Stop the Insanity!

Replies to This Discussion

Permalink Reply by Ravensara Travillian on February 22, 2011 at 4:18pm

You raise an important point. A lot of us don't want confrontation, and we want to behave in a live-and-let-live way. And it's important to know our own limits and boundaries. And I think your description of a bunch of pissed-off energy workers doing wildcat body work is a very plausible description of what could happen, especially if this issue is badly handled.

 

Yet as Vlad points out, being or becoming a profession is not just a question of raising educational hours. One ethical principle of professionalism is that if you know another member of the profession is committing a wrongful act, you have a positive duty (meaning you must act) to prevent harm. So if someone is making claims that are spurious by professional standards, you are required to do something about it. And that runs directly against what we were just talking about, about how we want to live and get along in the world with others.

 

So what do we do? Give up on becoming a profession, because we consider that the price is too high? Become a profession and accept the consequences, come what may? Adopt a tiered model, so that a professional hospital-based MT does not have any ethical obligation to confront dubious claims made by someone who does not want to work in a medical context? Something else entirely?

 

I honestly don't know, but I think it's essential that we have the discussion. These issues are too big and too important for us to ignore.

Ezekiel OBrien said:

I am generally too busy with my own practice to be concerned about my colleagues credentials or methods. In my own practice I limit my claims to "Massage might do your body good." Hell that might even squeeze by an FDA sniff test. I have found it most useful to rely on client testimonials over wild eyed health claims made by me. I honor the efforts of the certification and standards crowd. In fact, I think of them every time I mail a check to the ABMP or CAMTC. Your efforts do bear fruit. However, I do not believe it is my place to disinfranchise energy workers who make alleged spurious claims. In fact, if this is accomplished I think what you will end up with is a bunch of pised of?f energy workers with "bad" energy doing wildcat bodywork. I am not sure how that helps anyone in our vocation.

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Permalink Reply by Stephen Jeffrey on February 23, 2011 at 4:55am

Ravensara said

Yet as Vlad points out, being or becoming a profession is not just a question of raising educational hours. One ethical principle of professionalism is that if you know another member of the profession is committing a wrongful act, you have a positive duty (meaning you must act) to prevent harm. So if someone is making claims that are spurious by professional standards, you are required to do something about it. And that runs directly against what we were just talking about, about how we want to live and get along in the world with others.

 

Can you give examples of how you personaly delt with the person/persons concerned in this situation?

 

 

 

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Permalink Reply by Ravensara Travillian on February 23, 2011 at 5:13am

Other than educating my students how to think critically, how to evaluate claims, and how to be kind to other people's moral distress while not compromising on the principle of first responsibility to the client, no, I can't really say I have a lot of personal experience doing this.

 

There are many more people on this board who have much more experience at dealing with professional disciplinary matters than I have.

 

But it will become a much more acute question for me if we do commit to becoming a profession. If we are an industry, the standards are one thing; if we are professionals, the duties are higher. I am an advocate for becoming a profession; at the same time, I recognize that the path I am advocating will come at terrific cost (money and time, yes, but that's not all I am talking about by far), and I am not happy at that prospect.

 

I think that if we do decide to become professionals, we have to deal with the fact that through no fault of their own, people have been taught to make dubious claims. Changing from what you have been taught by trusted teachers (who themselves were taught by teachers they trusted, and so on back for generations) will cause a great deal of moral distress and backlash. It will not be an easy path.

 

Or we could stay in the current state, with all of its dissatisfactions, and watch people vote with their feet and dialogue deteriorate like the previous discussion did.

 

Or we could try a tiered model, so that we're not considered the same profession, and therefore we don't have to fight with each other over these things.

 

Or maybe there's another way. I don't know. But I think whatever we do (or let history do to us), growth is going to be hard and painful, as Daniel pointed out. 

Stephen Jeffrey said:

Ravensara said

Yet as Vlad points out, being or becoming a profession is not just a question of raising educational hours. One ethical principle of professionalism is that if you know another member of the profession is committing a wrongful act, you have a positive duty (meaning you must act) to prevent harm. So if someone is making claims that are spurious by professional standards, you are required to do something about it. And that runs directly against what we were just talking about, about how we want to live and get along in the world with others.

