Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
Is Primary Spine Care the Answer for Chiropractic?
Recently, we sat down with Mark Studin, DC, FASBE(C), DAAPM, DAAMLP, to discuss the state of chiropractic and why primary spine care may hold the key to chiropractic's future. Read what he had to share in this exclusive interview.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
February, 2015, Vol. 15, Issue 02
Mismatched Solutions to Our Most Pressing Problems
By Ralph Stephens, BS, LMT, NCBTMB
In the quest to make massage therapy into a profession, our stakeholder organizations have been engaged in various large-scale projects over the past five years to put some cornerstones into place.These are the kinds of efforts that were done long ago in other full-fledged health care professions, and that have been lacking in our field. It's no secret that massage therapy lacks consistent education, regulations and standards of practice, so the drive to create more consistency seems like it should be a good thing.
That would be the case if the solutions were properly configured to solve the problems and were achievable in the context of the field, as it currently exists. However, each one of these projects has missed the mark in different ways.
The Massage Therapy Body of Knowledge (MTBOK) featured a convoluted scope of practice definition and included a number of competencies that were above or outside of entry-level skills and knowledge, as most massage schools have been teaching their students. The Alliance for Massage Therapy Education (AFMTE) came in behind the MTBOK Task Force to recalibrate the competencies to a level that schools could be reasonably expected to produce. AFMTE also added a bridge between the competencies and curriculum delivery to aid schools in the implementation of the standards. Unfortunately, due to bruised egos, all of this work has been generally ignored by the massage field and is sitting on the proverbial shelf gathering dust.
This was followed closely by the Entry Level Analysis Project (ELAP), which was designed to establish what a foundational massage therapy curriculum should include. This effort, spearheaded by ABMP and AMTA, was conducted in secret by a handpicked group of experts that was selected by the heads of these two organizations. This was another well-intended effort that overshot the mark. Collectively, the 527-page Entry Level Massage Education Blueprint and the 266-page ELAP Core Report are beyond the grasp of most educators and practitioners in our field. As a result, these documents have joined the MTBOK on the back shelf.
While these projects have been taking place, the Federation of State Massage Therapy Boards (FSMTB) has been developing a Model Practice Act (MPA). This cornerstone piece is supposed to guide massage therapy regulation at the state level, by providing a template for both new massage laws and the revision of existing statutes in states already under regulation. Again, this sounds like a great thing, but the final version of the MPA, released in October 2014, contains numerous technical errors, as well as more dangerous provisions that have the potential to limit the scope of practice for massage therapists Hey, that's you and me!
The work of the MPA Task Force is a classic example of Death By Committee. FSMTB's group of state board reps took 42 months to come up with this all-important document. It would have been far more effective to hand this job to a few administrative law experts who could have delivered a superior product in just a few weeks. Too many cooks spoiled this broth and the result will be toxic for our field if the recipe is actually used at the state level. From my perspective, this is one project that should stay on the shelf, unless it is taken back for significant revision. Here are some of the most serious problems I see in the MPA (section numbers are as listed in the document).
The Scope of Practice definition in Section 104 is too limiting and non-specific. The practice of massage therapy is more multi-faceted than what is presented. If adopted by states, this definition is likely to shrink what massage therapists' are legally permitted to do. Florida would lose ultra-sound; Iowa would lose the ability to treat; no one would have the ability to assess. It is a scope perfect for non-specific, relaxation only massage. It could possibly make clinical, problem-solving massage beyond our scope. I don't think this is by accident or oversight. I will explain that more in my next column.
We have a once-in-a-generation opportunity to go beyond the kind of scope definitions found in current state massage statutes, to establish a new and more expansive model that more accurately reflects the full range and potential of what massage therapists may do in their practices. The FSMTB has blown this opportunity with their MPA and, if adopted, will deny the public access to the full potential of soft tissue therapy in the name of protecting them.
Those outside our field may try to keep massage therapy in a small box, but it is up to us to claim our turf. Remember that the scope definitions in our state massage statutes were developed as massage therapy advocates were trying to get initial licensure laws enacted. Inept compromises were made in many circumstances just to get a bill passed. We must look beyond those existing definitions to envision a truly representative scope for massage therapy. My colleague, Rick Rosen, presented a next-gen scope definition to FSMTB that would have accomplished this, but it and the feedback from many others unfortunately was ignored.
Section 106 of the MPA deals with Title Protection and it strays into muddy waters. The MPA has done nothing to solve the existing conundrum of which modalities should be covered by regulation and which should be exempt. In a few states (like Florida), there are no exemptions and all hands-on practitioners must have a massage license from the state board, as it should be. In states with more recently enacted laws, there is an inconsistent pattern of exemptions where certain modalities are included in one state, but excluded right across the state line. That doesn't make a bit of sense and it both impedes portability and limits our progress toward status as a unified profession. Another opportunity missed by the FSMTB's MPA.
Speaking of portability, Section 302 places undue limitations on Licensure by Endorsement, (Portability), as the MPA requires a massage therapist to hold a license in a state and be in active practice for two of the past three years to apply for licensure in another state. A person would also be required to pass the state's required massage licensing exam, even if a long-time massage therapist came into licensure in that state during grandfathering when no exam was required. Both these provisions are excessive and unnecessary. As long as a therapist has a valid license in one state and a clean record, they should be able to obtain license in any other state without jumping through more hoops. The MPA does nothing to further that. It also requires a temporary license for disaster relief workers (MERT Teams) and for continuing education providers. Again, this stifles the public access to massage in the name of protecting them. It will place a huge burden and expense on traveling instructors and will probably reduce the number of courses available to us. Thanks a lot.
Finally, the Legislative Declaration in Section 102 of the MPA labels massage therapy as a "healthcare profession," which is part true and part wishful thinking (in lieu of all the shortcomings and inconsistencies of our field). The key element that's missing here is any reference to massage therapy as a healing art, which is reflective of its long lineage and its true nature. Not to mention it's the language required in Iowa that provides massage with exemption from sales tax. This is a great error that must be corrected.
Judging from the lack of chatter about the Model Practice Act on social media, it appears that few people have paid attention to this project. While the MTBOK and the ELAP may not come knocking on your door anytime soon to take away aspects of your professional practice, you need to recognize that FSMTB and their misguided efforts on the MPA can and will do that very thing. Read the MPA, see for yourself and take action. Contact your State Board and strongly urge them to ignore and avoid the MPA for the sake of the massage consuming public and your ability to practice.
Click here for more information about Ralph Stephens, BS, LMT, NCBTMB.
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