Massage Politics: The Tragedy of Skilled Touch Continues
You can be outraged but you cannot be paralyzed.
-Bumpersticker
Don Shwartz, the former head of the Trager Institute, wrote the piece at this link in 1995. His words are as accurate today as they were then. The piece is a snapshot of the massage and touch vs massage therapy rift dividing our trade. The following exchange is a good example of the rift that persists.
I have had nastier exchanges with some folk but I share this one because my suspicion is the writer does not have an accurate history as to how and why she had to have the New Mexico education she received. Because of the lack of history, she has no sense or understanding as to why those in California and other free states continue to fight licensing. I have forwarded a link of this post to the New Mexico Woman. I thank Don Shiff, a New Mexico licensed therapist for his generosity in taking the time to discuss some points made by the New Mexico Lady.
Here's the story! On occassion, I organize SF/Bay Area gatherings. One friend I e-mailed took the liberty of forwarding my e-mail to her colleague. In response, my friend received a response with concerns the gathering would be political and stated a few positions. With permission of the friend that received the e-mail I responded to her questions, concerns and positions with the following. Some of the names have been changed to protect the not so innocent:
Hello New Mexico Lady,
I got your e-mail address from Didi. To get the politics out of the way:
(1) I am sorry to hear you are for licensing for the reasons you express. Your reasons are a marketed 'bill of goods' you have bought.
(2) If you don't mind, I will add you to my politics list so you can write in favor of the bill as it progresses. Whether you agree with me or not, at least you will know what is happening. You are part of the 90% of those in our trade that could write, as you did, "I had no idea that such a bill was even on the table." It is a sad state of affairs.
(3) Are you a member of the Amta or ABMP? Both have been putting out lots of info and opinion on the bill. Plug in at their sites for more info. With all of that said...This gathering is for networking. There is no agenda. The only way I will talk politics is if someone else brings it up (Gawd forbid).
In response to the above, I received the following:
From: A New Mexico Lady
Date: January 19, 2006 9:41:10 AM PST
Okay, I am going to have to bop Didi on the head for giving out my e-mail address. But that aside, I was not sure whether to waste my time writing back an excruciatingly annoyed e-mail to an obveously self-obsessed man who dares to call himself a "rubber" about whether massage therapy should or should not enter the realm of the respected world, or whether I should politely delete it and anything else that comes along from him. I normally don't open e-mails from addresses I don't recognize because they might contain viruses. I guess I should have gone by my old rule. But here I am, digitally ranting to a computer screen connected to someone I will in all likelyhood never meet. So I might as well back up my argument - even though I wasn't talking to you in the first place. I don't have time today to argue against each and every rediculous point you make on your blogs. But here are a few points that I am passionate about.
1.) I come from and was trained in New Mexico. Yes it is in this country, but you probably knew that. It is one of (the majority of) the states that requires National Certification and State Licensure. This is not a big ordeal like you make it sound. (The rest of her response is below)
2.) There is ABSOLUTELY NO LINK between prostitutes and massage therapists in New Mexico. (The rest of her response is below)
3.) Massage Therapists need more than 100 hours of training for a million reasons that I do not have time to write about at this time. Touch is a very powerful thing, and yes, it can hurt people. Emotionally and physically if not done with self-awareness, ethics, training and practice. An imperfect system is far better than no system at all - at least until we are all enlightened beings ~ which we are sorely ! far from, my friend.Thanks for listening.
-New Mexico Lady
To which I responded: I will send your entire response to Didi. Would you mind if I sent a copy to Don Shiff a fellow NM licensed practitioner??? I feel confident he would be interested in your point of view. You are the first to call me self-obsessed....I will have to check that out. On a personal level, I am saddened by your attack. I need to go under my cover, hold back my kneejerk reaction and say to myself, "Well...As you know, I am not for everybody and everybody is not for me." It is one of my truths. It is obvious we would have difficulty being in the same room...at least on this level.
Dare to call myself a rubber? Get a sense of humor... What makes you think "rubber" is so bad? It is a title from the Department of Labors Dictionary of Occupational Titles. Women had a chant.."Women unite. Take back the night." I am tempted to run with "Rubbers unite! Take back the right." I have to assume you are one of those who take in "masseuse" as though it were fingernails on a chalkboard.
On a political level, I will continue to blog in the way I blog. I have never been against high standards. It is imposing those standards as law like it is in NM. Plugging into Google using the words massage, massage therapy, etc will get you news reports disproving what you are saying in that the NCE and 500 hours separates us from the sex workers. In many ways it has helped the sex trade enabling folk to hide under the cover of licensing. Tragic but true...Don't listen to me, research it yourself.