 

Can you give examples of how you personaly delt with the person/persons concerned in this situation?

 

 

 

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Permalink Reply by Laura Allen on February 23, 2011 at 6:17am

I personally like the concept of tiered licensing--in theory. I haven't had any personal experience with it, and I'm not sure exactly how it works and how it's policed, so perhaps some of the people in places where it exists could enlighten me. IF, for example, someone is on the bottom tier, are they only qualified to do "relaxation massage?" How does that work? Are they allowed to be in business for themselves, or must they be employed in a salon or spa? My thought is that if they're allowed to be self-employed and open a business, what's to prevent them from doing anything they want to? Are they going to be disciplined for doing a medical massage? I really don't have a clear picture in my mind of the differentiation.

 

I was practicing Healing Touch for five years before I attended massage school, and I went to a very woo-woo school. I don't recall ever having any pyramids under the table, but I'm sure I've done things in the past that were at least that woo-woo. One thing I have never done, however, is to use ANYTHING concerning energy work on people who don't want it. I have never taken up one minute of a massage anyone paid for with doing energy work on them, chanting, ringing bells, or anything else remotely considered energy work--unless that's what the client was seeking. In spite of all the woo-woo at the school, we were in fact taught not to ever impose it on people who don't believe in it or want it.

 

Having been on a state board for the past five years, and been privy to many disciplinary hearings, I can say that we have never yet had anyone accused of "spurious claims." What we have had is MTs accused of committing sexual assaults on clients, MTs failing to follow draping requirements, MTs who told people that they had to have a breast massage and then proceeded to do it even though they had no training in it nor was it indicated; MTs breaking confidentiality, MTs who physically hurt someone--a couple of months ago it was a client who was bruised so badly she looked like she had been the victim of a beating, and we've also had people who were burned with hot stones. We've also had MTs doing massage while under the influence of alcohol, MTs who "counseled" people when they had no training to do so, MTs who didn't actually perform a sexual assault but who made inappropriate comments or did inappropriate things during the massage, MTs who extorted money from clients, and of course MTs who were practicing without a license.

 

The public probably doesn't realize that they could even complain to a board about a therapist making spurious claims.

 

As for other massage therapists being the one to report someone, I have in fact been amazed during my time on the board at how many of our cases have been one therapist accusing another, but there's another side to that, too. In a big city, one therapist will be much quicker to report another. In a small town or rural area, they won't do it as quickly because they don't want repercussions from locals...they are afraid it will cost them business for speaking out. I have had a lot of calls over the years from therapists in that position. And several times I have thought the accused therapist was not guilty, but that it was a case of professional jealousy and one therapist just trying to ruin another. I haven't ever seen one therapist accuse another (not officially at our board, anyway) of making spurious claims. I think for the most part they have a "live and let live" attitude and they're not going to report someone for having a pyramid under the table or doing energy work on unsuspecting clients who didn't ask for it.

 

As it is, it sometimes takes our board 3-6 months, and sometimes longer, to get disciplinary hearings scheduled from the time a person files the complaint. We have stayed in board meetings until after 8 pm deciding these things. People are entitled to a speedy resolution. If everyone who makes spurious claims and throws woo-woo in on a massage was reported to the board, I can only imagine what kind of bottleneck nightmare that would create for a state board.

 

And of course, you can always talk to the person and ask them to stop doing whatever objectionable act it is they're doing, but most of the time, I'd have to quote Dr. Phil and say "how's that working for you?" It's a catch-22. There's no one answer to any of these difficulties.

 

Ravensara Travillian said:

Other than educating my students how to think critically, how to evaluate claims, and how to be kind to other people's moral distress while not compromising on the principle of first responsibility to the client, no, I can't really say I have a lot of personal experience doing this.

 

There are many more people on this board who have much more experience at dealing with professional disciplinary matters than I have.

