resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
U.S. Olympians Have a DC in Their Corner
It's probably old news to you that doctors of chiropractic play an increasingly prominent role in treating athletes, from youth sports participants to weekend warriors, to elite / professional competitors.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
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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