I fully agree one needs more than 100 hours of training to be a massage therapist. As a matter of fact, I believe to be a massage therapist once should have 3300 hours as is required in British Columbia. I am ethical and believe I am not qualified to call myself a massage therapist, to me a misleading title, although I have a base of 1000 hours of training, have sat with some pretty heavy duty masters, Barnes, St John amongst others and 20 years of experience.
On the other hand, one needs less than 100 hours of training to do a massage or touch someone for a fee. You really do sound like an Amta officer. I could no more rejoin the Amta than I could convert to Judaism if I had to get circumcised.
Thanks for listening...Now you may hit delete!
------------------------------------------------------------------------
Unfortunately, she never responded to my response. I did take the liberty of forwarding her letter to my friend Donald Shiff. Following is Donald's response to her rant:
Dear Colleague:
My friend Rob Flammia sent me an excerpt of your post to him and asked me to comment. I wanted to make certain I understood your points in their correct context, so I asked for the whole post. He sent it to me without headers to preserve your privacy. I applaud his discretion.
Before I reply on a point/counterpoint basis, let me describe my background in the massage field so that you can better understand my perspective.
I received my initial 1000+ hour training at Heartwood Institute in Garberville, CA in 1983-4. I arrived in Santa Fe, NM in 1985 and worked there for 12 years before moving to Albuquerque in 1997 to finish a B.U.S. degree in Biology at UNM. I've lived and worked here ever since.
In 1990 I worked with an Amta-dominated group to write a licensing law for MT in NM. At the time, I thought that untrained, incompetent practitioners were physically injuring their clients. You see, when I was at Heartwood my mother got a Shiatsu session in Pittsburgh (PA) in which her edematous ankles were mauled with a golf tee. I thought that because my mother was hurt that injuries caused by incompetent practice must be common. In fact, it is exceedingly rare, as witnessed by the fact that liability insurance for MTs is ridiculously inexpensive. In essence, I projected my zeal to protect my mother on the public as a whole, although it took me many years to realize it.
I now believe that licensing MTs in unnecessary and unwise; however, my involvement with writing the law had some benefits. First, I was able to eliminate any reference to professional organizations and eliminate any favoritism towards their members. Second, I was able to create a generous provision for alternative qualifying (practical) experience as a form of education, up to 350 hours of the 650 we required! Unfortunately, that provision was eventually eliminated because it was impossible for those people to take the Nickbatomb exam which the Board later required for licensing. I feel the same way about the elimination of Alternative Qualifying Experience as a basis for licensure that Rob does about elimination of the Massage Entrance Exam for Amta membership. But that's another story, and it's water under the bridge. The point is that I believe that my efforts were instrumental in crafting one of the most equitable pieces of massage regulation that exists today.
While I was at UNM in 1997-8 I discovered the Body_Work e-mail list, which is now on yahoogroups. I was a rabid licensing advocate at the time, but I eventually changed my mind after long, sometimes vituperative discussions with people like Rob, Keith Eric Grant, and Jeff Thetford from FL. I also took the Avatar course, which allowed me to be more honest with myself about my own actions and motivations.
Because I helped write the NM Massage law, I feel responsible for making sure that the Massage Board makes good decisions and has fair rules. I helped write all the Board Rules at one point, including the Code of Professional Conduct, and I go to as many Board meetings as I can. Sometimes I manage to persuade the Board to my point of view and sometimes I don't. However, they always listen to me and value my perspective.
I have testified both for and against licensing provisions at the NM and MN legislatures. At this point, I believe massage licensing is a done deal in NM, and after 15 years the Board is finally getting its act together. However, I believe that licensing is neither necessary to protect the public nor desirable from the practitioner's perspective. There are better solutions to the problems that face practitioners than licensing.
OK, that was a really long biography! Let me answer the points you made in your e-mail to Rob.
You(New Mexico Lady) wrote:
(1) I come from and was trained in New Mexico. Yes it is in this country, but you probably knew that. It is one of (the majority of) the states that requires National Certification and State Licensure. This is not a big ordeal like you make it sound. It simply means that there is a higher standard of education, training, ethics, and accountability for massage therapists. In return they get a MUCH greater deal of respect (and not to mention pay) than "rubbers" from California. People there are shocked when I tell them that there is no licensure in California. I have never heard one person rant on and on about how "they are practically making touch illegal", nor even have any doubt that there should be licensure. "
(Don responds) I don't know your history, but I suspect that you were not practicing massage before NM required licensure. If that's correct, then you are comparing the situation in NM to CA the way it is today and assuming the differences between the two states are the result of licensing. I don't think that methodology is valid. There are vast differences in culture between the two states that have nothing whatsoever to do with professional regulation.