 

But it will become a much more acute question for me if we do commit to becoming a profession. If we are an industry, the standards are one thing; if we are professionals, the duties are higher. I am an advocate for becoming a profession; at the same time, I recognize that the path I am advocating will come at terrific cost (money and time, yes, but that's not all I am talking about by far), and I am not happy at that prospect.

 

I think that if we do decide to become professionals, we have to deal with the fact that through no fault of their own, people have been taught to make dubious claims. Changing from what you have been taught by trusted teachers (who themselves were taught by teachers they trusted, and so on back for generations) will cause a great deal of moral distress and backlash. It will not be an easy path.

 

Or we could stay in the current state, with all of its dissatisfactions, and watch people vote with their feet and dialogue deteriorate like the previous discussion did.

 

Or we could try a tiered model, so that we're not considered the same profession, and therefore we don't have to fight with each other over these things.

 

Or maybe there's another way. I don't know. But I think whatever we do (or let history do to us), growth is going to be hard and painful, as Daniel pointed out. 

Stephen Jeffrey said:

Ravensara said

Yet as Vlad points out, being or becoming a profession is not just a question of raising educational hours. One ethical principle of professionalism is that if you know another member of the profession is committing a wrongful act, you have a positive duty (meaning you must act) to prevent harm. So if someone is making claims that are spurious by professional standards, you are required to do something about it. And that runs directly against what we were just talking about, about how we want to live and get along in the world with others.

 

Can you give examples of how you personaly delt with the person/persons concerned in this situation?

 

 

 

• ▶ Reply

Permalink Reply by Kim Galliher on February 23, 2011 at 7:08am

Dr. Oz uses reiki for his patients (that are willing to accept it) before surgery, in the operating room and in recovery.  He is a top cardiac surgeon.  Does his openess to energy work and alternative healing methods make him a better doctor or a quack?  Does his use of energy work somehow discredit other surgeons?

 

There has been research done on various alternative healing methods-including prayer-that show positive results but there are still plenty of people that feel there needs to be more research or simply refuse to accept the research results-and that is their prerogative.  I think what is important to remember is that it takes all kinds.  What works for one person may not work for someone else. 

 

We may not be able to see energy work in action (which means we really cannot prove it exists without a doubt) but that doesn't mean we will not be able to prove it someday.  I think that was the point of calling out the times in history where science was "wrong".  Everyday we grow and learn and new things are discovered.  Whose to say that 25 years from now there won't be some sort of electronic device that can pick up on the nuances of energy and provides us with proof positive of its existence?

 

If you are someone who does not believe in energy work or alternative healing modalties it is your choice to not practice it. In our school we weren't really taught these different practices just introduced to them so that you know they are out there and you can look into them further IF you want to.

 

That being said I personally would not go to a massage therapist who told me some pyramid was going to heal me of my ailments, but that is a personal choice.

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Permalink Reply by Alexei Levine on February 23, 2011 at 8:15am

Great post Laura.  It got me thinking about how a tiered approach could be implemented.  One way to differentiate a higher level of certification and licensure would be to tie it to insurance reimbursement.  The state could define a scope of practice for these "medical massage therapists" which would be similar to how PT's are differentiated from PTA's and MT's.

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Permalink Reply by Daniel Cohen on February 23, 2011 at 8:36am

Alexei, I love this idea!  This would create a requirement that insurance accept "qualified" MTs. A clear road into insurance paid massage.

Alexei Levine said:

Great post Laura.  It got me thinking about how a tiered approach could be implemented.  One way to differentiate a higher level of certification and licensure would be to tie it to insurance reimbursement.  The state could define a scope of practice for these "medical massage therapists" which would be similar to how PT's are differentiated from PTA's and MT's.

• ▶ Reply

Permalink Reply by Christopher A. Moyer on February 23, 2011 at 9:03am

Dr. Oz uses reiki for his patients (that are willing to accept it) before surgery, in the operating room and in recovery.  He is a top cardiac surgeon.  Does his openess to energy work and alternative healing methods make him a better doctor or a quack? 

 

He does it himself, prescribes it, or endorses it?  If so, that is clear quackery. 

 

Does his use of energy work somehow discredit other surgeons?

