Licensing: Two Sides of the Political Coin
Introduction: To me, state licensing is an unnecessary bill of goods being sold by our friends at the American Massage Therapy Association (Amta).
In 1997, the Georgia Massage & Somatic Therapies Association(GaMSTA) defeated an Amta-GA effort to impose licensing in Georgia using a flyer that used a point/counterpoint format that is a template able to be used in any state dealing with Amta aggression. The template is a series of counterpoints with supporting statements with reasoning as to why the Amta reasons for licensing are just not strong enough reasons. Amta, as far as I know, has not done any more than state their position that licensing is needed to advance the profession of massage therapy.
The Amta left the rest of the profession behind a long time ago when they elected to stop discussing their position and begin using membership monies to lobby government to impose their agenda on all those desiring to provide touch for income.
My truth is the major beneficiaries of licensing are industry ie (mostly) the schools. Short programs teaching massage are replaced with minimum requirements of 500 hours of training to do massage for income. (As noted at the Flammia Touch, if what is being proposed in SB412 was law in 1986, I would not have entered this trade.)
Amta: Support Licensing of the Profession of Massage Therapy
The practice of Massage Therapy should be regulated by the State of Georgia because:
The public should be able to be assured that they are receiving professional Massage Therapy services from an ethical, qualified practitioner.
GaMSTA : A regulatory board establishes guidelines for scope of practice and educational requirements. It does not set ethical standards. Professional organizations provide a code of ethics for their members to embrace.
Amta: Currently, with no professional regulation in Georgia, anyone can call themselves a "Massage Therapist" and advertise publicly as a Massage Therapist.
GaMSTA: True. However, as the grandfather clause in Senate Bill 300 is written, prostitutes can be licensed as massage therapists, meaning prostitutes could continue to advertise. Further, it is debatable whether a regulatory board could protect the term "massage therapist."
Amta: Potential physical and emotional harm can result from massage therapy performed by untrained or unethical practitioners; there are many documented cases of such harm occurring.
GaMSTA: First, as for documented cases of physical and emotional harm, the Senate sub-committee who reviewed SB300 reports, "In response to a staff inquiry on behalf of the Council, The Governor's Office of Consumer Affairs researched their files for the past nine and one-half years for complaints against massage practitioners. However, they found no record of any such complaints. Similarly, contacts with Better Business Bureau of offices around the state resulted in finding no documented complaints against massage practitioners during the year ending July 9, 1997."
Second, the Georgia Chapter of the AMTA is diligently working to prove massage therapy is harmful to the public in order to get state licensing. The potential harm to our profession in the eyes of the public is tremendous. We have worked painstakingly to educate people about the benign nature of massage and somatic therapies. Are we prepared to throw that away for recognition by the state? Additionally, providing damaging information to the physical therapists and chiropractors, who already believe we encroach on their respective territories, can only hurt our profession in the end.
Third, insurance liability rates have remained basically the same over the past five years. If massage and somatic practitioners were causing harm, the insurance companies would be the first to adjust the rates charged for liability insurance. State licensure does not prevent inappropriate behavior and physical or emotional ham from occurring, as evidenced by the medical, nursing and psychological, etc. professions which have experienced criminal behavior from their licensed practitioners. (Criminal behavior is already covered by state criminal laws and would be beyond the jurisdiction of a regulatory board.)
Amta: More and more allied healthcare professions are utilizing Massage Therapy as an extremely effective complement to the services they provide. However, they cannot easily ensure that they are referring their patients to qualified Massage Therapies.
GaMSTA: Any reputable healthcare professional would require more than a state license for a referral. Further, SB300 does not distinguish among the wide range of modalities that exist in the massage and somatic profession.
Amta: All of the States surrounding the State of Georgia have instituted State Regulation of Massage Therapy - Alabama, Tennessee, South Caroline, North Carolina and Florida. In addition, twenty (20) other States regulate the Massage Therapy profession.
GaMSTA: Many states have licensing bills which have adversely affected massage and somatic practitioners. The defined scope of practice affects practitioners who do not consider themselves "massage therapists" yet they are treated as such under the licensing bill. This has driven many practitioners underground to avoid treatment as "massage therapists" and to escape the cost of additional education in techniques they do not use.
