resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
August, 2012, Vol. 12, Issue 08
The ELAP Project vs. The Seven Deadly Sins of Massage Education
By Ralph Stephens, BS, LMT, NCTMB
Author's Note: Ralph R. Stephens is a Director of the Alliance For Massage Therapy Education. This article represents his own, personal opinions and not those of the AFMTE.
One of the penalties of not participating in politics is that you will be governed by your inferiors." Plato
Part of political participation is being informed, and if you care at all about the future of our profession, I urge you to read the five page Entry Level Analysis Project (ELAP) description document at: www.abmp.com/downloads/ELAP_2012.pdf. The ELAP stated goal is to standardize educational hours, educational outcomes and improve "portability" – the ability to take licensure credentials from one state to another. All wonderful sounding things; who could be against them? I am not against any of them in principle, however I am extremely concerned about how they might be accomplished.
When you read the document, notice that the project's goal is to determine the minimum educational objectives and Knowledge, Skills and Attitudes (KSA's) needed for an entry-level therapist to pass a licensing exam (MBLEx) and give a "safe, competent" massage. Originally, it was just a safe massage. Competent was begrudgingly added due to the outcry of some concerned stakeholders. Never in the document will you find the term "Massage Therapy" or any other reference to being able to deliver therapeutic or clinical aspects of massage.
A new Job Task Analysis survey (JTA) is being conducted by the Federation of State Massage Therapy Boards (FSMTB) and it contains an add-on section to gather data for the ELAP. The analysis of this data will give more credence to therapists who have been in practice from one to four years and have performed at least 500 hours of massage. (Three years is where the high drop out rate begins.) Doing the math, this is one massage a day for two years or two massages a day for one year. This is what our associations feel is a "functional practice." (From the ELAP Description: "As shown by their persistence for this time, this group has demonstrated perseverance and the skills to develop a functional practice or work productively as an employee.") At two years out, would you define one to two massages a day as a functional practice?
Safety is not a significant problem in massage therapy. The incident rate of actual physical injury caused by massage therapists is miniscule. So, the standards determined necessary to prepare entry level therapists to pass the MBLEx, and give a safe massage, competently are going to be a very lowest common denominator. How is this going to elevate or improve our profession?
It appears the ELAP is a project designed to set another minimal entry-level standard. Why do it again? The data for entry-level KSA's is already on the table and just needs to be recognized and utilized. The danger here is, if this level of training, as defined in the project document, becomes our "standard," the potential exists to reduce/limit our scope of practice. This was tried already by the MTBOK project's scope definition, which fortunately has been mostly ignored. Particularly in states like Florida with a good scope of practice definition in their law, there is a lot to lose. What you might ask? Most likely, the casualty would be the ability to serve the public with the full potential of massage therapy. It could also lead to restrictions in our liability insurance coverage for "therapy," possibly requiring advanced certifications and additional insurance fees and riders to cover therapists doing therapeutic work. As you read the ELAP document, think about this, seriously.
Sadly, the need for the ELAP is based upon a fallacy. Then to begin to argue its minutia becomes an exercise in re-arranging the deck chairs on an adrift ocean liner. We do not need another blue–ribbon panel to set another standard or definition that ignores or papers over the fundamental problems of our profession.
The Real Problem
We have a real problem with substandard, inconsistent entry-level education causing poor quality massage to be delivered to the public. The problem with this low-quality massage training and its resulting low quality of massage practice is the unintended consequence of AMTA's policy of working to get 50 state licensure — no matter what the laws look like, with no attention paid to maintaining, much less expanding, our scope of practice or the regulation of entry-level training programs.
Over the past 15 years, the number of institutions offering entry-level massage training programs has expanded in recently licensed states. Most of these new programs were not traditional start-ups by long-time massage therapists who embodied the lineage of the field. For the first time, we saw the unfettered entry of for-profit career colleges and taxpayer-funded community colleges into our sector. It's simply supply and demand. The passage of new massage laws created new demand for the training required for licensure. These entities were in place with both classrooms and the Federal Student Aid eligibility to quickly add programs. The fact that there was not a population of trained massage therapy educators to teach these programs was not an issue, because the regulations for massage schools and instructors were lax or non-existent.
These institutions are opportunistic: they observe what's happening in the workplace and create or remove training programs according to what's hot and what's not. They have no long-term investment in the profession of massage therapy, as it's just another program to provide revenue. It's solely about the money and not about the lineage of massage therapy or who is being put out onto the street to practice it.
These developments have changed the landscape in ways we could not have imagined. In the rush to "elevate" massage to the status of a profession, AMTA (lately working with ABMP) has actually created a serious decline in the quality of massage services provided to the public (the unintended consequence). This problem is hard to get recognized, because most massage consumers don't know what a decent-quality massage treatment is like.
ABMP's latest massage consumer survey showed that 93% of massage clients were satisfied or very satisfied with the quality of massage they received. Does that mean massage therapists are doing a great job? No, it means most people have never experienced a good massage. To use a fast food analogy: a burger made from greasy, undercooked horsemeat is better than starvation, which is why a billion-dollar-a-year empire was able to be built on low-grade massage. Americans are so touch-starved that they will keep coming back for substandard massage, because it's better than not being touched at all.
How do we get the big players to own up to the respective roles they play in this situation? Neither ABMP nor AMTA have been willing to look at this. Not surprising, since students and graduatess from this sector have ballooned their membership rosters. They're both serving up "happy meals," and taking us on important-sounding trips to exotic lands named MTBOK, MOCC and now ELAP, all of which are distractions from the core problems. Despite their ongoing PR messages, these major organizations are interested fundamentally in their own well-being, and not the profession, much less the public. Actions speak louder than words.
At the very heart of the deterioration of massage quality delivered to the public is the lack of a trained teacher corps to staff all massage schools. To its credit, ABMP has created some basic teacher training seminars. However, they have also rejected as unnecessary and excessive the proposals for teacher education standards that have been developed by professional massage educators in a peer review process, which are based on teacher education standards recognized and used by a variety of other professions. Teaching theory and methodology is the issue here, not just knowledge of the subject(s) being taught.
The Seven Deadly Sins
Colleagues, here comes the real truth of the situation that no one has had the courage to put on the table until now. Standardizing the number of hours or the curriculum content (ELAP) will not improve educational outcomes as long as our massage educational institutions are allowed to:
The (ELAP) is a further diversion from the long and challenging work that will be needed to address these "sins." Two things are needed to "heal" the problem, money and moral conviction. ABMP, AMTA and FSMTB must be persuaded to give substantial and ongoing financial support to COMTA and AFMTE to assist them with their respective missions. COMTA because we need a strong accrediting agency dedicated to the field of massage therapy. That is the natural place for educational standards to live. AFMTE because their Teacher Education Standards Project (TESP) is the trail that the entire education sector must follow if we are to truly "elevate" the profession from the sad state in which it currently exists.
These organizations also need to take a public stand - an unequivocal position - that the operational practices listed in the "Seven Deadly Sins" are no longer acceptable in the massage therapy field; that we expect better from our schools and programs. They may not have the force of law, but such moral courage on the part of community leaders, consistently stated, can and will instigate a change in institutional behavior.
We must take up these challenges for the sake of the massage seeking public and for the lineage of our profession. Want to be part of the solution? Get involved. Thank you for your caring for our profession.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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