To The North Carolina Massage Board, 

My name is Larry Green and I am a NCBTMB provider and a member of the N.C. Coalition of Massage and Bodywork Instructors. 

I understand the board is considering changes to massage CE approval and oversight. I have been told we are invited to comment, although without a clear understanding of what it is we are to comment upon, it is hard to know what to write.

What problems currently exist should be publicly presented so the profession can respond about if these perceptions are valid. Allowing the whole profession to be made aware of them, and give input about upgrading the process, would be the smartest way to address any current shortcomings.

I have been told the original justification for changing CE approval and status involves that NCBTMB is somehow ‘unfit’ to be in charge of overseeing state safety enforcement, since the NC Massage Board has no ‘oversight’ with NCBTMB. And that the NC State Massage board somehow has some oversight over FSTMB. 

This does bring up a few questions- 

In a series of emails with Rick Rosen, and the chance to hear him speak about this in person, Rick says that Dale Atkinson, a well respected attorney wrote the opinion that NCBTMB was not properly qualified to serve the function of CE oversight. Mr. Atkinson was hired by FSMTB in a capacity to provide legal advice as FSMTB appears to be trying to supplant NCBTMB in this area. Mr. Atkinson may have a sterling resume, but as a hired lawyer to represent one side in a legal situation, his ‘legal opinion’ should be considered as just a paid legal opinion on behalf of a client looking for a legal justification. 

Has this opinion of his been held up in any court? If not, before a state board would act upon it the board should ask the state Attorney General’s office to weigh in on the validity of this position. Of course the NC Massage Board has a lawyer in Charles Wilkins. But Mr. Wilkins, in his position as board administrator, puts him and anyone in his law firm in a position to benefit from board decisions. I assume Mr. Wilkins would want to avoid any perception of impropriety (even if none existed) and would agree that should eliminate him from providing any conclusive ruling on this. It would make everything much cleaner for the board to have an outside legal ruling from the A.G’s office before the board acts on a recommendation from a hired consultant for the Federation.

As for the position that Dale Atkinson is promoting, as I understand it he claims any outside non-profit organization that has no accountability to the state institution tasked with protecting state citizens (in that area) is not acceptable legally. However, I find his argument not true already. There are many industries that self-govern their own safety standards and this is accepted by states and the federal government. For example the NCCAA is an independent non-profit that governs safety standards for college sports, like football. Clearly an area more likely to cause harm than massage. Yet the states already allow this outside non-profit agency to govern their state institutions and set safety standards. The state of NC had no input into the make up of the governing board for the NCAA. 

If Mr. Atkinson’s logic holds, then all states will be required to pass many new laws governing who can certify safety standards for products and services like baby car seats, bike helmets, flotation devices and more. Even lifeguards, certified by the American Red Cross, who are required by state law and paid by state funds at public beaches. Every state law passed to protect the public will require that outside safety rules, testing and approval come only from organizations that each state must have ‘oversight’ with.

I am not sure the current Republican leadership in our state would embrace this approach. If this is the legal lynchpin that you believe requires the board to make changes, I think you are obligated to share the ramifications with current elected state leaders and let them know that many other things will require re-examination in light of Mr. Atkinson’s opinion. This alone would be an excellent reason to have the A.G.’s office vet and publicly comment on Mr. Atkinson’s opinion. 

It may be that the NC Massage Board can choose to change it’s CE oversight from NCBTMB to FSTMB on a whim, not requiring a legal justification. If Mr. Atkinson’s legal opinion does not hold up, then to promote transparency I hope the board will publicly explain to the profession and the public what is the reasoning behind any plan to switch.

If the goal is to oversee quality CE classes, jumping from a proven provider of 20 years (NCBTMB) to a completely unproven and inexperienced provider (FSTMB), who has indicated they may not be interested to do the job of overseeing CE providership, seems imprudent. They have no track record and have not provided the public or the profession even an outline of what they intend to do for provider oversight.

 

If the goal is to develop the best standards then a three year period of using both organizations as providers would allow for continuity and give the board time to see if FSMTB is up to the task and can demonstrate they are better than NCBTMB. This should not be such a revolutionary idea as the board already allows more than one oversight organization to grant CE providership (NCBTMB and NCCOAM as per the current board rules.)

 

If the board does have a period of using both NCBTMB and FSTMB as providing CE oversight, then in advance benchmarks should be set up and made public to evaluate which, if either organization, is actually providing a competent job. 