Amta: Of the over 1,000 Massage Therapists who currently practice in Georgia, many go voluntarily to neighboring States, such as Florida and Alabama, to receive a professional Massage Therapy license - with Georgia dollars going to these other States!
GaMSTA: The criteria for creating a regulatory board is to "prevent harm to the public" not to create a money machine for the state.
Amta: The cost of State licensing of Massage Therapists should be underwritten by reasonable licensing fees collected from this large number of practitioners.
GaMSTA: What may be reasonable to the state may be devastating to a practitioner. Add to the state licensing fee (Tennessees's is $325) a mandatory business license fee, professional dues, CEU costs and possible exam costs. How many practitioners will this force out of business?
Amta: A nationally administered test - The National Certification Examination for Therapeutic Massage and Bodywork - has been developed and given to over 25,000 practitioners since its inception in 1992. This test is used as a competency test in many states, such as Florida and Washington. Thus, the State of Georgia would not have to spend money to develop a competency examination for professional Massage Therapists.
GaMSTA: The National Certification Exam is highly discriminatory because it
does not fairly test individuals whose training has been in modalities other than Swedish massage. It is not a true measure of a practitioner's proficiency in skilled touch.
Amta: The time has come to institute licensing of the profession of massage therapy for the benefit of all citizens of Georgia!
(At the time this point/counter point flyer was created, there was enough opposition that the Amta failed in their mission. In 2005, GA fell to the Amta onslaught.)
MISCONCEPTIONS ABOUT STATE LICENSING
Sponsors of SB300 reasoned that state licensing will provide credibility for our profession. Credibility comes from individuals becoming involved in professional associations and through individual educational standards, codes of ethics and the quality of work performed. A regulatory board establishes scope of practice and educational requirements, not credibility.
It has been implied insurance reimbursement will come if massage is licensed. Insurance reimbursement is a separate issue regulated by the insurance commission and is in no way connected with Senate Bill 300 - nor would it be with any future bill.
It has been implied that Chiropractors will be able to refer to "licensed" massage therapists. Chiropractic recently won back the right to refer, which was done specifically for MRI's and blood work. Their bill states referrals must be made to "licensed healthcare practitioners" which has caused confusion even in the Chiropractic profession. The GCA attorney has indicated it was not the intent of the bill to prevent Chiropractors from referring to massage therapists and has also indicated that steps will be taken to remedy the language in the rule. Unless stated specifically in a bill that massage and somatic practitioners are "licensed healthcare practitioners" a referral is not guaranteed. The term "healthcare practitioner" is not used in SB300 and would be difficult to incorporate into any bill for legal/medical reasons.
Other states are requiring state licensing, therefore, it is inevitable. Many states now wish they did not have licensing because of unexpected restrictions and interpretations. Senate Bill 300 is an example of poorly thought-out legislation that can create just this kind of environment.
If we do not regulate ourselves, someone else will do it for us. There is no historical basis for this concern. Even if this point had merit, it would not provide justification for rushing into bad legislation.
CONSEQUENCES OF STATE LICENSING
Our scope of practice would be narrowed substantially (influenced by the Physical Therapists & Chiropractors.)
(SB412 could be much more harmful than good if something like this (important link) escapes the watchful eye of stakeholders or as added at the last minute.)
Our profession could be monopolized through a regulatory board to which we would have limited access, whose agenda may be questionable and who has unlimited power. (How do you get on the board? Should school directors/owners be allowed on it? What is the limit of their power?)
The current definition will group somatic and touch practitioners with massage therapists. (You will have to attend a massage school certified by the regulatory board in order to practice.)
There will be additional fees and additional hoops to jump through in order to continue practicing. (The requirements are beneficial to AMTA members.) If you haven't taken the National Exam and attended a board certified massage school, you will have to do so. SB300 made no allowances for those individuals who have mentored or apprenticed.Continuing Education requirements are left up to the regulatory board.
State licensing will not eliminate the need for a business license within county or city municipalities.
The legislature has indicated a single board for massage therapists will not be approved. This means "massage therapists" will be put under the jurisdiction of another regulatory board (most likely the Chiropractic board) whose interests are not our own.
SB300 does not establish parameters for board response during an appeals process. The board could delay for as long as it chooses while effectively terminating the practitioner's business until a hearing takes place.
