resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
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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