Challenging Sacred Cows, Round Two

By Ralph Stephens , BS, LMT, NCBTMB

Challenging Sacred Cows, Round Two

By Ralph Stephens , BS, LMT, NCBTMB

Part I of this column in November 2011, rang a bell with many of you, mostly positive. I sincerely appreciate all the responses. I hope even more of you sent your input to the governing bodies of our profession. They need to hear the roar of the crowd in their boardrooms.

I want to clear up something before I go forward. First, an esteemed colleague and visionary of our profession wrote to me asking if I did not believe in science because of my comment, "While I am not a fan of evidence-based medicine..." Of course I believe in science. In fact, I believe Science is Golden. However, I am a seeker of truth and, quite often, science has become the seeker of political expediency. There is too much pseudo-science going on out there that's being accepted as truth. I am a huge fan of research and science. However, I do not see that evidence-based medicine and the resulting standards of care protocols have improved the health of the public. I do not believe that if we go to evidence-based massage protocols (for this you shall do that), we will serve the individual client better. It is an allopathic paradigm, based on obsolete Newtonian physics, desperately trying to protect allopath's Central Dogma. If we are going to base massage on research, it should be quantum physics-based, a new paradigm that treats the individual holistically. Sometimes I am probably too idealistic.

We have this deep longing to validate our profession through research. Yet, our profession is based on totally arbitrary standards, established out of expediency or consensus with no evidence or research to support them what so ever. Still, we defend them as if they had validity. Where did the 500-hour entry level standard come from? It was chosen in about 1985, primarily for the economic benefit of schools and to create more massage therapists faster. It was a down to a price instead of an up to a standard decision.

The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) institutionalized the 500-hour standard with its job task analysis. This was a classic case of "research" stacked to produce a desired outcome. The resulting certification exam degenerated into an entry-level licensing exam because that was where the money was. Yes, it was partly because it was the only "legally defensible exam" available and making it a licensing exam (forcing people to take it) generated the money to launch the organization successfully. However, it was a bastardization of the original vision, which was to elevate the profession with a meaningful certification. Instead, it set the lowest common denominator and institutionalized it.

There has been no scientific competency research to justify any of our various entry-level hour standards, 500, 650, 750, 1000 or whatever. Before we set any more standards based on arbitrary numbers of hours, we need competency-based criteria as to what is a required skill-set to provide excellent massage to the public. Work soon to be published by the Alliance for Massage Therapy Education (AFMTE) will clarify the MTBOK and map its knowledge, skills and attitudes into specific learning objectives. It is time we stopped picking our standards because some number looks or feels good. It is even more important that we stop picking hour numbers because that is how many it takes to get student aid, or maximize school efficiency or other greedy financial reasons. It is time we put the good of the massage consuming public first and focus all our efforts on serving them the best we can, with the highest quality and competency reasonably possible at entry level.

Where did 12 hours of mandated continuing education a year come from? It, too, is a dartboard number with no basis in reality. Is a day and a half a year really going to elevate anyone's skills? Is an unsafe therapist going to be made safe by 12 hours a year of forced attendance at some course or by purchasing a home-study program?

Since we so lust for research to validate what we do, how about validating our own standards with some? What proves that three hours of ethics every four years has any effect on the ethical behavior of our profession? Prove 12 hours (or however many hours) a year of mandated continuing education protects the public or brings about professional development. If you can't prove it, drop the mandate. What proves a provider approval process improves the quality of continuing education? All provider approval does is create cash flow for organizations and state regulatory boards. It does nothing to insure quality. It is another lowest common denominator process because if it is not, lawyers will tear it down. That is the society we live in. (Other times I am a realist.)

I am a continuing education provider. It is in my best economic interest to work for standards that force more people to take more continuing education. However, money is not my motivator. Providing the public with the best possible massage is. I do not think people forced to take continuing education necessarily learn a thing, practice safer, or utilize what they might learn. People should take continuing education because they want to better serve their clients, to become more successful, to grow and lots of other positive reasons.

As our various organizations attempt to improve our status by raising arbitrary standards, the new students, practitioners and providers are being "taxed" to death. As I look over the landscape of our profession, the most glaring inadequacy I see is the lack of standards and qualifications for massage instructors. While I am not a fan of following the allopathic model, in this case, I think it is time we follow the lead of nurses (and primary/secondary schools) in establishing qualification for massage educators. We need more quality in education, not necessarily more quantity. The time has come for this stage of advancement in the massage profession.

A new organization has been created and is working toward this and other improvements in massage education. It is the Alliance for Massage Therapy Education. You need to support this group immediately and help bring about this important plank in the professional development of our profession – the establishment of standards and training programs for massage therapy instructors at all levels.

We need to demand our standards for educational hours and continuing education hours be based on quality, scientific, non-politically or economically influenced research instead of "dart board numbers." If we can't prove it, why do it? Here is a great job for The Massage Therapy Foundation and a good reason to support and donate to them, too.

Membership organizations should be encouraged to contribute and support these efforts, but have little or nothing to say in the process. Their primary interest is more members, which is the main reason we have the mess of regulatory incongruences and arbitrary standards we have today.

As The World Turns

Meanwhile, the FDA is posed to take away food supplements. If you value your access to supplements, check out my previous article at We are in the economic and political mess we are in because of the Ruling Class in Washington, DC. They write the laws, not Wall Street. As we enter this election year, remember it is all the fault of incumbents. Vote against every incumbent, of either party, every election. It is our only hope of breaking the Ruling Class and restoring freedom, which brings prosperity.