A majority of states require licensure now, but NM was in the minority when we started licensing MTs. The Nickbatomb exam didn't exist. NM adopted it as its licensing exam as a step toward portability when it became available, and when the Federation of State Massage Boards creates its own exam I predict that NM will be one of the first states to adopt it because Nickbatomb will never allow any oversight by the states, which the Board absolutely requires to fulfill its regulatory mandate.
More required education means a great deal of expense to students who may never make a living doing the work. An estimated 80% of massage school graduates are not practicing massage two years after they graduate. Even if that number is 70% after three years, that's a lot of time and effort, much less money, to put into an education that most won't end up using. Massage is a skill that comes more from the hands and heart than from the head. If you have the gift in your hands, then the education can be of great benefit. If you don't have the gift for the work, then no amount of education or training will make you even minimally proficient.
I'm sure you had some classmates who just plain sucked at doing the work. Do you think their effort was worthwhile? How about those creepy guys? Did the six-count- 'em-six hours of ethics the state required when you were in school make them ethical? Weren't they still just as creepy after that class? Didn't you avoid them like the plague and do anything you could to keep their hands off of you? The only people who benefit from mandatory education own the schools. They are the major power in the profession, and they are the major beneficiaries of licensing.
I sometimes need to hire other MTs to work on clients that I can't for a variety of reasons. I have received more massages than I can count from a wide variety of therapists over the years. The best ones were from two women who had no formal training whatsoever. The first one learned by massaging her MS-stricken mother as a child. She was fortunate enough to have been grandfathered into licensure, and I have been trading work with her for the last 21 years. The second traded work with roommates who had been going to massage school. She came to NM later, and she can't work here, even though she does better work than most long-time MTs I know. She probably doesn't want to work as an MT now, but she never had the chance. What's fair about that?
I don't even want to start talking about how widely the quality of the education varies from school to school. All I can say is that I pity the poor therapists who went to crappy schools. It's hard enough to make a living in this field without being handicapped by having wasted 650 hours at a school that would just as soon teach you to be a medical transcriptionist as a massage therapist.
There is some advantage to having a Board for accountability, I agree. However, MN's Health Freedom approach gives oversight without requiring a standardized mandatory education. I think that's far superior to requiring an expensive private education just to see whether you have what it takes to survive, much less thrive, as a Massage Therapist. Besides, oversight doesn't keep people from doing bad things. The scheduler at a local massage school reportedly raped a client at the school last year. Did his massage license keep him from raping the client? Did having a Massage Board speed up his trial and sentencing? Of course not.
According to both the current and former Massage Board Administrators, the overwhelming majority of complaints against LMTs in NM come in two categories: unlicensed practice and sexual misconduct. However, when a client of mine complained that a previous MT had physically hurt her, the complaint was dropped because the Board didn't want to punish the therapist for a he said / she said situation, even though the client submitted her medical records! The burden of proof is very high, and Board members are not trained in adjudicating such matters. If you think it's hard prove physical harm, how much harder must it be to prove sexual misconduct when there's no physical evidence at all? Generally, it takes at least three complaints before the Board feels safe enough to take action. I'm absolutely not accusing the Board of protecting wayward MTs from the consequences of their malfeasance. However, they are risk-averse, so they're unwilling to risk being sued for violating a licensee's civil rights.
I can't speak to the issue of respect given MTs. I was rarely mistaken for a prostitute even back in the 80's when I was just out of school. That may be because I'm a man, or it may be because the population of NM is low enough that sex for sale is not as much of a problem here. However, I do still get men calling me for sexual favors, even though my advertising stresses clinical benefits for people who have been in car wrecks. Sleazy people will assume that you are sleazy. It's not about you. If you are confident in your abilities, then most people will treat you as a professional.
I don't know what MTs make in CA. It's hard to make a living doing massage anywhere. I suspect that any difference in pay, especially at the entry level, has more to do with the availability of workers than with any benefit conferred by licensing. I can tell you what massage prices are like in Albuquerque. If you work for a gym or spa, you can expect to be paid about $15 to 25 per hour plus tips. Private practice rates run from $35 to $65 per hour, more for outcalls. I suspect that experienced therapists like Rob in major CA cities can charge higher rates than I can here. $65/hr. is all the Albuquerque market can bear. Of course, clinical injury treatment billed to third parties is much higher. But that's a specialized niche.
