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Beyond Common Sense . . . MT Research

We all know how good MT feels. But relatively little money and energy has been invested in a healing art which comes without known side-effects. Even the few widely-spread counterindications for MT are laregely based on vague, unchallenged ideas, and are not universally accepted. Very late and far too little, nevertheless, signs of a more scientific interest are sprouting everywhere.

ASSOCIATED MTs NEAR YOU(sm) invites research instituitions and scientific publications to share such literature by E-Mail: mt@infohouse.com. for future publication in this area @ MASSAGE THERAPY WEB CENTRAL.

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Pratice Issues For Present and Future LicMTs
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Health Issues For Body-Minded Interanuts In this expanding collection of articles, MASSAGE THERAPY WEB CENTRAL brings you a variety of issues and ideas, the goal being to inform, stimulate, and motivate massage therapists towards greater appreciation of their healing art and towards greater professionalism.

We invite fellow LicMT to submit ideas, articles, and commentaries by E-Mail: mt@qwl.com. for future publication in this area. And, when accepted, we reserve the right to edit submitions for length and clarity. [When you send a proposal, please include your background and qualifications regarding your proposed piece.]

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By Chris Connors (1996)

In an emerging industry where, as yet, few boundaries have been clearly set between massage therapy practiced as a health profession and the commercial massage variety, the hot current debate about the value and necessity of a professional state license is one of many signs of the deep investment (economic and otherwise) which practitioners located in every corner of the "massage industry" map feel they have in this ancient, great, yet troublesome healing art.

What in the 90's seems to aggrevate this debate is the growing perception of the imbalance of influence between those who make their living as massage therapists versus those who make a living offmassage therapists in favor of the latter. The two groups do not necessarily share the same interests, and even their initial motivation can be worlds apart. And while more and more practicing massage therapists are beginning to realize that they are not fully recognized health professionals, they have often been misinformed about what will advance their status, earning power and work-satisfaction.

Many massage therapists, for instance, have been wrongly led to believe that the massage therapy license is a private agenda of a particular professional organization rather than the public policy matter that it actually is. And many, including licensed MTs, are under the misleading impression that a national certificate issued from within the profession has a legal status equal to (if not greater than) a professional state license! It is little wonder, therefore, that some massage therapists, have been misled to believe--sometimes by the newer commercial massage therapy associations' officials--that their professional state massage license is nothing more than "just a piece of paper..." with little hope of ever becoming what it has been for all other state licensed health professions.

But is the MT license in fact "just a piece of paper..." ? Well, it certainly is not to all those who have worked so hard and long to bring about the passing of state licensing laws. Not to those who have worked so hard to change the long-standing demeaning sexist title to the appropriate gender neutral "massage therapist." Not to those--like the MTs in the state of Maryland, a state which has just passed its MT licensing law- who for more than ten years were faced with Cease and Desist orders initiated by other health professions. Not to the people in the state of Washington, where licensed massage therapy sessions are now covered by health insurance. Not to ASSOCIATED MTs NEAR YOU(sm)--a professional network of present and future licensed massage therapists (LicMTs) dedicated to ethical promotion, mentoring, and advocacy. Not to anybody with far-sighted professional and economic vision.

In most established health professions, their practitioners have to be state licensed, and practicing without a professional license is a felony. Although never a fool-proof 100% guarantee of the quality of service rendered (although in the case of Massage Therapy, the process, especially the licensing test, can--and should--be updated and improved), a state license is and remains the most fundamental credential protecting the consumer from the practice of a health profession learned as a hobby by watching a videotape or taking a weekend course on the subject or from the purely commercial, assembly-line salon type of practice. Indeed, the most readily recognizable professional credential in the US and elsewhere, a license to practice, is the most likely vehicle to usher in badly needed third-party coverage for professional-quality MT services and the funding for equally important research on the subject validated by a cross-section of research institutions.

