Massage Therapy Body of Knowledge

Comment

Comment by Mike Hinkle on October 24, 2009 at 8:54pm

How would those already licensed be handled? Some have extensive training already. What about time in grade?

Comment by Keith Eric Grant on October 24, 2009 at 8:46pm

Mike says

I have been trying to make sure we weren't running into 3,000 hours for the industry. Because everyone keeps using Canada as the guidelines.

BC is at 3000 hours. Ontario is at 2200 hours. Both provinces regulate massage only for inclusion in the health care system. In both provinces it is a title act that doesn't require access to any of the items on the centralized list of restrict/reserved acts. Outside of that massage can be done unregulated as long as it doesn't imply being a "Registered Massage Therapist" or RMT. These are also monolithic systems of training. Neither province embodies the concept of specialties.

The U.S., in contrast, mostly uses a system of practice acts because the motivating reason for U.S. licensing was control of commercial touch (i.e. that was the motivating factor for the legislators to pass the bills). If we define the entry level job description to be the same as they use in Ontario, we might end up needing 2200 hours. We might also find that they are teaching items unnecessary to the job description and be able to teach more efficiently. I do not think that, since we in general have no underlying unregulated massage, the entry level will be set at the monolithic health system training of the Canadian provinces. It simply does not make sense to do that for people who are going to work in a spa or corporate massage outlet. We, as I've noted previously, could come up with a series of post-licensing specialty certifications to handle inclusion in the U.S. health care system via competency assurance for defined job descriptions. If one licensed and then did all the specialty certifications, it might come to 3000 hours. Depending on the entry level job description agreed upon, it likely would fall between 300-700 hours. But states, students, and 3rd parties would know exactly what those hours imply in terms of assured competency and job tasks. That assurance implies credibility -- i.e. we see what you claim to be able to do and we see exactly why that claim is valid.

Comment by Mike Hinkle on October 24, 2009 at 8:41pm

Carl and you will never convince me that 100 hours is enough time to put a person on the street charging for swedish or any type of massage. I think that is detremental to the profession and it is heading in the wrong direction. That is not "f......." as you say. (Very poor taste) I is expressing my opinion, which I thought was ok in this discussion.

No one is challenging your years of service or expertise in the field. I think it hurts the profession. Hundreds of teachers are begging for the profession to grow and I see few pulling in the other direction.

There is nothing you or I can do to individually control this issue. We merely are expressing our opinions. I am sorry if that offends you. That was not my intent. I just can't grasp how changing everything when it isn't needed is the way to go.

Comment by Keith Eric Grant on October 24, 2009 at 8:22pm

Mike says:

Now I find out CA allows therapists to be certified in Swedish and on the streets practicing on people, not in clinic under supervision, at 100 hours.

I've said this several time, but will repeat myself once again. The CAMTC lower level certification is 250 hours, required to be at (or at least graduating from) a single school and to include certain components of anatomy and physiology. There a some areas of California that have little or no local regulation, more up in the far north. If you read the report (I've linked to it twice), you will understand why the 250 hour level exists. California has a lot of practitioners and schools and the two tier law is a balance between regulation and economic damage to existing business practices.

People who graduate from our sports and deep tissue certificate program at a level of 250 hours do not give "lousy massages". I've had students who have graduated from 720 hour programs take these classes because we give better kinesthetic training than they received for all their hours. Took me a long while to figure out why we kept getting them. People give lousy massages when they have not been trained and practiced in the knowledge and skills to give good ones. They often can, however, answer multiple choice questions on a test just fine. Doesn't help their massages a bit. You have to define the outcomes you want and teach to them. If you don't define the right outcomes, people will teach to what you do define. Of course, some of us teach what we believe should be taught, but we are largely hangovers from an earlier age.

Teaching massage is very much like teaching people to play music. It is a skill that requires practice with awareness. It doesn't matter how many hours you spending learning about music. You start learning to play when you actually pick up the instrument. Based on that, I would have no hesitation about being on the table of one of the first (100 hour) graduates or of our 250 hour graduates. I would expect (and do expect as a teacher) that the 250 hour graduates have extended their capabilities and areas of practice. Having been teaching these classes since for 17 years, I think I have accumulated some experience to speak from. I can't speak to your experience or training. It is what it is.

Comment by Keith Eric Grant on October 24, 2009 at 7:26pm

Excuse me, Mike.

I believe it was you who asked what could be provided for 100 hours and 250 hours and what the cost might be? I provided an example to answer that question. That was not advocating for anything. You asked. I answered. Period.

Carl and I are individuals. Sometimes we agree. Sometimes we strongly disagree. In general, however, we respect each others opinion and, to steal a phrase from Monty Python, refrain from "farting" in each others general direction even when we disagree.

