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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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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?
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
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.
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.
December, 2013, Vol. 13, Issue 12
Tremors in the Massage Industry
By Pete Whitridge
Change, challenges and consolidation have created recent tremors in the industry and I have been asked to comment on some current trends in massage education. I will address school sustainability, massage training and accreditation issues here. I will address other school and education issues in future articles.
Over the last 25 years, the number of massage schools has grown to approximately 1,600 schools. The 2008 market collapse and resulting recession have had a dramatic affect on all massage school programs. Whether sole proprietor, career training institute or corporate-owned school, enrollments have dropped significantly.
In summary, we have 300 fewer schools in the massage universe since 2009. Student enrollments are down 18.8% since 2011, and down 50% since 2005. We have 50% more schools then we had in 1998, yet we are educating a similar number of students. More schools and fewer students make for a highly competitive and fractured market.
administrators and teachers, I have identified a few factors that contribute to school closures: State school licensure requirements, Federal Department of Education "gainful employment" and "placement" requirements, lack of quality lead generation, competition with larger massage programs with better financial resources, staff and infrastructure. Practically all corporate, university and career training institutions are accredited. This fact allows these schools to out compete small, owner-operated schools by offering grants and loans.
We have more than 1,300 massage schools in this country. 52% of schools are proprietary, yet only 20% of proprietary schools are accredited. This means proprietary schools have yet to embrace accreditation as a means to stabilize their programs by accessing Title IV funding. It might be time to reassess this situation.
Does being accredited make a difference? The ABMP biennial school enrollment census suggests accreditation does make a difference. When proprietary schools are compared based on accreditation status, accredited schools enroll close to 50% more students than non-accredited proprietary schools. The differences in enrollment between accredited and non-accredited schools could be a market driver in the future.
Additionally, Career Training Institutes enroll more than two times more then proprietary schools according to the census. All CTI's are accredited and have the infrastructure to recruit students for a variety of programs. Maybe it is time to review your long-term sustainability by exploring the value of obtaining accreditation. Maybe its time to explore synergistic trainings that help establish your school as an education hub. Whether esthetics, personal training, or yoga therapy, attracting health-oriented leads may help enrollment at your school.
Is accreditation the answer for small schools? The report shows approximately 60% of massage programs hold some form of accreditation. These programs offer student loans and grants and are able to demonstrate financial stability. Accredited schools report yearly to their commissioners and renew on a five-year cycle. While many of these accredited schools are able "to withstand the bumps of competition and a sluggish U.S. economy," these schools still face limited income potential if they only enroll an average of 20 to 35 students per year!
The ABMP enrollment census outlines the average number of students enrolled per year for each category of school: CTI, college/university, corporate-owned, public and proprietary. Four of the five categories of school enroll 35 or fewer students per year, with CTI's enrolling an average of 85 students per year. Yet, the CTI's have closed programs at a larger rate as compared to proprietary schools. This means CTI's are not as profitable as they need to be and are closed. The CTI's will move on to something more profitable. I speculate that many low enrollment CTI' and corporate schools will move on to offer and focus on more lucrative programs such as respiratory therapy, fitness training or nursing education. Federal placement and gainful employment rules will also force training centers to enroll students for programs that actually provide jobs and career longevity. Education is a business and when the numbers don't warrant having a program, programs will be shuttered. Be ready to absorb market share when a program is closed in your area. CTI's can add and subtract programs based on enrollment and profitability.
Floods of Change
What about the small schools? It's clear there are hundreds of small programs in our field. Can these low enrollment programs last? Is it profitable for a program to have one to five instructors, maintain enrollments and management to compete with larger education corporations, community colleges and the newest players on the scene, the osteopathic and chiropractic colleges such as Bastyr, University of Western States and the University of Bridgeport?
The answer for some small schools owners is decidedly, "No." For example, the Core Institute in Tallahassee, Fla., has shuttered its entry-level program. They are now focusing only on continuing education and specialty certifications. The Atlanta School of Healing Arts (ASHA) was shuttered because the Federal Department of Education demanded a large bond from the school to remain Title IV eligible. The school was not able to meet this requirement and the DOE revoked eligibility. Finally, the loss of a massage school to flooding. Did this owner have reserves to survive until the location can be rebuilt? Will this school be able to re-open, enroll students and survive another day?
I encourage all small school owners to work together to support high standards of entry-level education, qualified teachers in these programs and financial responsibility so that the school has reserves to cushion a blow to enrollment. Institutional accreditation may solve some of these issues by providing guidance, support and peer review. Eligibility for Title IV funds is also an important consideration when applying for accreditation.
