resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
November, 2013, Vol. 13, Issue 11
It's Time to Stop Chasing Rainbows
By Ralph Stephens, BS, LMT, NCTMB
Would you rather be told the truth, even if it were unpleasant – or would you prefer to hear a fabricated storyline that sounds great and matches what you wish for? Many of the "stakeholder" organizations in the massage therapy field are betting that you want the second option and are hoping you can't tell the difference between the two.
"Truthiness" may be commonplace on the political landscape, but we're being bamboozled by the leaders of our field who are pushing an overblown agenda for the massage therapy profession. It's a scenario impossible to achieve from our status quo and could actually cause more damage than good.
Instead of addressing the inherent weaknesses in massage therapy education and practice, these organizations are ramping up efforts to move our field into mainstream healthcare. We're getting served up messages that highlight the expanded opportunities, increased earnings and greater professional recognition awaiting rank-and-file therapists when we get to the "promised land" of integration with Big Medicine. To be sure, massage folks are hungry for better pay and more respect, but the powers that control our healthcare delivery system are not interested in letting any other practitioner groups into the game – especially when there are reimbursement dollars on the table.
But wait a minute ... doesn't the Affordable Care Act have language that mandates coverage for licensed practitioners of complementary and alternative therapists? Yes, but Section 2706 is on the chopping block, as the medical, hospital and insurance lobbies are gearing up to get this provision removed as Obamacare goes into effect. Even if that part of the law stands and is implemented, massage therapists would be at the lowest level of the totem pole. National certification for our field is meaningless and irrelevant here.
We'd be in a system in which reimbursements for massage services would be low, wages paid to massage therapists in medical facilities would also be low (probably not much more than what techs are paid to clean bedpans) and we would lose the most important thing we have today: autonomy.
Being able to treat who we want, using the techniques we choose, with the opportunity to address the whole person (and not just a symptomatic complaint) is a major part of what has made massage therapy successful in the marketplace. Let's not kill the goose that laid the golden egg. Consumers are looking for alternatives to the rushed, impersonal and reductionistic care that is the norm in our medical mainstream. Sacrificing our freedom as practitioners for an empty promise of a brighter future would be a tremendous loss. It's time for our massage organizations to stop chasing rainbows, get honest with themselves and their constituents, and work on solving the real problems limiting our progress as a profession.
Massage therapy is not ready for prime time because we still lack: 1) a consistent scope of practice; 2) consistent standards in massage education; and 3) requirements for teacher training. Until we handle this (which will take at least a decade), the quality of services delivered to consumers on a daily basis will remain random and often ineffective. The growing body of research on the therapeutic effects of massage is a good thing, but it is merely theoretical. By itself, research will not advance the profession; the entire corps of 300,000 massage and bodywork therapists must be able to provide quality treatment on a regular basis.
Research data comes from specific aspects of massage performed under controlled conditions. Because of the serious training and skill deficits that exist, many therapists are unable to provide competent massage that meets the expressed needs of the client. Our massage organizations should fund a research study on the hallmarks of effective treatment and investigate the percentage of therapists who are actually able to deliver a treatment to these standards. And contrary to the "public safety" mantra hammered into our heads as the reason we have subjected ourselves to state massage regulation, there is little actual harm done in the practice of massage therapy. We do not have a safety problem – the crisis is with our deliverables.
In the August 2012 edition of this column, I wrote about the "Seven Deadly Sins of Massage Education." I'm sorry to say these sins are being repeated daily by a sizeable number of our schools and no organization or state agency is holding them accountable. The Alliance for Massage Therapy Education recently completed the first phase of its National Teacher Education Standards Project, which was to define the Core Competencies for Massage Therapy Teachers. We now have the model for teacher development, but the "Big Three" organizations in the massage field – ABMP, AMTA and FSMTB – have refused to contribute a dime to the Alliance to move this project forward. It's shameful.
Instead, these same organizations have spearheaded and funded two major initiatives that have taken huge chunks of time, money and expertise, and have failed to produce results that are actually usable to improve the quality of massage education and practice. I'm referring here to the Massage Therapy Body of Knowledge (MTBOK) and the still-in-process Entry Level Analysis Project (ELAP). In both cases, the organizations came together under a feel-good banner of cooperation, but dropped the ball when it came time to supervise these efforts to ensure they remained on track.
