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The first draft of the ELAP ...
What in the #Hashtag is going on with Facebook?
Facebook has adopted the ‘hashtag’ ...
An Interview with Bill Brown, New Executive Director of AMTA
Bill Brown became the new ...

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ABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Alternative Health News
Study: Acupuncture for Acute Low Back Pain More Effective Than Drugs
New research by Korean doctors of Oriental Medicine suggested that an acupuncture method could reduce acute lower back pain faster and more effectively than conventional drug injections.
The Physiology of Anger
Most of us recognize and have felt anger at some point in our lives. Anger can be seen as a natural response to some kind of pain, whether emotional or physical.
Weaving Eastern & Western Medicine Together: Q&A with Beijing's Dr. Kezhen Zhang
Dr. Kezhen Zhang M.D., is currently the founder and president of Beijing Taijitang Traditional Chinese Medicine Hospital.
Dry Needling is Acupuncture: But What of Education? What of Public Safety?
One of my patients told me recently, that their physical therapist used a "dry needle" and that it wasn't acupuncture. Apparently, physical therapists (PT) are taught to tell their patients that "only acupuncturists practice acupuncture."
The Monkey on Your Back
Many practitioners run their clinic without any extra help—at least initially. I've always been pretty good at multi-tasking. Having nine kids taught me how to wear multiple hats and juggle a lot of responsibilities. Running a clinic is similar.
Pre-Conception Wellness: What Do Your Patients Need to Know?
Deciding to have a baby is one of the most important decisions a woman will ever make. But how many women are really prepared for a healthy pregnancy?
Extraordinary Vessels and Emotional Healing
In addition to the 12 primary Organ-related meridians in the body, there are other energy circulation channels that have been mapped out by Traditional Chinese Medicine. Probably the most significant of these are called the Eight Extraordinary (or Extra) Vessels.
A Solution for the Primary Care Crisis?
A white paper generated by the ACCAHC Primary Care Project and UCLA Center for Health Policy Research Senior Research Scientist, Michael Goldstein, PhD, addresses a clear oversight noted in recent workforce analyses designed to assess the nation's primary care needs.
Beauty is Averageness
After seeing Kim Kardashian's face all over the Internet -and my inbox- following her posting on getting facial acupuncture, I recalled the work of Michael Cunningham who was at the University of Louisville when I was doing my doctoral work.
Keeping Up With Western Medicine Advancements: The Amazing World of Imaging Studies
When patients with neuromuscular problems come to you for treatment there is usually a lot you can do for them to improve their mobility or reduce their pain, whether it is a middle age woman with a frozen shoulder.
Weight Training: Are Cheat Reps Worth It?
While resting between exercises at the gym recently, a young lifter asked me for a spot on a set of barbell bench presses. The bar was loaded with a moderately heavy amount of weight that at first glance appeared to be too heavy for his frame.
10 Life Lessons That Will Change the Way You Practice
"What would you do if you knew you couldn't fail?" I have posed this question for years to groups I've spoken to across the country and around the world.
A Medication Primer for Alternative Health Care Practitioners (Part 2)
Morphine is arguably the greatest drug of all time, at least in the sense that it is so powerful in relieving pain.
Healing the Qi: The Boston Marathon Bombing
On Monday, April 15 2013, locals and visitors from around the globe gathered for the world's largest marathon in the city of Boston. With 23,000 participating in the race and many more on the sidelines, the marathon represents a Boston institution.
Becoming a Concussion Expert in Your Community: What You Need to Know (Part 2)
What makes an individual an expert in concussions? Obtaining education about concussions and treating concussed patients are two factors that lead to expertise.
Chiropractic Care for Veterans: Serving Those Who Served (Pt. 2)
To what extent do you think the role of chiropractors in the VA can serve as a model for greater chiropractic integration elsewhere in the American health care system? That's a very important question.
News in Brief
In Remembrance: A Moment of Silence for Robin McKenzie (1931-2013); DC Re-Elected to Co-Chair AMA Code Review Board; WFC Celebrates 25 Years.
Treating Rib Joints to Protect Thoracic Stability
It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate.

Changing Times
If you visit the website of the JAMA and search on the word chiropractic, more than 200 results appear. If you sort that list chronologically and look at the oldest entry, you will find "Medical News" that includes the following.
Obesity is a Shen Problem
The expressions "obese" and "obesity" are not pejorative terms. They are scientific terms, determined solely by the Body Mass Index scale, which combines a person's height and weight in a mathematical formula. A number of 30 and above denotes "obesity."
Maintaining Professional Boundaries in a Facebook World: Social Media Guidelines for DCs
A few months ago, I received an unexpected message on my Facebook account: "Hi Doc, do you remember me? I'm so happy to find you here on Facebook. It's been years since I have seen you and I'm glad to reconnect with you.
We Get Letters & E-Mail
The "Great Opportunity" for Chiropractic: Expanded Scope of Practice; The SOAP Note: An Effective Tool for Documentation; Treating Patients Goes Beyond Following Established Protocol.
Three Essential Herbal Products For Your First-Aid Kit

There are three Chinese patent medicines that belong in everyone's first aid kit. All three are for topical application, and all three provide extraordinary benefits unavailable from any domestic over-the-counter.


It's About the Word
The new patient was already a fan of chiropractic. "I liked the guy a lot," he said of the previous DC he had consulted. "But he is on the other side of town, and I just can't get there after work. So he sent me to you, since you're his buddy."
Protein and Weight Loss
Recently I was asked by the staff at Dynamic Chiropractic to referee some of their water-cooler discussions regarding nutrition. Topping their list was this one about protein and weight loss: "Why is protein important for weight loss and how much should I eat?"

Lateral Femoral Cutaneous Nerve Entrapments
The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis.

