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Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
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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