resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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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