For the above reasons, combined with an undoubtedly re-tooling and down-sizing of our US economy, a state license is in the best interest of present and future massage therapists who are interested in a professional-quality worklife. It is this that can allow practitioners to flourish in their private practices and open up meaningful job opportunities in recognized professional-level health institutions such as hospitals and research centers for others. Because the expense of a state license is picked up mainly by the tax-payer, it is the least expensive way for massage therapists to achieve the above goals. No less important, state licensing is the most democratic way to regulate the profession. Unfortunately, too few massage therapists realize that if, for instance, we donžt like a particular licensing test, or if we would like inter-state reciprocity (which ideally we should have), we can speak up and do something about it. As citizens, we have the constitutional guarantee of free speech!

With tremendous public interest in bodymind healthwork, with massage therapy being one of the three most used alternative forms of healthcare, and with more than twenty states in the US already requiring licensing, (and that trend is only growing), there is no doubt that it is the efforts and well-earned achievements of those who are licensed that are substantially responsible for the growing professional legitimacy and acceptance of MT. (It is in that light that it is little wonder that Washingon, a state under an MT licensing law, was the first to offer coverage for MT services.) And there is little doubt that no health profession has ever claimed its legitimate place on the map of the healing arts without its accomplishing state-by-state regulation until nationwide. Clearly, MT--as a profession--is heading in this direction. It would therefore seem that celebrating and actively promoting licensed massage therapists be it through its oldest national professional association, AMTA-- hopefully with active help from all other professional massage therapy organizations-- is only the logical course of events. One easy and effective way to start is by listing state licensed massage therapists with their professional designation--LicMT--after their names. Todate, only ASSOCIATED MTs NEAR YOU(sm) is publishing such well-deserved public info in its print Directory and in its online Directory.

Strangely enough, LicMTs is the one group of practitioners which has been sorely overlooked and neglected. And while more and more unsuspecting young people are being attracted to MT schools and lured into non-professional, commercial work settings with the promise of a "career as a health professional," it is actually becoming more and more difficult to develop a massage therapy career, that is, a career as a LicMT. Ironically, precisely at a time when the demand for legitimate massage therapy is on the rise and more MT licenses are being issued every year, the LicMT, the committed practitioner--believe it or not--could become . . . an endangered species.

Painful as it is, whether from exaggerated promises to unrealistic expectations, from not enough education to the state of the economy, from a growing exploitation of LicMTs by the Beauty and Fitness industries to the serious attempts (by some physical therapists, chiropractors, and nurses) to appropriate MT as a mere specialty of another health profession, LicMTs are not as thriving as they should be.

The hard-tissue chiropractic modality has shared some of the status-related problems which massage therapy, its much older soft-tissue counterpart, still very much has to wrestle with. Chiropractors, however, never took a "let's wait and see and just talk a lot about it" approach. Can anyone imagine chiropractors seriously getting together to discuss whether or not they should all be state-licensed? Of course not. Only massage therapists--under a clearly commercial influence and against their own professional interest--still do.

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By Alessie Astrogano (1996)

NY--In the Fall issue of AMTA-NYS IN TOUCH newsletter chapter, President Pat Donohue, LicMT, issued an invitation to AMTA members to express themselves fully on the subject of the revision of the current definition of "Massage Therapy" in the NYS law. Now that's the kind of freedom of speech which is always desirable. Freedom of speech, certainly, was high on Bruria Ginton's agenda when (in 1980) as NYS Chapter president, she created AMTA's first state newsletter. And, surely, all LicMTs, AMTA members or not, should make themselves informed on the issues involved and should make every effort to accomplish the changes that will most benefit all MTs, present and future, and, hopefully, also usher in reciprocity of our MT license across all licensing states.

The time has always been right to stress the concepts that will, if effectively implemented and supported by MTs everywhere, move individual licensed MTs forward toward the professional success that their training efforts (and thousands of dollars in schooling costs) so strongly justify. Actually, these concepts are indispensable if licensed Massage Therapy is to remain a viable, self-maintaining profession in the face of, yes, ever-mounting illegal, winked-at, and very unfair competition. Unlike most massage therapy organizations, ASSOCIATED MTs NEAR YOU(sm) has from its very start been straight forward in its unequivocal support of a nation-wide network for the promotion of a legal, state-licensed status for all qualified MTs--even if, to accommodate the particular needs of an individual state, the details of such efforts are understandably worked out at that state level. For this, indeed, a more precise, more encompassing definition of MT is required.