 

I would say yes.

 

There has been research done on various alternative healing methods-including prayer-that show positive results but there are still plenty of people that feel there needs to be more research or simply refuse to accept the research results-and that is their prerogative. 

 

Actually, this isn't true.  In a class I am teaching right now my students have had the opportunity to examine the research on intercessory prayer.  The large scale studies with good methodology are clear in their results - it doesn't work.  The results of the Benson STEP study actually suggest that if a patient knows they are being prayed for, it may be bad for them, perhaps because they take less good care of themselves, or the medical staff does, or they experience pressure to recover faster that actually impedes their progress.  Don't take my word on it, though - the Benson study, which is not overly technical and quite readable for a scientific study, is available here.

 

We may not be able to see energy work in action (which means we really cannot prove it exists without a doubt)

 

On many occasions on this board I have pointed out that verifying the claims of energy work requires nothing special. Running such an experiment would be easy.  All one has to do is control for all possible confounds, and then see if interrater reliability can still be achieved.

 

but that doesn't mean we will not be able to prove it someday. 

 

That's true, but then we can say this about any possible natural phenomenon.  It's possible there is a tiny teapot orbiting the sun.

 

I think that was the point of calling out the times in history where science was "wrong".  Everyday we grow and learn and new things are discovered.  Whose to say that 25 years from now there won't be some sort of electronic device that can pick up on the nuances of energy and provides us with proof positive of its existence?

 

Yes, it is possible that a technological advance will give us new insight into the energy systems of the body.  But, as I noted above, we can easily test the claims of so-called energy therapies right now.  And folks have done it previously, too, and the results of well-designed studies are quite clear.  The fact is, proponents of these practices pay no attention.

 

If you are someone who does not believe in energy work or alternative healing modalties it is your choice to not practice it. 

 

Absolutely true.

 

In our school we weren't really taught these different practices just introduced to them so that you know they are out there and you can look into them further IF you want to.

 

But here is where problems arise, especially if massage therapy wants to be seen as a profession.  Professions, as Raven is pointing out, have responsibilities that go beyond delivering whatever some element of the market requests.  Therapeutic professions have a duty to provide therapies that have some validity.

 

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Permalink Reply by Ravensara Travillian on February 23, 2011 at 9:19am

The results of the Benson STEP study actually suggest that if a patient knows they are being prayed for, it may be bad for them, perhaps because they take less good care of themselves, or the medical staff does, or they experience pressure to recover faster that actually impedes their progress.

Or perhaps because they think that other people have given up on them. We really do respond strongly to other people's expectations, both for good and for ill.

Christopher A. Moyer said:

Dr. Oz uses reiki for his patients (that are willing to accept it) before surgery, in the operating room and in recovery.  He is a top cardiac surgeon.  Does his openess to energy work and alternative healing methods make him a better doctor or a quack? 

 

He does it himself, prescribes it, or endorses it?  If so, that is clear quackery. 

 

Does his use of energy work somehow discredit other surgeons?

 

I would say yes.

 

There has been research done on various alternative healing methods-including prayer-that show positive results but there are still plenty of people that feel there needs to be more research or simply refuse to accept the research results-and that is their prerogative. 

 

Actually, this isn't true.  In a class I am teaching right now my students have had the opportunity to examine the research on intercessory prayer.  The large scale studies with good methodology are clear in their results - it doesn't work.  The results of the Benson STEP study actually suggest that if a patient knows they are being prayed for, it may be bad for them, perhaps because they take less good care of themselves, or the medical staff does, or they experience pressure to recover faster that actually impedes their progress.  Don't take my word on it, though - the Benson study, which is not overly technical and quite readable for a scientific study, is available here.

 

We may not be able to see energy work in action (which means we really cannot prove it exists without a doubt)

 

On many occasions on this board I have pointed out that verifying the claims of energy work requires nothing special. Running such an experiment would be easy.  All one has to do is control for all possible confounds, and then see if interrater reliability can still be achieved.

 

but that doesn't mean we will not be able to prove it someday. 