Will accreditation help my school? Isn't it expensive? How much paperwork is required? The Commission on Massage Therapy Accreditation (COMTA) is working to help schools wishing to obtain accredited status by formulating a pre-accredited status where a school would work toward full accreditation over a two year period by applying with COMTA, demonstrating activity in alignment with a Self Study Report and reporting back to the commission yearly. The COMTA commissioners met on October 23, 2013, and I understand the group is very interested in supporting schools in this area.
I encourage all school owners, administrators, CE providers and LMTs to volunteer as peer reviewers with COMTA to experience the process of traveling for a site visit and evaluating fellow school programs. Peer review volunteer opportunities are available throughout the year. You can apply as a volunteer whether you are an educator, LMT or compliance wonk like me. COMTA also has three commissioner positions open for election this year. They are recruiting commissioners in the areas of esthetics practitioner, an employer position and a public member. If interest, visit www.comta.org/about-comta/commissioners-elections-appointments/.
Want more students? Need to compete with within your market? Accreditation could make the difference. Evaluate your school curriculum and administration compared to the COMTA standards. Using these standards will help you as you plan for future sustainability. Even if you just volunteer as a peer reviewer, you will have a better understanding of the process and can evaluate the pros and cons for your school.
A historic school closes and sends shock waves across the education community. The Boulder College of Massage Therapy announced in June 2013, that they would be closing their doors. Many educators and therapists shuddered deeply. Even after an angel investor helped temporarily reopen the school, BCMT permanently shuttered its doors on September 26, 2013. For more information, visit http://bcmt.org/.
This is a big issue in our field. The reasons stated on the BCMT site are chilling and unfortunately, familiar.
"...This is the second closure of BCMT in the last six months. The first closure was the result of multiple factors related to the financial health of the school over the past several years. However, in the last 18 months, BCMT had increased enrollment, revamped its curriculum, raised job placement rates and improved its financial solvency. Despite these efforts, the school was unable to overcome a constellation of issues related to the previous years of financial losses and the decrease in value of the real estate asset, the BCMT campus. Multiple attempts to reach an agreement with the real estate bondholder, as well as multiple attempts to be acquired by larger educational entities, were unsuccessful."
We would be wise to reflect further on what forces brought such a fine program to close. "As a founder of the International School of Bodywork (IPSB), I find BCMT's recent closure especially troubling. My school was born of a similar ilk of human potential and spiritual seekers. Both schools have attracted individuals wanting a top-notch vocational education balanced by artistic and humanistic values. Both schools have similar approvals, institutional objectives, established and award-winning faculty," said Carol Osborne.
Carole also outlined more issues all massage schools face:
Despite these challenges, many schools have adapted and enhanced their programs to meet the needs of the 21st century student and the current marketplace. Yet, many graduates still struggle to establish an economically viable practice in these weak financial times. Interestingly, we also hear from many spa and massage franchise owners that there are not enough quality massage therapists. The somewhat contradictory nature of these developments can be bewildering and they merit some meaningful discussions between schools, educators and employers.
How can we have so many schools, yet so few "quality" therapists? Looking over the data from the 2013 survey, four of the five categories of schools have less the 25 students per year and even the career schools average only 85 graduates per year. I speculate that these smaller programs have only one or two teachers in the classroom and the teachers may not have extensive teacher training but are rather content experts; a successful therapist in town.
This scenario has played out many times over the past decade as massage schools expanded into Corporate/CC/University settings. These schools tend to hire content experts with some experience in the field and then recruit from alumni when seeking replacement teachers or teaching assistants. Teacher pay is not known to be more than $25/hour at most colleges and universities. Teachers in these small career training or community colleges are operating without much peer support and tend to have a high turnover rate.
Growth within the massage education industry has ended. Will your school thrive, survive or close? Could acceptance of voluntary accreditation and the imposition of strict standards for licensure, training and enforcement create more consolidation, weed out weak schools and force the remaining schools to step up their game? Massage as a "growth" center peaked back in 2010, and has been on a downward trend ever since.
In future articles, we'll look at entry-level education, an ongoing issue for the last few years. I will offer a report on the ELAP project, the recommended standards and their ramifications for massage schools, teachers and administrators.
Pete Whitridge currently is the President of the Alliance for Massage Therapy Education (AFMTE). He is a faculty member and former Director of Education for the Florida School of Massage in Gainesville, Fla., and past chairman of the Florida Board of Massage Therapy, and past legislative chair for the Florida State Massage Therapy Association.
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