Pandora's Box? Licensing Massage
by C. JeAnne Frey, CMT
25 August 2009
In 1998, 21 states and the District of Columbia had massage laws in effect, with 7 more pending. That number has now grown to 42 plus DC, which might be part of the reason I haven't seen a discussion among body workers about the pros and cons of licensing in some time. Lately, I've been missing that debate.
In Maryland, where I was living when I started professional massage training, statewide massage regulations had already passed and would go into effect several months after I and my classmates graduated. Because licensing in two of the three places students attending that school were likely to practice was already a done deal, our training steered us toward getting licensed. For the few months between graduation and the law going into effect, I had to deal with a different license for every county, which was, to put it bluntly, a pain in the posterior.
When the state law did go into effect, I was pleased to have one place to write a check to instead of four, and the consolidation of paperwork as a mobile massage therapist made my life somewhat easier. Given the choice of several sets of regulations to be mindful of or one overarching code, I was more than happy to have the state license body workers. After all, I'd never known any other form of practice. Others spoke about the days before regulation. To me and other brand-new massage providers, that was like our parents or grandparents talking about the days before television…it was outside of our experience. To some degree, we thought we could understand. It sounded either like the good old days they said it was or it sounded like being without creature comforts we were accustomed to, depending on our position. Either way, we'd known from the start of our training that if we wanted to practice openly, we would have to submit the paperwork, write out the check, and be ready for audit just in case one day we became the one out of 300 or so selected for review by the licensing board.
The most frequently cited reason that I've seen for enacting laws requiring massage providers to be licensed is "public protection." The brief form of the story goes something like this: people who haven't been properly trained could injure their clients, so a license is needed to protect the public from these unskilled intuitive touch providers. (Uh-huh. Right.) States make money off of licensing programs. I personally don't believe for a moment that the cost of administering licenses isn't met by the fees collected, especially in places where all licenses expire at the same time, regardless of the application date.
Most of the massage therapists I knew who were in favor of being regulated when the law in my state was still being debated were of the opinion that having a license would legitimize the field. Yes, massage has been a legitimate practice for millennia and doesn't need the government seal of approval to verify that. Yet anyone who thinks there aren't people out there who are still confused, misguided, or worse about what massage is must be living in a very different world than most of us. The idea was that having a legal definition of what massage was and a list of approved providers would stop people using massage as a front for other activities. I agreed at the time that enough press about what massage really is might reduce the number of harassment calls massage therapists receive.
Sadly, the local TV news stations were more interested in publicizing the massage parlors that were shut down for being fronts for prostitution. While those working at these places could be charged with "impersonating a massage therapist," the stories very, very rarely mentioned that there was a law, let alone that the law required massage therapists (our legal title, and that's fodder for another subject entirely) to have completed a certain number of hours of training. Certainly the stations had no interest in specifying that licensed massage providers do not engage in a wide variety of acts, including operating outside our scope of practice. Examples of what we don't do range from the prostitution they loved to broadcast to entering into the medical territory of diagnosis. Perhaps I'm wrong on this, but I can't imagine anyone would expect a sex worker to tell them if their spine was out of alignment. Acknowledging that many of us working outside of the most clinical of settings still offered clinical work apparently didn't fit into the three and a half minutes set aside for such stories. That the vast majority of us are practicing what is, admittedly, an old profession, but is hardly the oldest profession wasn't racy enough to sell advertising. Once again, I've digressed.
I now have the option to allow my license to lapse, if I so choose. What passes for licensing where the majority of my practice is boils down to title protection for the terms "massage therapy" and "massage therapist." If I or any massage provider drops the "T" word in any form, we are free to practice at will…at least for the time being. That said, personally I have no intention of allowing my license to lapse. It's easier to stay current than to reapply later, and I do enjoy the security (real or perceived, it matters not to me) of being able to say "I'm a licensed healthcare provider…how dare you ask me to engage in sexual activity!" Besides, I worked hard in my initial training, in studying for the national certification exam (another topic in and of itself,) in continuing education classes, and in building and maintaining my practice. Those of us who make it in this field do, regardless of what some ads for training programs I've been told about imply.
I'm still considering what it says about me that I have such a love/hate affair with statewide regulation of massage therapists. In general, I'd like to see governments, be they federal, state/province, or city/town stay out of people's private lives. For all the talk in recent years about how laws governing businesses in the U.S. have become lax, certainly my business hasn't been given free reign. I can't say that I believe we're better off as body workers in the U.S. since the number of regulation states has nearly doubled. (I'd love to know how it is for massage therapists in Canada and elsewhere, should anyone care to comment here or at the forum.) While massage has grown in popularity with the general public during that time, I don't believe for one second it's the laws that can take credit for that. Credit for more and more people choosing massage each year goes to the massage providers themselves and their clients who have spread the word.
It doesn't seem at all likely that any jurisdictions will repeal their laws regulating those of us who touch for a living. While I certainly don't advocate breaking any laws, review and questioning the benefits of massage regulation might well be in order.
Next time: Massage licensing's impact on massage education.
C. JeAnne Frey has been a Certified Massage Therapist since 1999. She operates her private massage and energy work practice, Treat Yourself Right! Massage and Bodywork, in Charlottesville, VA. She can be reached at jeanne@tyrmassage.com.