Introduction: To me, state licensing is an unnecessary bill of goods being sold by our friends at the American Massage Therapy Association (Amta).
In 1997, the Georgia Massage & Somatic Therapies Association(GaMSTA) defeated an Amta-GA effort to impose licensing in Georgia using a flyer that used a point/counterpoint format that is a template able to be used in any state dealing with Amta aggression. The template is a series of counterpoints with supporting statements with reasoning as to why the Amta reasons for licensing are just not strong enough reasons. Amta, as far as I know, has not done any more than state their position that licensing is needed to advance the profession of massage therapy.
The Amta left the rest of the profession behind a long time ago when they elected to stop discussing their position and begin using membership monies to lobby government to impose their agenda on all those desiring to provide touch for income.
My truth is the major beneficiaries of licensing are industry ie (mostly) the schools. Short programs teaching massage are replaced with minimum requirements of 500 hours of training to do massage for income. (As noted at the Flammia Touch, if what is being proposed in SB412 was law in 1986, I would not have entered this trade.)
Amta: Support Licensing of the Profession of Massage Therapy
The practice of Massage Therapy should be regulated by the State of Georgia because:
The public should be able to be assured that they are receiving professional Massage Therapy services from an ethical, qualified practitioner.
GaMSTA : A regulatory board establishes guidelines for scope of practice and educational requirements. It does not set ethical standards. Professional organizations provide a code of ethics for their members to embrace.
Amta: Currently, with no professional regulation in Georgia, anyone can call themselves a "Massage Therapist" and advertise publicly as a Massage Therapist.
GaMSTA: True. However, as the grandfather clause in Senate Bill 300 is written, prostitutes can be licensed as massage therapists, meaning prostitutes could continue to advertise. Further, it is debatable whether a regulatory board could protect the term "massage therapist."
Amta: Potential physical and emotional harm can result from massage therapy performed by untrained or unethical practitioners; there are many documented cases of such harm occurring.
GaMSTA: First, as for documented cases of physical and emotional harm, the Senate sub-committee who reviewed SB300 reports, "In response to a staff inquiry on behalf of the Council, The Governor's Office of Consumer Affairs researched their files for the past nine and one-half years for complaints against massage practitioners. However, they found no record of any such complaints. Similarly, contacts with Better Business Bureau of offices around the state resulted in finding no documented complaints against massage practitioners during the year ending July 9, 1997."
Second, the Georgia Chapter of the AMTA is diligently working to prove massage therapy is harmful to the public in order to get state licensing. The potential harm to our profession in the eyes of the public is tremendous. We have worked painstakingly to educate people about the benign nature of massage and somatic therapies. Are we prepared to throw that away for recognition by the state? Additionally, providing damaging information to the physical therapists and chiropractors, who already believe we encroach on their respective territories, can only hurt our profession in the end.
Third, insurance liability rates have remained basically the same over the past five years. If massage and somatic practitioners were causing harm, the insurance companies would be the first to adjust the rates charged for liability insurance. State licensure does not prevent inappropriate behavior and physical or emotional ham from occurring, as evidenced by the medical, nursing and psychological, etc. professions which have experienced criminal behavior from their licensed practitioners. (Criminal behavior is already covered by state criminal laws and would be beyond the jurisdiction of a regulatory board.)
Amta: More and more allied healthcare professions are utilizing Massage Therapy as an extremely effective complement to the services they provide. However, they cannot easily ensure that they are referring their patients to qualified Massage Therapies.
GaMSTA: Any reputable healthcare professional would require more than a state license for a referral. Further, SB300 does not distinguish among the wide range of modalities that exist in the massage and somatic profession.
Amta: All of the States surrounding the State of Georgia have instituted State Regulation of Massage Therapy - Alabama, Tennessee, South Caroline, North Carolina and Florida. In addition, twenty (20) other States regulate the Massage Therapy profession.
GaMSTA: Many states have licensing bills which have adversely affected massage and somatic practitioners. The defined scope of practice affects practitioners who do not consider themselves "massage therapists" yet they are treated as such under the licensing bill. This has driven many practitioners underground to avoid treatment as "massage therapists" and to escape the cost of additional education in techniques they do not use.