Making the claim that because the state of NC is one out of 33 states governing the Federation, therefore the state of NC has oversight to FSTMB decisions does not hold water.  The Federation could vote to do something contrary to our state board's wishes, even something the NC board might find inappropriate. Yet if they allow the Federation to set the standards the state board is still relinquishing their true oversight. 

From where I sit this appears to be part of a power struggle going on in massage and most of us do not know all the issues, players and agendas. A few years ago there was a board struggle within the NCBTMB board. Members who opposed changes resigned or were kicked out and wrote public blogs/posts about it.  http://www.ramblemuse.com/mps/documents/NCBTMB_LeadershipCrisis.pdf

 

I did not follow the story closely. I heard that the remaining NCBTMB board was planning (at least in part) to provide services like ABMP.  Stepping on ABMP's turf. The founder of ABMP in response initiated the move for state boards to create an alternative to NCBTMB.  www.abmp.com/les-sweeney-blog/2012/03

I imagine various people who were involved will have differing viewpoints on the events. I am only aware of this from the periphery and do not know much detail.

 

The recent announcement by FSTMB to create 'uniformity' in massage laws looks to me like they are trying to supplant NCBTMB. FSTMB's document only lists them and does not mention NCBTMB's current status or position. You can read the document here.      http://www.abmp.com/downloads/Model_Practice_Act.pdf   

 

This FSTMB Model Practice Act indicates massage should require anyone teaching massage continuing education to get some teacher training certification. Remarkably no other profession requires that for CE’s and CEUs. My friend and student, Dr. Pat Schreiber, Ph.D in education, former Director of Training and Staff Development for Forsyth County School Systems, says that to offer CEUs to public school teachers does NOT require any formal training or certification in how to teach. The same is true for college professors, and people who offer CEUs for CPAs, lawyers, nurses, P.T.s, O.T.s, D.C.s and M.D.s. If massage moves in this direction the one thing that will happen is many of the best qualified experts in many allied fields will not be able to teach massage therapists!

Also in this Model Practice Act, the justification (rational) and the proposed wording for 'model' state laws looks potentially like a push to sweep all (or as much as possible) energy work into massage. As someone who does and teaches energy work, I am not interested in massage claiming I am under them, or they are in charge of me and my work without even consulting me and my colleagues. Energy work is different than massage. A recent survey of massage therapists found 44.1% include some energy work in their practice. I think it is great if individual massage therapists want to broaden their practice beyond just soft tissue manipulation. It makes sense to me because it is effective.

The Model Practice Act language and the rational are intentionally broad and specifically promote that no exemptions should be in the law. In NC the law currently says that if your intention is to impact the energy system you are exempt from the massage law. For people who do Healing Touch, Kinesiology, Reiki and many other current and emerging systems who have not been invited to participate in this potential expansion of massage, we would not be interested to be taken in without consent and participation. If massage is interested to pull energy work under them, the ethical thing would be transparency and inclusion in the process. If the Federation or any state boards are not doing this, then all the talk about being in charge of 'ethics' falls short. 

I was first alerted to this ‘attempt to take over energy work’ by another practitioner from a different system. When I read the Model Practice Act I saw that it could be seen in the light she saw it. I am hoping that is not the case, and that it turns out to be merely a situation were the Model Practice Act says things that could be misconstrued, and that in fact there is no intention to do this. If the board would be willing to publicly state that there is no intention to make energy work part of massage, I believe many people, including the board, can avoid the kind of struggle and suspicion that serves no one.

 

I do have an idea of how to improve CEs for the field.

Whoever is overseeing this area ( NCBTMB, FSMTB or another entity) could create an online, open evaluation system. Let anyone who has taken a CE class be able to go onto the site and rate the class and instructor, similar to how Amazon has people rate books. Then everyone could see how well previous students felt about the class. This would help everyone in choosing future classes.

There would need to be a way to create some anonymity for each person who enters a rating, and a way to ensure only people who actually took the class are able to post a rating once. This would do a great job of weeding out poor instructors and poor classes, and insure that higher standards in continuing education were naturally evolving and being overseen by the entire field, rather than only a small group of appointed experts.

 

It could even include (possibly) that this form was required by every CE participant for class completion. By so doing a database would be able to tell each licensing board immediately who actually has attended CE classes and who has not. This could save boards a huge amount of work. It would be the responsibility of each MsT to input their classes and then match it with a roster from the instructor. That way people could not falsely claim to have attended a class (because they are not on the instructor's roster), and no one could post negative ratings onto an instructor's classes just to make them look bad.

I am sure there would some kinks to work out, and input from multiple people would improve the concept. 

Thank you,

Larry Green