resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
April, 2014, Vol. 14, Issue 04
Finding a Bridge to Somewhere
By Ralph Stephens, BS, LMT, NCTMB
In this, the third column in what I am calling the Policy Wonk Trilogy, we will look at the best solution on the block to uplift our profession, elevate our educational system and improve the quality of massage delivered to the public.If you have not read the two previous columns, they are in the November 2013 and February 2014 issues of Massage Today. And please note the therapy tip at the end of this column.
It's time to get out the shovels and dig deep enough to find a real solution to the primary problem plaguing the profession of massage therapy. First, high-profile projects like the MTBOK or the ELAP can have no real impact because there is no way to compel implementation of their recommendations. That is probably a good thing considering their recommendations miss the mark. However, if we go down to the foundational structure, it becomes apparent to the careful observer that the real problem is how we regulate our massage schools. Most state departments of education and boards of massage do little to regulate free-standing massage schools and massage programs in other institutions. Some basic forms are filed, maybe a bond posted and that's it. In most jurisdictions, it is just a business tax and permit.
When we started passing licensing laws for massage therapists, there needed to be qualifications to obtain a massage license. Since at that time there was no accreditation agency functioning in our profession, most state licensing laws specified education hours and curriculum, and gave the Massage Board some authority to oversee massage schools. This pattern has continued over the past 15 years. However, almost universally, these boards are understaffed, have little inspection ability and neither board members nor professional staff have the requisite experience with educational administration.
No other profession tries to define and enforce its educational standards through licensing statues and state board rules. Ours does because we did not understand the proper structure of professional regulation as we passed our patchwork of lousy massage regulations, with a few good ones here and there. By contrast, licensure in most professions requires that an applicant has graduated from a school accredited by the accrediting agency that is dedicated to that profession. Done. You won't find specifics on the number of clock hours of classroom training in other profession's licensing laws, or any mention of the required courses in the training curriculum. THAT IS ALL HANDLED AT THE ACCREDITATION LEVEL. The system of state occupational licensing boards was created to regulate practitioners – not educational institutions. This is a fundamental flaw that must be changed. Until it is, this "achilles heel" will maintain the current inconsistencies and inefficiencies of educational regulation and will prevent massage therapy from becoming a true profession.
It is time we change our statues to require institutional or programmatic accreditation for all massage schools from one specialized accrediting agency. It's a simple solution with ample precedent in other professions. However, the path to getting there is complex and fraught with obstacles. First of all, there are seven different agencies recognized by the U.S. Department of Education (DOE) that accredit massage schools and programs. On top of that, only about half of all massage programs are offered in an accredited institution. And only four states that license massage therapy require accreditation of massage schools.
The Commission on Massage Therapy Accreditation (COMTA) is the only one of the seven accrediting agencies that is considered by the DOE to be a specialized accreditor for massage therapy and it is the only one that has developed and implemented competency-based curriculum standards. They're the home team here, but they've been under supported by the major organizations in our field and are struggling to attract and keep enough schools under their wing to remain viable.
We already have the vehicle to bring about the needed improvements in massage education – and DOE has given COMTA the blessing to do so. As the common accrediting agency for all massage institutions, COMTA could implement the teacher education standards developed by the Alliance for Massage Therapy Education. As well, its competency-based curriculum standards would create greater consistency in entry-level training programs; something that the MTBOK and ELAP are incapable of doing on their own.
As the FSMTB develops its Model Practice Act as a guide for state massage regulation, it should specify that an applicant for licensure has graduated from a COMTA-accredited institution. State massage boards do not have the expertise, the staff or the authority to bring about the educational changes we need to deliver competent professional massage to the public. Trying to integrate the findings of the ELAP and MTBOK projects into our laws will be an expensive and time-consuming effort. Even if that were to be accomplished, it would still have little effect as licensing boards cannot effectively enforce standards on massage schools.
Needless to say, this will require a huge paradigm shift, which is seldom easy and often painful. Several obstacles must be worked out and it will take time, maybe a decade. Schools that have institutional accreditation from one of the six general vocational accrediting agencies must have a way to add programmatic accreditation from COMTA in addition to their existing status. These schools cannot and will not leave their existing accrediting agency that provides the gateway for students in all of their various programs to receive Federal Student Aid.
Then there is the issue of the other half of all massage schools that are not currently accredited. Most have stayed away from this process because they do not want the headaches of administering Federal Student Aid – or simply lack the financial resources to be able to meet the DOE's eligibility requirements. For these schools, COMTA must be able to create (again with the DOE's permission), a kind of "lite" accreditation process that is not a gateway to financial aid. For those who may remember, the original acronym for this agency in the early 1990's was COMTAA, which stood for the Commission on Massage Therapy Accreditation and Approval. It's time to bring back an approval-level function to be able to bring all massage educational institutions under one regulatory roof.
I am asking for a lot here, but massage therapy has emerged in a very different way than other regulated professions. While we desperately need to move the oversight of schools to COMTA, we must do it in a way that does not unduly punish schools or cause them to perish. Instead of funding more "Bridges to Nowhere" projects like MTBOK and ELAP, our stakeholders should be funding COMTA and the lobbying necessary to accommodate our profession's transition to a properly regulated entry-level education industry.
Stimulus - Response
While some believe that we "relax" muscles by physical pressure and stretch forces applied by the common massage techniques, there is another possibility. Maybe all we are doing is some form of stimulus response. Are we merely providing a stimulus to the nervous system and that stimulus causes the nervous system to "relax" a muscle and/or vasodilate blood vessels? Do you know how the nervous system "perceives" the touch you apply? Do you know how the stimulus of a particular massage stroke is perceived by the nervous system? If not, you are working blind. Each massage stroke is perceived by the nervous system as a specific stimulus and it elicits a specific response. To get the desired response you better be applying the correct stimulus.
Might it be that we are stimulating mechanoreceptors which elicit a relaxation or inhibition response? Might there a better way to manually elicit an inhibition response than the tried and true method of sustained pressure and deep stripping effleurage causing at least discomfort to the patient and over time injury to most therapist? Stay tuned for the answer. You will be surprised.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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