resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Taking Another Step Toward a Secure Future
In 2008, the Council on Chiropractic Guidelines and Practice Parameters (CCGPP) released a literature review on chiropractic care for low back disorders.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
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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