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Massage Today
April, 2010, Vol. 10, Issue 04 >> Philosophy

Do the Planes Land?

By Keith Eric Grant, PhD, NCTMB

In the South Seas, there is a cargo cult of people. During the war, they saw airplanes with lots of good material and they want the same thing to happen now. So they've arranged to make things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head to headphones and bars of bamboo sticking out like antennas - he's the controller - and they wait for the airplanes to land.

They're doing everything right. The form is perfect. It looks exactly the way it looked before. But it doesn't work. No airplanes land. So I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but they're missing something essential, because the planes don't land. - Richard P. Feynman1

These are interesting times to watch separate threads of technological, political and multidisciplinary professional maturation converge and, at times, conflict. They are, in part, also interesting times for me personally to observe because I've long had involvement in different "camps."

One of the threads has been moved toward evidence-based medicine (EBM). A tutorial produced jointly by Duke University and the University of Northern Carolina-Chapel Hill sets out a definition: "EBM is the integration of clinical expertise, patient values and the best evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology."4

In EBM, we have the combination of patient/client-centered treatment with evaluation of evidence on effective treatment for specific conditions. The application of the concept was well discussed in a New York Times article by David Leonhardt.2 I do want to stress that being evidence-based does not remove the need or effectiveness of good client communication and rapport, nor contradict the observation that such rapport is, in and of itself, healing.3

Another response of health care to technology has been the emergence of standards for managing competency. These include maintaining learning modules, identifying learning gaps relative to job descriptions, and maintaining competency profiles for individual practitioners. While there are more general initiatives, much of the work in the health care realm seems to be centered with the MedBiquitous Consortium. These efforts will enable the management of job-oriented learning in health care to be more task-connected than has previously been possible.

On the political level, with the great majority of states regulating massage, a consortium of agencies with such regulatory responsibility becomes possible. This possibility was realized in 2005, with the creation of the Federation of State Massage Therapy Boards (FSMTB). It places the discussion and assessment of entry-level requirements where, under the U.S. system of laws, the legal right and responsibility of regulatory rests with the individual states. Within such discussions, however, are considerations of the essential body of knowledge that defines massage therapy as a profession and the definition of massage therapy as a health care profession. These, in turn, raise questions and conflicts.

One conflict comes in the definition of massage therapy as a well-defined health care participant, versus the much broader definitions that were used to move a panoply of practices out from under local government regulation. A second conflict is the definition of knowledge; whether what is claimed to be knowledge is specific enough to be verifiable, has a sound evidence base for effectiveness, and is consistent with known laws of physics. My opening quote is drawn from such considerations of science versus pseudoscience; in short, "do the planes land?"

Finally, technology has quickened the base and the inclusiveness of discussion. Particularly in recent months, forums under the Ning groupware platform have become a place for discussion, often with some fire and heat. Here, specifically, I'm thinking of the Massage Professionals site and the Science-Based Massage Therapy site.

Ultimately, these discussions will involve comparisons between organizations, countries, viewpoints, academic and organizational activities, and massage therapy with evolution of health care in general. The discussions are likely to be heated at times, but rarely dull. It can be an exciting and painful process to watch a profession evolve and mature.


  1. Feynman RP. Cargo Cult Science. Commencement address given at California Institute of Technology.
  2. Leonhardt D. Making Health Care Better. New York Times, 3 Nov, 2009.
  3. Lown B. The Lost Art of Healing. New York: Ballantine Books, 1999.
  4. Schardt C, Mayer J. Introduction to Evidence-Based Medicine. Duke University Medical Center Library and Health Sciences Library, 2004.

Click here for previous articles by Keith Eric Grant, PhD, NCTMB.


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