What I have advocated is simply this. That a minimum competency job description and task breakdown should be created. That the states should, likely through the means of the FSMTB come to some consensus of tasks to be included and/or, where they cannot agree, what sets of tasks differentiate them. That the required tasks be used to create a corresponding body of knowledge for development of curricula that directly and efficiently addresses the regulatory responsibilities for competency assurance of the various and combined states. Period.

I have also said that, beyond licensing or other state regulation, there is considerable opportunity for specialty certification as is done by the American Board of American Specialties.

I have tried to provide multiple views from different agencies of how they, as regulatory agencies, view occupational regulation.

If you find this demeaning or belittling, I don't view that as my problem. That was not my intent nor do I believe that I have said anything to that effect. Nor do I particularly appreciate the professionalism of you and others going onto another equally public thread on this domain and "farting" in the general direction of this discussion and the people involved. Is this really the face the professional face that you and others wish to show the world? It likely is true that reputation management on social media should be added as a competence. As others have said, you can spend years building a reputation and ruin it with a single click.

Comment by Mike Hinkle on October 24, 2009 at 7:13pm

Well if this is the case for the profession, I feel, we are not headed in the right direction. I have been trying to make sure we weren't running into 3,000 hours for the industry. Because everyone keeps using Canada as the guidelines. I wonder how the therapists feel in Canada about this certification. I know states have the right. But how does the profession feel?

Now I find out CA allows therapists to be certified in Swedish and on the streets practicing on people, not in clinic under supervision, at 100 hours. I am at a lost. Our class was put into clinic our second week, because the Senior Class graduated. Were we ready for clinic? No. We're we ready to work for revenue, representing the profession to the public? NO WAY!

I think this will really hurt the profession. Does it make students happy? Of course. Will it allow people to make money? Yes. Will people get lousy massages, I'd bet on it! This does not help the profession.

Comment by Keith Eric Grant on October 24, 2009 at 6:44pm

Mike,

The states, via the forum of the FSMTB, can agree on any entry level job description that they feel fulfills their responsibility to regulate for public safety and public benefit. That is one reason I can't estimate how many hours would be required -- I can't foretell what they would decide upon. But I assume that they would negotiate an entry level description that they in consensus feel is adequate. That, btw, in no way restricts post licensing learning or certification, any more than it does for the medical profession. Take a look at the information on the ABMS and specifically What Board Certification Means. I don't understand what you consider to be belittling in such an approach.

This simply fits into a bigger picture of state rights and responsibilities to regulate for the public benefit. Again I will note the statement on the purpose of regulation from the HPRAC report.

The important principle underlying each of the criteria [for regulation] is that the sole purpose of professional regulation is to advance and protect the public interest. The public is the intended beneficiary of regulation, not the members of the profession. Thus the purpose of granting self-regulation to a profession in not to enhance its status or to increase the earning power of its members by giving the profession a monopoly over the delivery of particular health services. Indeed, although these are common results of traditional regulatory models, they are undesirable results, and the model of regulation we recommend [the RHPA] aims to minimize them.

For comparison one can also look at an extensive review of occupational regulation prepared in 1999 by the auditor general of Minnesota. That report references a FTC Economic Bureau report on the Costs and Benefits of Occupational Regulation by Cox and Foster that I made available online several years back.

Comment by Mike Hinkle on October 24, 2009 at 6:33pm

Keith,

No. That is what California is doing. When I read the BOK, their effort is to set the minimum "entry level criteria." It far, far exceeds the excuse of standards set for any massage work that you and Carl are trying to frame. You are trying to make it as easy as possible for students. Not what is needed for a profession. So now instead of having one set of rules for all, you'll have many.

Your methods will not work for what they are doing. We are tring to increase the standards and profession, not regress. If all Carl wants to do is keep things to a minimum, good luck.

The profession and stakeholders want to grow the profession. This is going backwards.

Comment by Keith Eric Grant on October 24, 2009 at 6:14pm

Mike,

The implication of regulating is that you are regulating for minimum competence as well as setting up a structure for oversight against malfeasance. The implication of specialty certification is that you are certifying for minimum competence in a specialty area. Both of these would have job descriptions, tasks, and thus KSAs. That is what regulating/certifying for competence means.

Outside of licensing or specialty certification, one could teach or learn what one wished based on arbitrary levels of teacher and student interest. It could be largely exploratory and free form, as long as both teacher and students are congruent with the program and what they experience within it.

Comment by Mike Hinkle on October 24, 2009 at 6:09pm

The BOK is looking for a set of standards that will uniform the country. This is an effort to minimally educate and put practitioners on the street. I can't believe you would support this type of massage education.

I will not support this in any form like this. This belittles the entire profession in my opinion. It is an insult to the healthcare industry and I hope this legislation sunsets. This is not professional. You can use and site 1,000 studies to say it is. It will not get my vote.

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