NML 2.) There is ABSOLUTELY NO LINK between prostitutes and massage therapists in New Mexico. Why Not? Who would go through 500+ hours of school and an exam to have an add with a picture of their ass in the back of the Guardian? I can not tell you how many times I tell people here that I am a massage therapist and they look at me like I am a whore. Not that I am against prostitution, I just think it should be legalized so that we don't have to share a job title.
Don responds: I beg to differ. All you have to do is look at the back page of Albuquerque's weekly rag, the Alibi. How about these salacious ads: Healing hands for heavenly bodies. Massage for men by masculine masseur. Mesmerizing massage by Miss Viki. These people are licensed (or at least they claim to be.) They are also prostitutes, and they make a hell of a lot more money than "legitimate" therapists. Why? Because sex sells. If you're making $100 to $300 per hour, the price of a massage education is negligible. In addition, sex workers probably have more time on their hands, so to speak, than most people do to go to school.I do agree that prostitution should be legalized. However, there will still be people doing sexual massage for hire. The only difference is that they will be able to be honest about what they're doing.
NML 3.) Massage Therapists need more than 100 hours of training for a million reasons that I do not have time to write about at this time. Touch is a very powerful thing, and yes, it can hurt people. Emotionally and physically if not done with self-awareness, ethics, training and practice. I have received very bad massages and have heard horor [sic] stories about them from numerous clients. There needs to be a system of accountability. Not that I think the government is excellent by any means at these things, but it is the only system we have got. An imperfect system is far better than no system at all - at least until we are all enlightened beings ~ which we are sorely(!) far from, my friend
(Don Responds) The likelihood of serious physical harm from massage is very, very low. My friend and colleague Keith Eric Grant did a study in 2003 that you can retrieve at http://www.ramblemuse.com/articles/medline_massage_injury.pdf. He concludes "This number of cases of injury found [11 in 39 years] is far too small to be statistically meaningful in estimating risk from massage, except to verify that it is negligible." Mr Grant also concluded that "There is no explicit correlation of the occurrence of injuries with technical training or its lack." A study by a man named Ernst came to the same conclusion. Physical injury from massage is a true rarity, despite dataless claims by Amta and Nickbatomb licensing proponents. You have been sold a bill of goods by liars with a political agenda.
I have received some very bad massages in my time, mostly from licensed MTs. I can't say that any of them harmed me. However, I do insist on trading work with anybody I hire or refer to. Licensing and mandatory education do not guarantee competence. More to the point, Massage Boards are not in a good position to respond to quality control complaints. "S/he gave me a shitty massage" is not actionable. "S/he hurt me" is very difficult to prove, as my client discovered. Massage Boards do not enforce codes of ethics. They do enforce codes of professional conduct, which are essentially list of actions and inactions for which a licensee can be sanctioned. For example, "If you engage in sexual conduct [as defined in these rules] with a client, *and s/he complains about it later,* we can take your license away." If there is no complaint, there is no basis for action. Indeed, several complaints may be necessary to establish a pattern of behavior before the Board can justify a sanction. In their defense, what are they supposed to do when a client complains, "He touched my breast!" and the therapist says, "I did no such thing!" One or the other is probably lying, but which one? They have no way of knowing.
Licensing and mandatory education likewise do not mitigate potential emotional harm. Do you really think that requiring a certain number of hours of ethics classes will keep MTs from molesting their clients? Don't be naive. Unethical people will continue to act unethically regardless of any number of hours of classes. Moreover, sexual predators are remarkably resistant to psychological treatment. While there's a big difference between an MT who can't control his horniness and a child molester, your proposed solution will not solve any problems. Sexual misconduct is a problem in every medical field. Indeed, licensing may lull consumers into a false sense of security.
You may be right that there needs to be some system of accountability. However, an oversight board can be created to manage complaints against practitioners without requiring lengthy, expensive, mandatory education, as was done in MN under their Freedom of Access Act. Massage licensing laws are about power, control, and limiting competition. They do not protect the public from any harm that the marketplace cannot handle. If you don't do good work, you're not going to be in business long. That's just as true for a massage therapist as it is for a plumber. I'd rather have a talented amateur work on me than an talentless "professional" with a license.
Respectfully,
Donald F. Schiff, BS, BUS, LMT, RMTI.
NM LMT #8
NM Registered Instructor #I-112
Stonecircle Massage, Albuquerque, NM
5 March 2006
------------------------------------------------------------------------------
SB412 is coming!! It is a foot in the door for licensing in California. Let's let folk know we don't want or need it. More within a day or two.