The MTBOK was supposed to produce the definitive set of knowledge, skills and abilities an entry-level massage therapist needs to practice safely and effectively. The eight-member task force that did the actual work overshot that mark by a country mile. And despite a prodigious follow-on effort by AFMTE to remap the competencies and make them relevant to entry-level massage education, the final product has been put on a back shelf for a five-year period by these organizational "stewards."
If one useless project wasn't bad enough, we now have the same organizations forcing the ELAP upon us. This time, the entire project was conceived in secret and there was no opportunity for therapists and educators to put their names in the hat to be considered for the hand-picked work group. In addition, the public comment opportunity that was provided by the sponsoring organizations was so long and hard to navigate that it's likely only a handful of people outside of the work group itself have been able to grasp the recommended curriculum map as a whole. Since it's impossible to give an educated opinion on individual standards or competencies without seeing how they relate to the entire document, the feedback from the field cannot be considered valid.
Many of the standards contained in the draft version of the ELAP are significantly beyond or outside of what is generally considered entry-level education in our field. It appears the sponsoring organizations are using the ELAP (as they did with the MTBOK) to push massage therapy into a framework whereby it can be accepted by the medical mainstream, rather than identify and set standards based on what actually exists today. This is not a virtual-reality game, my colleagues ... this is our lives, our careers, our profession – and the 5,000-year-old lineage of a healing art. Would you give up all this for a feeling of greater self-esteem?
We can raise the number of entry-level education hours to another arbitrary number, but will that increase the earning potential of new massage school graduates? I doubt it, but it will most certainly increase their student-loan debt. (I will expand on this in my next column.) Will more hours, poorly taught, result in the delivery a better or safer massage to the public? Highly unlikely. Membership organizations like ABMP and AMTA are in the business of attracting and retaining members. Therefore, they benefit from serving up fantasy pictures of the profession to encourage people to join and renew. Who wants to hear that most massage therapists have short career spans and don’t earn much money? That’s a guaranteed buzz-kill!
For their parts, FSMTB and NCBTMB are in the testing business, even though they cloak their endeavors in the garb of public protection. Their revenue is dependent on how many people take their exams and the money bags have shifted in the past four years away from NCB to FSMTB. For every six new therapists who enter the field, five leave. That revolving-door scenario means a constant supply of new test-takers. Do the math.
And what about dear, lonely COMTA? One of the hallmarks of a fully-fledged profession is having a specialized accrediting agency for that field that is recognized by the U.S. Department of Education. COMTA is just that, but it's lost in a sea of six other agencies that accredit massage schools and programs. In most fields, there is just one such agency and all schools are required to be accredited by it. That's how consistent standards are held and enforced.
COMTA is essential to the development of a bona fide massage therapy profession, but it, too, has gotten the orphan treatment from the Big Three. In the past, AMTA pledged to provide financial support to COMTA "in perpetuity." That sounds like forever to me, but the AMTA Board of Directors yanked its commitment in 2008. Since then, COMTA has struggled to grow its market share of massage schools in the shadow of much larger and better-funded accreditors.
COMTA has one of the best templates for entry-level education: its Competency-Based Curriculum Standards. All COMTA schools are required to uphold these standards and they would provide a solid basis for all massage programs. We did not need the MTBOK and ELAP to reinvent the wheel when we already had a proven model to guide and improve massage education.
The Massage Therapy Foundation is AMTA's latest darling, to the tune of about $500,000 year in financial support. AMTA has pledged to support the Foundation "in perpetuity," which sounds really good until you remember how it treated COMTA. Who doesn't love research? It's beneficial, as I indicated above, but it can also be an elegant distraction that shifts our attention away from the unpleasant realities of the massage therapy field as it exists today.
As long as these organizations continue acting in their self-interests, putting forth puffery projects that boost their image and refusing to focus on solutions to the real problems, the status quo will persist. I'm reminded of the final courtroom scene from the 1992 movie "A Few Good Men," when the Navy JAG officer played by Tom Cruise is cross-examining the hardened Marine colonel played by Jack Nicholson. With his back pinned to the proverbial wall, the colonel shouts at the young attorney, "You want the truth? ... You can't handle the truth!" When it comes to the future of massage therapy, we want the truth and we can handle it. Stakeholder leaders, be advised.
WOW – This is my 80th column. Thank you all for your support, feedback and comments. The Holidaze are upon us. Try to remember these holidays are about more than shopping.
May we be reading this column in Massage Today again this time next year, healthier, happier, more prosperous and in a more peaceful world. And to all, a good night!
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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