From sleaze to prestige

Along with the new millennium has come a whole new breed of health-care providers. Once more or less equated with topless bars and even prostitution, massage and bodywork therapists have finally escaped the label of “adult entertainment” (and the jurisdiction of the vice squad) to find their proper place among their true peers — physicians, chiropractors, acupuncturists, nutritionists and physical therapists.

Legislation passed in 1998 requires anyone practicing massage therapy or bodywork in this state to be professionally licensed by the North Carolina Board of Massage and Bodywork Therapy. The board painstakingly established thoughtful rules for professional licenses, and tough standards for schools offering massage-therapy programs. All massage therapists must obtain their professional licenses by Dec. 31, 2000, or they will no longer be allowed to practice in the state of North Carolina.

To help readers understand the law’s nature and scope, I have selected several items from the North Carolina Massage and Bodywork Therapy Practice Act, General Statutes, Chapter 90, Article 36: Rules and Regulations of the Board, Administrative Code, Title 21, Chapter 30:

Section 90-623. License required.

(a.) A person shall not practice or hold out himself or herself to others as a massage and bodywork therapist without first applying for and receiving from the Board a license to engage in that practice …

(c.) It shall be unlawful to advertise using the term “massage therapist” or “bodywork therapist” or any other term that implies a soft tissue technique or method in any public or private publication or communication by a person not licensed …

Section 90-634. Enforcement; injunctive relief.

(a.) It is unlawful for a person not licensed or exempted under this article to engage in any of the following:

1. Practice of massage and bodywork therapy.

2. Advertise, represent, or hold out himself or herself to others to be a massage and bodywork therapist …

(b.) A person who violates subsection (a) of this section shall be guilty of a Class 1 misdemeanor. (Note: A Class 1 misdemeanor is punishable by up to 45 days in jail and an unlimited fine determined by the court.)

(c.) The board may make application to superior court for an order enjoining a violation of this Article. Upon a showing by the Board that a person has violated or is about to violate this Article, the court may grant an injunction, restraining order, or take other appropriate action.”

As you can see, this is pretty serious business, and it should be. Would you choose to be treated by a physician who wasn’t licensed? Of course not. Would a physician capable of satisfying the relevant standards jeopardize his or her career by not obtaining a professional license? Of course not. Would a school choose to graduate inadequately trained students and thereby prevent them from becoming the licensed professionals they desire to be? I should hope not!

Who benefits from these strict new laws? Everyone. First, let’s address the client. Massage therapy has evolved from a collection of simple relaxation techniques into a diverse array of highly refined, result-oriented therapies. In addition to basic Swedish (relaxation) massage, we now find neuro-muscular therapy for deep-tissue-related work; lymphatic drainage massage, which helps detoxify the body; sports massage therapy, catering specifically to athletes; pregnancy, infant and geriatric massage, with all the indications and contraindications appropriate to those groups; Chinese acupressure (shiatsu), which affects the body’s energy meridians just as acupuncture does; and many others. Approved massage schools are required to offer in-depth education in anatomy, physiology and pathology. The scientific element of massage-therapy programs is as important as the massage techniques themselves. The body is being treated physically and quite directly, so it’s extremely important to know not only where the muscles are, but also the veins, arteries, lymphatic vessels, nerves and organs. There are hundreds of indications and contraindications for massage therapy and bodywork. An under-educated massage therapist could cause serious injury to any part of the body, just as a surgeon could if he or she lacked a thorough knowledge of human anatomy and physiology.

Next, let’s consider the therapist. The days of “intuitive” massage are over; it’s no longer possible to take a weekend workshop and promptly hang up a massage-therapy shingle. Today, licensed massage and bodywork therapists have achieved a new level of distinction, respect and professionalism. Insurance companies are beginning to cover these services, and while many bodyworkers will choose to remain “cash” practitioners, some will now be able to offer insurance work, allowing those who can’t afford to pay the full cost themselves to benefit from massage therapy. Under these conditions, massage therapists will more readily gain the respect of other licensed health-care professionals, encouraging cross-discipline collaboration and helping referral networks grow. Practitioners’ self-esteem will increase, knowing that they’re able to satisfy the high standards required by the state board, and being licensed professionals will help inspire confidence among the general public.

And then there are the massage schools. Graduates of schools that have not been approved by the state board are not eligible for a regular state license. Approved schools must satisfy extremely stringent requirements — closely following COMTA (Commission of Massage Therapy Accreditation) standards — regarding curriculum, educational staff, administrative staff, finances and facilities. Our new laws have significantly raised the bar on the quality of education for massage-therapy students. State-board-approved schools can be proud of the education they provide, and their students will graduate with confidence, knowing they received a first-rate education.

We all need to take some responsibility to uphold this new level of professionalism. Clients need to make sure they’re being treated by a licensed massage bodywork therapist. If you’re seeing a therapist who’s not yet licensed, encourage him or her to apply for a license. If they aren’t licensed by the deadline, seek out a licensed professional instead.

Therapists need to take all the necessary steps to become nationally certified and licensed by the state board. Careers are at stake, as are professional reputations. Any therapist, however experienced, who lacks the educational credentials needed to meet national and state requirements, should strongly consider seeking additional education. I know a very talented local massage therapist who had been practicing for 20 years. But because she was not nationally certified, she was denied her position as massage therapist in a downtown business. Resentfully, she enrolled in a massage school for additional training. But when she graduated, it was with gratitude and appreciation for the higher level of education she’d received, and a tremendous amount of pride for having taken responsibility for her career. She is now nationally certified and has applied for her state license. The whole certification and licensing process takes about three months.

Approved massage schools need to maintain the highest educational and professional standards to help ensure their graduates’ continued success. As an ongoing resource for knowledge and support, schools must stay informed — both about issues affecting the profession as a whole and about those impacting individual graduates. Schools should thoroughly educate their students on the relevant laws, encouraging them to uphold the law in every respect.

Admittedly, there has been some debate about the idea of regulating this profession. But I have attended many state-board meetings in Raleigh, and I must say that the North Carolina Board of Massage and Bodywork Therapy is one of the hardest-working, most dedicated groups of people I have ever encountered. Passionate about every aspect of this profession, these folks have written rules and regulations designed to protect the general public, massage therapists and massage schools alike. Rather than unfeeling state bureaucrats, I’ve found loving, caring people who have all our best interests at heart. Rather than feeling that someone is looking over my shoulder, I feel I am being looked after and held accountable in my chosen profession. Yes, it causes us to work a little bit harder and costs a little bit of money. But I, for one, feel much more secure in this profession now than I ever did with the vice squad looking over my shoulder.

Peggy M. Huff is the president and CEO of PMG HealthCom Inc. and the Center For Massage & Natural Health, a fully state-approved massage school and therapy center. For more information or to find a licensed massage and bodywork therapist near you, contact the Center For Massage & Natural Health at (828) 252-0058 or visit their Web site (www.centerformassage.com). To apply for a license or obtain a copy of the Practice Act, contact the North Carolina Board of Massage and Bodywork Therapy in Raleigh at (919) 546-0050 or visit their Web site (www.bmbt.org).