You can be outraged but you cannot be paralyzed.
-Bumpersticker
Don Shwartz, the former head of the Trager Institute, wrote the piece at this link in 1995. His words are as accurate today as they were then. The piece is a snapshot of the massage and touch vs massage therapy rift dividing our trade. The following exchange is a good example of the rift that persists.
I have had nastier exchanges with some folk but I share this one because my suspicion is the writer does not have an accurate history as to how and why she had to have the New Mexico education she received. Because of the lack of history, she has no sense or understanding as to why those in California and other free states continue to fight licensing. I have forwarded a link of this post to the New Mexico Woman. I thank Don Shiff, a New Mexico licensed therapist for his generosity in taking the time to discuss some points made by the New Mexico Lady.
Here's the story! On occassion, I organize SF/Bay Area gatherings. One friend I e-mailed took the liberty of forwarding my e-mail to her colleague. In response, my friend received a response with concerns the gathering would be political and stated a few positions. With permission of the friend that received the e-mail I responded to her questions, concerns and positions with the following. Some of the names have been changed to protect the not so innocent:
Hello New Mexico Lady,
I got your e-mail address from Didi. To get the politics out of the way:
(1) I am sorry to hear you are for licensing for the reasons you express. Your reasons are a marketed 'bill of goods' you have bought.
(2) If you don't mind, I will add you to my politics list so you can write in favor of the bill as it progresses. Whether you agree with me or not, at least you will know what is happening. You are part of the 90% of those in our trade that could write, as you did, "I had no idea that such a bill was even on the table." It is a sad state of affairs.
(3) Are you a member of the Amta or ABMP? Both have been putting out lots of info and opinion on the bill. Plug in at their sites for more info. With all of that said...This gathering is for networking. There is no agenda. The only way I will talk politics is if someone else brings it up (Gawd forbid).
In response to the above, I received the following:
From: A New Mexico Lady
Date: January 19, 2006 9:41:10 AM PST
Okay, I am going to have to bop Didi on the head for giving out my e-mail address. But that aside, I was not sure whether to waste my time writing back an excruciatingly annoyed e-mail to an obveously self-obsessed man who dares to call himself a "rubber" about whether massage therapy should or should not enter the realm of the respected world, or whether I should politely delete it and anything else that comes along from him. I normally don't open e-mails from addresses I don't recognize because they might contain viruses. I guess I should have gone by my old rule. But here I am, digitally ranting to a computer screen connected to someone I will in all likelyhood never meet. So I might as well back up my argument - even though I wasn't talking to you in the first place. I don't have time today to argue against each and every rediculous point you make on your blogs. But here are a few points that I am passionate about.
1.) I come from and was trained in New Mexico. Yes it is in this country, but you probably knew that. It is one of (the majority of) the states that requires National Certification and State Licensure. This is not a big ordeal like you make it sound. (The rest of her response is below)
2.) There is ABSOLUTELY NO LINK between prostitutes and massage therapists in New Mexico. (The rest of her response is below)
3.) Massage Therapists need more than 100 hours of training for a million reasons that I do not have time to write about at this time. Touch is a very powerful thing, and yes, it can hurt people. Emotionally and physically if not done with self-awareness, ethics, training and practice. An imperfect system is far better than no system at all - at least until we are all enlightened beings ~ which we are sorely ! far from, my friend.Thanks for listening.
-New Mexico Lady
To which I responded: I will send your entire response to Didi. Would you mind if I sent a copy to Don Shiff a fellow NM licensed practitioner??? I feel confident he would be interested in your point of view. You are the first to call me self-obsessed....I will have to check that out. On a personal level, I am saddened by your attack. I need to go under my cover, hold back my kneejerk reaction and say to myself, "Well...As you know, I am not for everybody and everybody is not for me." It is one of my truths. It is obvious we would have difficulty being in the same room...at least on this level.
Dare to call myself a rubber? Get a sense of humor... What makes you think "rubber" is so bad? It is a title from the Department of Labors Dictionary of Occupational Titles. Women had a chant.."Women unite. Take back the night." I am tempted to run with "Rubbers unite! Take back the right." I have to assume you are one of those who take in "masseuse" as though it were fingernails on a chalkboard.
On a political level, I will continue to blog in the way I blog. I have never been against high standards. It is imposing those standards as law like it is in NM. Plugging into Google using the words massage, massage therapy, etc will get you news reports disproving what you are saying in that the NCE and 500 hours separates us from the sex workers. In many ways it has helped the sex trade enabling folk to hide under the cover of licensing. Tragic but true...Don't listen to me, research it yourself.