 

That's true, but then we can say this about any possible natural phenomenon.  It's possible there is a tiny teapot orbiting the sun.

 

I think that was the point of calling out the times in history where science was "wrong".  Everyday we grow and learn and new things are discovered.  Whose to say that 25 years from now there won't be some sort of electronic device that can pick up on the nuances of energy and provides us with proof positive of its existence?

 

Yes, it is possible that a technological advance will give us new insight into the energy systems of the body.  But, as I noted above, we can easily test the claims of so-called energy therapies right now.  And folks have done it previously, too, and the results of well-designed studies are quite clear.  The fact is, proponents of these practices pay no attention.

 

If you are someone who does not believe in energy work or alternative healing modalties it is your choice to not practice it. 

 

Absolutely true.

 

In our school we weren't really taught these different practices just introduced to them so that you know they are out there and you can look into them further IF you want to.

 

But here is where problems arise, especially if massage therapy wants to be seen as a profession.  Professions, as Raven is pointing out, have responsibilities that go beyond delivering whatever some element of the market requests.  Therapeutic professions have a duty to provide therapies that have some validity.

 

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Permalink Reply by Ravensara Travillian on February 23, 2011 at 9:20am

I think that is a really good suggestion. I would support that.

Alexei Levine said:

Great post Laura.  It got me thinking about how a tiered approach could be implemented.  One way to differentiate a higher level of certification and licensure would be to tie it to insurance reimbursement.  The state could define a scope of practice for these "medical massage therapists" which would be similar to how PT's are differentiated from PTA's and MT's.

• ▶ Reply

Permalink Reply by Ravensara Travillian on February 23, 2011 at 9:25am

Jesus, Laura. Bruising and extortions?

 

Sitting here writing a lesson on how to know whether or not an MT should accept a client with fibrodysplasia ossificans progressiva, I'm deeply grateful that others are doing the hard, gritty work of interacting with the most difficult aspects of humanity. It's hard and important work, and I'm glad you did it, and that someone else will take the baton from you.

 

Thank you for being willing to take on the responsibility.

Laura Allen said:

I personally like the concept of tiered licensing--in theory. I haven't had any personal experience with it, and I'm not sure exactly how it works and how it's policed, so perhaps some of the people in places where it exists could enlighten me. IF, for example, someone is on the bottom tier, are they only qualified to do "relaxation massage?" How does that work? Are they allowed to be in business for themselves, or must they be employed in a salon or spa? My thought is that if they're allowed to be self-employed and open a business, what's to prevent them from doing anything they want to? Are they going to be disciplined for doing a medical massage? I really don't have a clear picture in my mind of the differentiation.

 

I was practicing Healing Touch for five years before I attended massage school, and I went to a very woo-woo school. I don't recall ever having any pyramids under the table, but I'm sure I've done things in the past that were at least that woo-woo. One thing I have never done, however, is to use ANYTHING concerning energy work on people who don't want it. I have never taken up one minute of a massage anyone paid for with doing energy work on them, chanting, ringing bells, or anything else remotely considered energy work--unless that's what the client was seeking. In spite of all the woo-woo at the school, we were in fact taught not to ever impose it on people who don't believe in it or want it.

 

Having been on a state board for the past five years, and been privy to many disciplinary hearings, I can say that we have never yet had anyone accused of "spurious claims." What we have had is MTs accused of committing sexual assaults on clients, MTs failing to follow draping requirements, MTs who told people that they had to have a breast massage and then proceeded to do it even though they had no training in it nor was it indicated; MTs breaking confidentiality, MTs who physically hurt someone--a couple of months ago it was a client who was bruised so badly she looked like she had been the victim of a beating, and we've also had people who were burned with hot stones. We've also had MTs doing massage while under the influence of alcohol, MTs who "counseled" people when they had no training to do so, MTs who didn't actually perform a sexual assault but who made inappropriate comments or did inappropriate things during the massage, MTs who extorted money from clients, and of course MTs who were practicing without a license.

 

The public probably doesn't realize that they could even complain to a board about a therapist making spurious claims.

