scope and quality. What we need are curricula with academic integrity, not just some arbitrary number of hours and a few learning objectives.
Further, clock hours are an unsound way to specify an educational program. We need to move to an academic credit-hour system, like every other healthcare profession. We must move to an educational system based on competencies, which includes assessment of student performance at each level of their training. COMTA has had a competency-based curriculum standard for more than a decade, yet our major stakeholders are off to re-invent the wheel. Why not use COMTA's existing program, updated with the MTBOK, now with its re-mapped KSAs? (More brilliant work done by the Alliance.)
Besides, job task analyses (JTA's) (the ELAP is to be based on a new JTA being done for the MBLEx), while psychometrically valid and legally defensible, measure what people who are not necessarily successful and who do not know what they do not know, think others should know to be successful. They primarily serve to dumb a profession down, especially as its level of competency decreases. New JTA's only lower the floor. It is time our profession comes up to a competency standard developed by successful experts, not down to a price or worse, to a continually lower common denominator.
The "license portability" promised by this ELAP project will likely not happen, as there are many other factors besides hours in laws and rules that affect portability. Supporting model legislation by the Federation of State Massage Therapy Boards (FSMTB) is the best way to achieve portability. Besides, portability is not the burning issue nor essential for the development and improvement of a profession.
A "Kneaded" Idea
Come-on stakeholder leaders, don't waste our dues dollars on another ivory tower task force whose report will be thrown on the pile with all the others. It is time to support:
If you really want to do something constructive, help us dramatically modify or put the ineffective modular program format out to pasture for good. And for extra credit, how about developing and implementing reasonable admissions standards instituted in every school that offers a massage program? We should not be throwing our doors open to the academically inept, and/or ethically challenged (like felons) guaranteeing failures, loan defaults, and future ethics complaints.
This approach is the most efficient way for massage therapy to achieve its potential with both the public and the arising integrative medicine-healthcare community – both of whom are waiting for us to elevate ourselves to a true alternative healthcare profession. Will we step-up and meet their expectations? More importantly, will we decide to live up to the potential our profession has to offer the public?
Think about it. If you care, get involved.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
comments powered by Disqus