Amta: Of the over 1,000 Massage Therapists who currently practice in Georgia, many go voluntarily to neighboring States, such as Florida and Alabama, to receive a professional Massage Therapy license - with Georgia dollars going to these other States!
GaMSTA: The criteria for creating a regulatory board is to "prevent harm to the public" not to create a money machine for the state.
Amta: The cost of State licensing of Massage Therapists should be underwritten by reasonable licensing fees collected from this large number of practitioners.
GaMSTA: What may be reasonable to the state may be devastating to a practitioner. Add to the state licensing fee (Tennessees's is $325) a mandatory business license fee, professional dues, CEU costs and possible exam costs. How many practitioners will this force out of business?
Amta: A nationally administered test - The National Certification Examination for Therapeutic Massage and Bodywork - has been developed and given to over 25,000 practitioners since its inception in 1992. This test is used as a competency test in many states, such as Florida and Washington. Thus, the State of Georgia would not have to spend money to develop a competency examination for professional Massage Therapists.
GaMSTA: The National Certification Exam is highly discriminatory because it
does not fairly test individuals whose training has been in modalities other than Swedish massage. It is not a true measure of a practitioner's proficiency in skilled touch.
Amta: The time has come to institute licensing of the profession of massage therapy for the benefit of all citizens of Georgia!
(At the time this point/counter point flyer was created, there was enough opposition that the Amta failed in their mission. In 2005, GA fell to the Amta onslaught.)
MISCONCEPTIONS ABOUT STATE LICENSING
Sponsors of SB300 reasoned that state licensing will provide credibility for our profession. Credibility comes from individuals becoming involved in professional associations and through individual educational standards, codes of ethics and the quality of work performed. A regulatory board establishes scope of practice and educational requirements, not credibility.
It has been implied insurance reimbursement will come if massage is licensed. Insurance reimbursement is a separate issue regulated by the insurance commission and is in no way connected with Senate Bill 300 - nor would it be with any future bill.
It has been implied that Chiropractors will be able to refer to "licensed" massage therapists. Chiropractic recently won back the right to refer, which was done specifically for MRI's and blood work. Their bill states referrals must be made to "licensed healthcare practitioners" which has caused confusion even in the Chiropractic profession. The GCA attorney has indicated it was not the intent of the bill to prevent Chiropractors from referring to massage therapists and has also indicated that steps will be taken to remedy the language in the rule. Unless stated specifically in a bill that massage and somatic practitioners are "licensed healthcare practitioners" a referral is not guaranteed. The term "healthcare practitioner" is not used in SB300 and would be difficult to incorporate into any bill for legal/medical reasons.
Other states are requiring state licensing, therefore, it is inevitable. Many states now wish they did not have licensing because of unexpected restrictions and interpretations. Senate Bill 300 is an example of poorly thought-out legislation that can create just this kind of environment.
If we do not regulate ourselves, someone else will do it for us. There is no historical basis for this concern. Even if this point had merit, it would not provide justification for rushing into bad legislation.
CONSEQUENCES OF STATE LICENSING
Our scope of practice would be narrowed substantially (influenced by the Physical Therapists & Chiropractors.)
(SB412 could be much more harmful than good if something like this (important link) escapes the watchful eye of stakeholders or as added at the last minute.)
Our profession could be monopolized through a regulatory board to which we would have limited access, whose agenda may be questionable and who has unlimited power. (How do you get on the board? Should school directors/owners be allowed on it? What is the limit of their power?)
The current definition will group somatic and touch practitioners with massage therapists. (You will have to attend a massage school certified by the regulatory board in order to practice.)
There will be additional fees and additional hoops to jump through in order to continue practicing. (The requirements are beneficial to AMTA members.) If you haven't taken the National Exam and attended a board certified massage school, you will have to do so. SB300 made no allowances for those individuals who have mentored or apprenticed.Continuing Education requirements are left up to the regulatory board.
State licensing will not eliminate the need for a business license within county or city municipalities.
The legislature has indicated a single board for massage therapists will not be approved. This means "massage therapists" will be put under the jurisdiction of another regulatory board (most likely the Chiropractic board) whose interests are not our own.
SB300 does not establish parameters for board response during an appeals process. The board could delay for as long as it chooses while effectively terminating the practitioner's business until a hearing takes place.
posted by Rob Flammia | 8:08 PM
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