 

As for other massage therapists being the one to report someone, I have in fact been amazed during my time on the board at how many of our cases have been one therapist accusing another, but there's another side to that, too. In a big city, one therapist will be much quicker to report another. In a small town or rural area, they won't do it as quickly because they don't want repercussions from locals...they are afraid it will cost them business for speaking out. I have had a lot of calls over the years from therapists in that position. And several times I have thought the accused therapist was not guilty, but that it was a case of professional jealousy and one therapist just trying to ruin another. I haven't ever seen one therapist accuse another (not officially at our board, anyway) of making spurious claims. I think for the most part they have a "live and let live" attitude and they're not going to report someone for having a pyramid under the table or doing energy work on unsuspecting clients who didn't ask for it.

 

As it is, it sometimes takes our board 3-6 months, and sometimes longer, to get disciplinary hearings scheduled from the time a person files the complaint. We have stayed in board meetings until after 8 pm deciding these things. People are entitled to a speedy resolution. If everyone who makes spurious claims and throws woo-woo in on a massage was reported to the board, I can only imagine what kind of bottleneck nightmare that would create for a state board.

 

And of course, you can always talk to the person and ask them to stop doing whatever objectionable act it is they're doing, but most of the time, I'd have to quote Dr. Phil and say "how's that working for you?" It's a catch-22. There's no one answer to any of these difficulties.

 

Ravensara Travillian said:

Other than educating my students how to think critically, how to evaluate claims, and how to be kind to other people's moral distress while not compromising on the principle of first responsibility to the client, no, I can't really say I have a lot of personal experience doing this.

 

There are many more people on this board who have much more experience at dealing with professional disciplinary matters than I have.

 

But it will become a much more acute question for me if we do commit to becoming a profession. If we are an industry, the standards are one thing; if we are professionals, the duties are higher. I am an advocate for becoming a profession; at the same time, I recognize that the path I am advocating will come at terrific cost (money and time, yes, but that's not all I am talking about by far), and I am not happy at that prospect.

 

I think that if we do decide to become professionals, we have to deal with the fact that through no fault of their own, people have been taught to make dubious claims. Changing from what you have been taught by trusted teachers (who themselves were taught by teachers they trusted, and so on back for generations) will cause a great deal of moral distress and backlash. It will not be an easy path.

 

Or we could stay in the current state, with all of its dissatisfactions, and watch people vote with their feet and dialogue deteriorate like the previous discussion did.

 

Or we could try a tiered model, so that we're not considered the same profession, and therefore we don't have to fight with each other over these things.

 

Or maybe there's another way. I don't know. But I think whatever we do (or let history do to us), growth is going to be hard and painful, as Daniel pointed out. 

Stephen Jeffrey said:

Ravensara said

Yet as Vlad points out, being or becoming a profession is not just a question of raising educational hours. One ethical principle of professionalism is that if you know another member of the profession is committing a wrongful act, you have a positive duty (meaning you must act) to prevent harm. So if someone is making claims that are spurious by professional standards, you are required to do something about it. And that runs directly against what we were just talking about, about how we want to live and get along in the world with others.

 

Can you give examples of how you personaly delt with the person/persons concerned in this situation?

 

 

 

• ▶ Reply

Permalink Reply by Kim Galliher on February 23, 2011 at 11:10am

Dr. Oz does not practice reiki himself but allows reiki practitioners to do the work.  He also tracks the information regarding reiki receiving patients vs non reiki receiving patients.  While you may see it as quackery and think that it somehow lessens the quality of other cardiac surgeons Dr. Oz remains one of the top cardiac surgeons in the world and is well-respected throughout the health community.

 

I will look into the study quoted as showing prayer NOT working but you should look into the work of Dr. Bernard Grad and there are other studies that show it worked as well in double blind studies.  The Brandeis study has been used to prove that it does work and also that it does not work so I guess there is room for interpretation in the actual results.

 

I do think if you are practicing different modalities you should be marketing it as such.  Keep massage as massage and your reiki, reflexology, egoscue separate.  People that are paying for a massage should be able to simply get a massage and not have other things shoved down their throat.

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