I fully agree one needs more than 100 hours of training to be a massage therapist. As a matter of fact, I believe to be a massage therapist once should have 3300 hours as is required in British Columbia. I am ethical and believe I am not qualified to call myself a massage therapist, to me a misleading title, although I have a base of 1000 hours of training, have sat with some pretty heavy duty masters, Barnes, St John amongst others and 20 years of experience.
On the other hand, one needs less than 100 hours of training to do a massage or touch someone for a fee. You really do sound like an Amta officer. I could no more rejoin the Amta than I could convert to Judaism if I had to get circumcised.
Thanks for listening...Now you may hit delete!
------------------------------------------------------------------------
Unfortunately, she never responded to my response. I did take the liberty of forwarding her letter to my friend Donald Shiff. Following is Donald's response to her rant:
Dear Colleague:
My friend Rob Flammia sent me an excerpt of your post to him and asked me to comment. I wanted to make certain I understood your points in their correct context, so I asked for the whole post. He sent it to me without headers to preserve your privacy. I applaud his discretion.
Before I reply on a point/counterpoint basis, let me describe my background in the massage field so that you can better understand my perspective.
I received my initial 1000+ hour training at Heartwood Institute in Garberville, CA in 1983-4. I arrived in Santa Fe, NM in 1985 and worked there for 12 years before moving to Albuquerque in 1997 to finish a B.U.S. degree in Biology at UNM. I've lived and worked here ever since.
In 1990 I worked with an Amta-dominated group to write a licensing law for MT in NM. At the time, I thought that untrained, incompetent practitioners were physically injuring their clients. You see, when I was at Heartwood my mother got a Shiatsu session in Pittsburgh (PA) in which her edematous ankles were mauled with a golf tee. I thought that because my mother was hurt that injuries caused by incompetent practice must be common. In fact, it is exceedingly rare, as witnessed by the fact that liability insurance for MTs is ridiculously inexpensive. In essence, I projected my zeal to protect my mother on the public as a whole, although it took me many years to realize it.
I now believe that licensing MTs in unnecessary and unwise; however, my involvement with writing the law had some benefits. First, I was able to eliminate any reference to professional organizations and eliminate any favoritism towards their members. Second, I was able to create a generous provision for alternative qualifying (practical) experience as a form of education, up to 350 hours of the 650 we required! Unfortunately, that provision was eventually eliminated because it was impossible for those people to take the Nickbatomb exam which the Board later required for licensing. I feel the same way about the elimination of Alternative Qualifying Experience as a basis for licensure that Rob does about elimination of the Massage Entrance Exam for Amta membership. But that's another story, and it's water under the bridge. The point is that I believe that my efforts were instrumental in crafting one of the most equitable pieces of massage regulation that exists today.
While I was at UNM in 1997-8 I discovered the Body_Work e-mail list, which is now on yahoogroups. I was a rabid licensing advocate at the time, but I eventually changed my mind after long, sometimes vituperative discussions with people like Rob, Keith Eric Grant, and Jeff Thetford from FL. I also took the Avatar course, which allowed me to be more honest with myself about my own actions and motivations.
Because I helped write the NM Massage law, I feel responsible for making sure that the Massage Board makes good decisions and has fair rules. I helped write all the Board Rules at one point, including the Code of Professional Conduct, and I go to as many Board meetings as I can. Sometimes I manage to persuade the Board to my point of view and sometimes I don't. However, they always listen to me and value my perspective.
I have testified both for and against licensing provisions at the NM and MN legislatures. At this point, I believe massage licensing is a done deal in NM, and after 15 years the Board is finally getting its act together. However, I believe that licensing is neither necessary to protect the public nor desirable from the practitioner's perspective. There are better solutions to the problems that face practitioners than licensing.
OK, that was a really long biography! Let me answer the points you made in your e-mail to Rob.
You(New Mexico Lady) wrote:
(1) I come from and was trained in New Mexico. Yes it is in this country, but you probably knew that. It is one of (the majority of) the states that requires National Certification and State Licensure. This is not a big ordeal like you make it sound. It simply means that there is a higher standard of education, training, ethics, and accountability for massage therapists. In return they get a MUCH greater deal of respect (and not to mention pay) than "rubbers" from California. People there are shocked when I tell them that there is no licensure in California. I have never heard one person rant on and on about how "they are practically making touch illegal", nor even have any doubt that there should be licensure. "
(Don responds) I don't know your history, but I suspect that you were not practicing massage before NM required licensure. If that's correct, then you are comparing the situation in NM to CA the way it is today and assuming the differences between the two states are the result of licensing. I don't think that methodology is valid. There are vast differences in culture between the two states that have nothing whatsoever to do with professional regulation.