As for revising the definition , Ginton's suggestion--very close to Donohue's proposed revision--is as follows:

"Massage Therapy is the bio-mechanical manipulation of soft-tissue through the implementation of intentional, structured, and studied assessment and touch, incorporating one of/or a variety of Western- and/or Eastern-based approaches for purposes of prevention, rehabilitation, and healing. Massage Therapy includes the use of passive exercise and passive stretching, heat, cold, hydrotherapy, heliotherapy, electro-mechanical devices, herbal applications or chemical preparations, and neutral or aromatic lubricants."

On the books, the practice of massage--in any form--without a license in New York State is a felony. Why not a campaign by LicMTs for the enforcement of this vital (toothed) provision of the law--to make it bite! Why shouldn't consumers have the right to benefit from a law which was initially written for their protection? And when will LicMTs begin to report to their State Office of Professional (mis)Conduct all the unlicensed--illegal--practitioners who undercut them in so many ways--in their pockets as well as in their professional status and future success? Can anyone imagine chiropractors or other doctors conducting long debates about the value of their state-licenses? Of course not! Or failing to report unlicensed practitioners?

Just like Donohue, Ginton too has been doing massage for more than 30 years. In the first 15 years, however, said Ginton: "Massage, for me, was only a much appreciated hobby related to my athletic activities as a girl and a young woman. In 1978, I decided to become licensed and to practice massage as a licensed professional. MT was no longer just a hobby." And, unlike Donahue, Ginton emphasizes, "I have never considered it a trade."

Would it be OK for Ginton--after 17 years of professional practice as a leading massage therapist with an international reputation to come up with "The Gintuina"(sm) or "Gintossage"(sm)" or just the "Ginton Method"(sm)"? Yes, that would absolutely be OK. Would it, however, be OK for her to then say: "Now let's forget the MT license. It's too much of a nuisance. I'm not doing massage any more. Why, I'm doing something unique and different. I'm doing the new and original 'Ginton thing.' I can then make much more money teaching 'it' to the general public and telling everybody not to worry about the massage therapy license . . ." Would that be fair and square and legal? Certainly not. "I can a1so assure you," adds Ginton, "that although--when I get to it--I may very well teach my method, I will not do it outside the profession, against all my duly licensed MT colleagues, pretending, while doing so, that I am bringing 'peace to the world'--all the way to my bank . . . "

Most important, now is the time (if ever at all) to mount a well-financed campaign for the right to Third-Party Payment for massage therapy as a duly recognized health care modality under the law--already in over 20 states and growing! With the sky-rocketing costs of conventional medical care today, there shall never be a more opportune time than the present to make the case for massage therapy, the preventive and healing art without side-effects--or scandalous costs! And this is a concerted approach that all MT organizations should be making--in force--to all third-party payers!

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A VIABLE MT PRACTICE: Reality Or Illusion?
By Associated MTs NEAR YOU(sm) special correspondent (1995)

When given a chance to talk about it, most licensed massage therapists (LicMTs) will tell you that they want to work in a professional setting such as a private or group practice. They want to be respected as hard working health professionals and to be appropriately compensated for their work. They want to be able to afford an apartment, a car, a vacation now and then, support a long-held artistic interest or a special hobby . In short, they want a decent life. That's what being a licensed health professional should mean. In reality. Few, however, have been fortunate enough to earn a decent living as LicMTs or enjoy the quality of their work life. Indeed, many LicMTs end up working in locker rooms and beauty/rubbing salons, where they serve a purely commercial interest--not their own and not a truly professional interest. Others are on the exhausting house-call, schlepp-a-table circuit. Many LicMTs are in debt, a growing number still live with their parents, and few can secure a solid reitrement plan or save for the future. Many do not even have health insurance, not to mention any disability plan. And as a result of such "assembly-line" work, a growing number of LicMTs succumb to a variety of chronic, eventually debilitating repetitive strain injuries.