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Massage Today
November, 2012, Vol. 12, Issue 11

The Role of CE for Massage Therapists

By Whitney Lowe, LMT

A couple of states and the Federation of State Massage Therapy Boards (FSMTB) are questioning the need for continuing education (CE) for massage therapists. The repercussions of removing CE will affect the massage therapy profession and ultimately the quality of care for clients in those states who implement the policy. Professionals interested in the advancement of the profession should be paying close attention to this debate.

Unlike other healthcare fields such as physical therapy or occupational therapy, massage therapy is actually two primary "tracks." The first track is geared towards the use of massage as a personal care service, with a focus of general relaxation and wellness enhancement. While massage performed for personal care can enhance health, the focus of this track is not the use of massage as a specific treatment. The second track is the use of massage as a healthcare modality. Massage therapists using massage as a healthcare modality address pain and injury complaints, from the mild to the severe, or other issues of compromised health for an individual.

There currently exist no state licensure credentials that distinguish personal care massage therapists from those using massage as a healthcare modality.

Public safety is the primary issue when evaluating the need for CE. Sometimes the public safety concern is conflated to issues of hygiene or ethics only. However, massage as a pain or injury intervention and treatment modality is anything but benign. When performed inappropriately or for a medical condition where it should not be used, there is clearly the potential for harm to the client. Those working with massage in this capacity must be familiar with the contraindications, assessment and treatment protocols, as well as the cognitive components (anatomy, biomechanics, condition specifics, etc) that function to inform the therapist's work with their clients. In addition to the number of other skills that contribute to quality care such as client relations, care and clinical experience.

massage thearpy Right now, for the massage profession, it is inappropriate to remove provisions for maintaining licensure that require advancing the education and training of therapists beyond the entry level. While CE is genuinely debatable for massage therapists working exclusively within the personal care track, it is not for those applying massage as a treatment modality for specific healthcare needs. Without a method for discriminating between the two tracks, CE requirements need to be maintained for the entire massage profession.

Why CE Must Remain a Requirement

There are many good arguments in favor of continuing education in the massage profession. Below are the primary points that frame the importance of the issue.

First, CE fills in training gaps in basic education. The minimum requirement for licensure in many states is 500 hours of training. Even in a top-notch 500 hour program, this is nowhere near enough time to prepare an individual for the complexities of clinical practice that are required for advanced therapeutic massage treatment. While many schools are increasing their requirements and trying to prepare their students for the higher expectations of today's clients, there is no standardization in curricula to meet this particular goal and no state licensures specifically for this type of work.

Second, CE develops clinical competence. It is through the gradual and continual efforts to develop clinical competence that a massage therapist develops their professional skills to a level sufficient to treat clients with musculoskeletal conditions. The Accreditation Council for Graduate Medical Education (ACGME) has noted that clinical competence is not the achievement of a static set of skills. Rather, competence is something developed over time as an individual continually invests in their own self-improvement. The ACGME has described six core competencies that should be developed by medical professionals, which are a very good model for skills a massage therapist in the healthcare environment should aspire to as well. They include: patient care, medical knowledge, practice-based learning and improvement, professionalism, interpersonal and communication skills and systems-based practice.1

massage therapy Thirdly, CE protects the public. With few exceptions, massage therapists today seek to boost their clientele and practice by taking advantage of the demand for therapeutic massage. If CE is not mandatory, many will not choose any training above and beyond their entry-level training. This is simply not adequate for the many complex clinical decisions faced in addressing compromised health conditions. It is through mandatory CE that massage therapists address their knowledge and skill gap so they can practice in a manner that is competent, effective and safe to the public. Continuing education is the graduate program in the massage therapy field.

Currently, the massage profession by default is set up with a built-in reliance on CE. As the massage profession develops and its healthcare track matures, perhaps it will seek accrediting evaluation criteria that emphasize its role as a therapeutic treatment (similar to the programmatic accrediting criteria for physical therapy and occupational therapy).

With standardized curricula, assessments and accreditation criteria aimed at producing massage therapists equipped for the therapeutic roles they eventually choose, perhaps then we can debate the need for mandatory continuing education. However, note that there is a strong history in every healthcare profession of continuing education requirements in order to maintain the competence level of practitioners.

Resources & Recommended Reading

  1. Heffron MG, Simspon D, Kochar MS. Competency-based physician education, recertification, and licensure. WMJ: Official publication of the State Medical Society of Wisconsin. 2007;106(4):215–8. Available at: www.ncbi.nlm.nih.gov/pubmed/17844712. Accessed September 5, 2012.
  2. Campbell C, Silver I, Sherbino J, Cate OT, Holmboe ES. Competency-based continuing professional development. Medical teacher. 2010;32(8):657–62. Available at: www.ncbi.nlm.nih.gov/pubmed/20662577. Accessed August 27, 2011.
  3. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226–235. Available at: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11779266.
  4. Marinopoulos SS, Dorman T, Ratanawongsa N, et al. Effectiveness of continuing medical education. Evidence report/technology assessment. 2007;(149):1–69. Available at: www.ncbi.nlm.nih.gov/pubmed/17764217. Accessed September 5, 2012.
  5. O'Neil KM, Addrizzo-Harris DJ. Continuing medical education effect on physician knowledge application and psychomotor skills: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest. 2009;135(3 Suppl):37S–41S. Available at: www.ncbi.nlm.nih.gov/pubmed/19265074. Accessed August 3, 2012.
  6. Davis D, O'Brien MA, Freemantle N, et al. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA : the journal of the American Medical Association. 1999;282(9):867–74. Available at: www.ncbi.nlm.nih.gov/pubmed/10478694. Accessed September 5, 2012.
Click here for more information about Whitney Lowe, LMT.

 

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