A majority of states require licensure now, but NM was in the minority when we started licensing MTs. The Nickbatomb exam didn't exist. NM adopted it as its licensing exam as a step toward portability when it became available, and when the Federation of State Massage Boards creates its own exam I predict that NM will be one of the first states to adopt it because Nickbatomb will never allow any oversight by the states, which the Board absolutely requires to fulfill its regulatory mandate.
More required education means a great deal of expense to students who may never make a living doing the work. An estimated 80% of massage school graduates are not practicing massage two years after they graduate. Even if that number is 70% after three years, that's a lot of time and effort, much less money, to put into an education that most won't end up using. Massage is a skill that comes more from the hands and heart than from the head. If you have the gift in your hands, then the education can be of great benefit. If you don't have the gift for the work, then no amount of education or training will make you even minimally proficient.
I'm sure you had some classmates who just plain sucked at doing the work. Do you think their effort was worthwhile? How about those creepy guys? Did the six-count- 'em-six hours of ethics the state required when you were in school make them ethical? Weren't they still just as creepy after that class? Didn't you avoid them like the plague and do anything you could to keep their hands off of you? The only people who benefit from mandatory education own the schools. They are the major power in the profession, and they are the major beneficiaries of licensing.
I sometimes need to hire other MTs to work on clients that I can't for a variety of reasons. I have received more massages than I can count from a wide variety of therapists over the years. The best ones were from two women who had no formal training whatsoever. The first one learned by massaging her MS-stricken mother as a child. She was fortunate enough to have been grandfathered into licensure, and I have been trading work with her for the last 21 years. The second traded work with roommates who had been going to massage school. She came to NM later, and she can't work here, even though she does better work than most long-time MTs I know. She probably doesn't want to work as an MT now, but she never had the chance. What's fair about that?
I don't even want to start talking about how widely the quality of the education varies from school to school. All I can say is that I pity the poor therapists who went to crappy schools. It's hard enough to make a living in this field without being handicapped by having wasted 650 hours at a school that would just as soon teach you to be a medical transcriptionist as a massage therapist.
There is some advantage to having a Board for accountability, I agree. However, MN's Health Freedom approach gives oversight without requiring a standardized mandatory education. I think that's far superior to requiring an expensive private education just to see whether you have what it takes to survive, much less thrive, as a Massage Therapist. Besides, oversight doesn't keep people from doing bad things. The scheduler at a local massage school reportedly raped a client at the school last year. Did his massage license keep him from raping the client? Did having a Massage Board speed up his trial and sentencing? Of course not.
According to both the current and former Massage Board Administrators, the overwhelming majority of complaints against LMTs in NM come in two categories: unlicensed practice and sexual misconduct. However, when a client of mine complained that a previous MT had physically hurt her, the complaint was dropped because the Board didn't want to punish the therapist for a he said / she said situation, even though the client submitted her medical records! The burden of proof is very high, and Board members are not trained in adjudicating such matters. If you think it's hard prove physical harm, how much harder must it be to prove sexual misconduct when there's no physical evidence at all? Generally, it takes at least three complaints before the Board feels safe enough to take action. I'm absolutely not accusing the Board of protecting wayward MTs from the consequences of their malfeasance. However, they are risk-averse, so they're unwilling to risk being sued for violating a licensee's civil rights.
I can't speak to the issue of respect given MTs. I was rarely mistaken for a prostitute even back in the 80's when I was just out of school. That may be because I'm a man, or it may be because the population of NM is low enough that sex for sale is not as much of a problem here. However, I do still get men calling me for sexual favors, even though my advertising stresses clinical benefits for people who have been in car wrecks. Sleazy people will assume that you are sleazy. It's not about you. If you are confident in your abilities, then most people will treat you as a professional.
I don't know what MTs make in CA. It's hard to make a living doing massage anywhere. I suspect that any difference in pay, especially at the entry level, has more to do with the availability of workers than with any benefit conferred by licensing. I can tell you what massage prices are like in Albuquerque. If you work for a gym or spa, you can expect to be paid about $15 to 25 per hour plus tips. Private practice rates run from $35 to $65 per hour, more for outcalls. I suspect that experienced therapists like Rob in major CA cities can charge higher rates than I can here. $65/hr. is all the Albuquerque market can bear. Of course, clinical injury treatment billed to third parties is much higher. But that's a specialized niche.