Starting out, most licensed professionals in other fields are likely to work for well-established, more experienced colleagues, where they can comfortably learn the business aspects of their field while "paying their dues" and "working their way up" in a professional setting. Such settings are often places where they will meet a mentor who becomes a trusted and inspiring colleague, someone who is usually available for prorfessional advice, general support and perhaps even for future partnership. For LicMTs, regrettably, such opportunity rarely exists. "A mentor?" most of them will ask. "What is a mentor?"

After ten years in the profession," says a LicMT who prefers to remain anonymous, "I had to return to the assembly-line at a beauty salon. It's pretty awful. It certainly isn't why I had become a licensed massage therapist. My stomach turns and my self-esteem drops each time I accept a tip, but right now it's seems as though there is no other choice. I am thinking of going back to school to study PT. PTs can at least work in hospitals. Of course, I believe that there should be, but there are no real professional openings for LicMTs."

When asked why she felt that she had no choice, this LicMT continued, "I look around at the other LicMTs who work with me. They are all nice people, really. The young ones think that they will do cosmetic massage work only until they pick up enough clients and then go on to open their own practice. But I already know that it doesn't work out that way. When more and more people offer bodywork without being licensed, when professional settings are very rare, when the public has not been informed about the difference between the professional and the beauty/rubbing settings, how can we ever compete with the mega-promotional budgets of the 'beauty and fitness' industry? As for the the older ones, well, they have pretty much given up trying. Their acceptance of this reality, of low but steady income and quiet desperation, keeps them going. We all realize--actually--that by working for these establishments we are supporting them, not the other way around, but it seems too late to change. If we had only been informed when we started out . . . . . ."

Founder of ASSOCIATED MTs NEAR YOU™, Bruria Ginton, LicMT, has been studying the economic infrastructure of massage therapy ever since, in 1989, she opened her own professional Healing Arts and Workshop facility, QWL SPACE. With an undergraduate degree in marketing research and graduate education in organizational behavior under her belt, she went to the library only to discover that there were no professional or business statistics on MT. "From the standpoint of the USA economy, it's as though the profession didn't even exist," she recalls. Later on, she uncovered two other facts which indicate that MT has been more of an exploitable commodity than a respectable and enduring health profession: Very few MTs are reported as tax-payers because, obviously, most of them do not turn a profit, and although hundreds of new MTs graduate from MT schcools, the profession, as recorded by the NY State Board of MT, does not reflect that growth. That means that many LicMTs burn out and leave the profession.

"Today," says Ginton, "MT is at a cross-roads. Many of us who have been involved in upgrading the viability and image of MT as a profession--including the title change from the sexist masseur/masseuse to the gender-neutral professional Massage Therapist--now realize that a professional title alone is not enough for overall success. Typically, MTs are to drawn to the profession as a way of being part a wonderful healing art, a way of self-expression and "doing their thing." Very few notice that a professional infrastructure is badly missing, that commercial trends dominate the profession, and that, in a shrinking US economy we will continue to have, at best, a beautiful hobby and, at worst, a sweat-shop type of existence, good for a few years but not conducive to the development of professional pride and satisfaction." To break the "glass locks" on the gates of professional success, Ginton and her professional supporters continue their campaign to inform the public about the difference between professional-quality massage therapy and the "assembly-line" in a responsible hype-free way. "ASSOCIATED MTs," explains a licensed MT who has been working for and with Ginton for a few years, "is the first promotion co-op that's addressing my urgent need to increase business in a dignified yet affordable way. I don't want to get into "cosmetic" massage. I want to do serious bodymind healthwork. Long ago, Bruria convinced me to join the American Massage Therapy Association (AMTA), always pointing out the importance and achievements of a national association. But today, AMTA serves so many different interests, the schools, the seminars, the certificates, the products, you know, that LicMTs like me don't feel that our professional economic needs come first. Ironically, for me, MT was meant to provide a more stable source of income than, let's say, show business. . ." I agree, says another co-founding member of ASSOCIATED MTs. "As a professional network, ASSOCIATED MTs is small enough and toatally focused. When you join, you no longer have to wonder if your professional license actually means very much . . ."

ASSOCIATED MTs NEAR YOU™ intends to keep up a steady flow of communication so that eventually all MTs and the industry's truly supportive institutions will benefit from its serious effort.

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