NML 2.) There is ABSOLUTELY NO LINK between prostitutes and massage therapists in New Mexico. Why Not? Who would go through 500+ hours of school and an exam to have an add with a picture of their ass in the back of the Guardian? I can not tell you how many times I tell people here that I am a massage therapist and they look at me like I am a whore. Not that I am against prostitution, I just think it should be legalized so that we don't have to share a job title.
Don responds: I beg to differ. All you have to do is look at the back page of Albuquerque's weekly rag, the Alibi. How about these salacious ads: Healing hands for heavenly bodies. Massage for men by masculine masseur. Mesmerizing massage by Miss Viki. These people are licensed (or at least they claim to be.) They are also prostitutes, and they make a hell of a lot more money than "legitimate" therapists. Why? Because sex sells. If you're making $100 to $300 per hour, the price of a massage education is negligible. In addition, sex workers probably have more time on their hands, so to speak, than most people do to go to school.I do agree that prostitution should be legalized. However, there will still be people doing sexual massage for hire. The only difference is that they will be able to be honest about what they're doing.
NML 3.) Massage Therapists need more than 100 hours of training for a million reasons that I do not have time to write about at this time. Touch is a very powerful thing, and yes, it can hurt people. Emotionally and physically if not done with self-awareness, ethics, training and practice. I have received very bad massages and have heard horor [sic] stories about them from numerous clients. There needs to be a system of accountability. Not that I think the government is excellent by any means at these things, but it is the only system we have got. An imperfect system is far better than no system at all - at least until we are all enlightened beings ~ which we are sorely(!) far from, my friend
(Don Responds) The likelihood of serious physical harm from massage is very, very low. My friend and colleague Keith Eric Grant did a study in 2003 that you can retrieve at http://www.ramblemuse.com/articles/medline_massage_injury.pdf. He concludes "This number of cases of injury found [11 in 39 years] is far too small to be statistically meaningful in estimating risk from massage, except to verify that it is negligible." Mr Grant also concluded that "There is no explicit correlation of the occurrence of injuries with technical training or its lack." A study by a man named Ernst came to the same conclusion. Physical injury from massage is a true rarity, despite dataless claims by Amta and Nickbatomb licensing proponents. You have been sold a bill of goods by liars with a political agenda.
I have received some very bad massages in my time, mostly from licensed MTs. I can't say that any of them harmed me. However, I do insist on trading work with anybody I hire or refer to. Licensing and mandatory education do not guarantee competence. More to the point, Massage Boards are not in a good position to respond to quality control complaints. "S/he gave me a shitty massage" is not actionable. "S/he hurt me" is very difficult to prove, as my client discovered. Massage Boards do not enforce codes of ethics. They do enforce codes of professional conduct, which are essentially list of actions and inactions for which a licensee can be sanctioned. For example, "If you engage in sexual conduct [as defined in these rules] with a client, *and s/he complains about it later,* we can take your license away." If there is no complaint, there is no basis for action. Indeed, several complaints may be necessary to establish a pattern of behavior before the Board can justify a sanction. In their defense, what are they supposed to do when a client complains, "He touched my breast!" and the therapist says, "I did no such thing!" One or the other is probably lying, but which one? They have no way of knowing.
Licensing and mandatory education likewise do not mitigate potential emotional harm. Do you really think that requiring a certain number of hours of ethics classes will keep MTs from molesting their clients? Don't be naive. Unethical people will continue to act unethically regardless of any number of hours of classes. Moreover, sexual predators are remarkably resistant to psychological treatment. While there's a big difference between an MT who can't control his horniness and a child molester, your proposed solution will not solve any problems. Sexual misconduct is a problem in every medical field. Indeed, licensing may lull consumers into a false sense of security.
You may be right that there needs to be some system of accountability. However, an oversight board can be created to manage complaints against practitioners without requiring lengthy, expensive, mandatory education, as was done in MN under their Freedom of Access Act. Massage licensing laws are about power, control, and limiting competition. They do not protect the public from any harm that the marketplace cannot handle. If you don't do good work, you're not going to be in business long. That's just as true for a massage therapist as it is for a plumber. I'd rather have a talented amateur work on me than an talentless "professional" with a license.
Respectfully,
Donald F. Schiff, BS, BUS, LMT, RMTI.
NM LMT #8
NM Registered Instructor #I-112
Stonecircle Massage, Albuquerque, NM
5 March 2006
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SB412 is coming!! It is a foot in the door for licensing in California. Let's let folk know we don't want or need it. More within a day or two.
posted by Rob Flammia | 8:17 PM
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