MLN Vol.12.No.1

Massage Law Newsletter

Vol. 12,  No .1                                  ISSN 1073-5461                                      October 1999   

CORRESPONDENCE WITH WILLIAM A. PHILLIPS ABOUT

REGULATION OF MASSAGE THERAPISTS IN PENNSYLVANIA

Albert Schatz, Ph.D.

To: William A. Phillips

Central Unit Representative, Pennsylvania Chapter, AMTA (PA-AMTA)

Article II in the Bylaws of AMTA sets forth the Purposes of AMTA. Paragraph C in Article  II tells us one purpose of AMTA is to "Foster ... the exchange of ideas ... among its members and others who are part of the field of massage."

An "exchange of ideas" often involves disagreement. Legitimate disagreement is a basic ingredient of democracy and an indispensable component in the search for truth. "Where all men think alike, no one thinks very much." - Walter Lippmann

The truth about state regulation cannot be determined by wishful thinking based on pleonasm, tautology, and the echolalia of dogma. It is determined by research and objective evaluation of well-documented information.

"I think. Therefore I am."

René Descartes

This report and my two previous reports  (in the Massage Law  Newsletter. Vol. 11, Nos. 3 and 4) which I sent you, invite an exchange of ideas. They express my disagreement with the alleged need for the  state regulation that PA-AMTA has been promoting, and with how PA-AMTA reported the results of its two surveys. My two reports present  well-documented reasons that justify my disagreement. My disagreement is impersonal. It does not   attack anybody. Nor does it question anyone's good faith.

How I became involved

 in state regulation

Your October 22, 1999, letter, comments on whether I am a massage therapist, and on my interest in state regulation. I am a retired Swedish Massage therapist. Information about how I became involved in massage, is in  my article, What is a Research Scientist Doing With Massage? in the AMTA's Massage Therapy Journal 33:32-38. 1994.

Information about how I became involved in state regulation is in my reports in the Massage Law Newsletter and in the Spiritual Massage Ministry Newsletter (Vol. 3. Nos. 3 and 4). More information about me and the research I have done is in the section of this report entitled, Who am I?

A matter of simple logic

Here is a brief history of my search for  reality in state regulation. In 1987, people told me that regulation was needed to protect the public from harm. So, I asked, "What harm has  actually occurred?" But nobody was able to answer my question, This told me that those who were promoting state regulation to allegedly protect the public from harm did not know whether any harm had actually occurred. I found this astonishing.

Their first order of business should have been to find out (a) how much well-documented harm had actually occurred, especially  in people with contraindications; (b)  how many massage therapists had harmed how many people, (c) what kinds of harm had occurred, and (d) how serious it was. After obtaining this information, they should have decided how much well-documented harm there has to be and how serious that harm has to be to justify the need for licensure to protect the public from that harm. No such research was ever done.

There is no justification for promoting licensure for any reason  before the above-mentioned protocol has been followed. This is a matter of simple logic.

There is well-documented evidence

that massage is safe

The massage literature in the U.S. provides no epidemiological data about the morbidity (i.e., harm) associated with massage therapy,

In 1993, I began finding definitive information.  But it was not information about harm that had actually occurred. It was well-documented evidence that serious  harm has not occurred, that massage is safe, and that state regulation is therefore  not needed to protect the public from harm

In 1993, I learned that a governmental agency in the Canadian Province of Quebec had conducted an extensive two year research project to determine the incidence of harm associated with massage. The results revealed that massage therapists, regardless of their training, did not cause any harm. For this reason, Quebec has not regulated massage therapists.

In 1993, I learned that Doug Alexander, in Ontario, Canada, did a database survey on the internet to find out what harm had been caused by massage therapists. He found no such harm and concluded that massage was "relatively safe."

In 1997, I learned that a Georgia senate committee disregarded the undocumented evidence of harm which the Georgia Chapter of AMTA had submitted in support of a senate bill to regulate massage therapists. The senate committee then did its own research and concluded:

"There is no documented danger of actual harm to the public."

"The potential for harm to the public appears to be remote and would not be alleviated by licensing."

In 1998, Massage Magazine interviewed Doug Alexander, who was then Editor of the Journal of Soft Tissue Manipulation. Alexander said, "Massage and bodywork are safe. There have never been any cases of physical injury to people."

Regulation makes

no sense

People began  promoting state regulation to allegedly protect the public from harm, without having done  any research to determine whether harm had actually occurred. This promotion has continued despite the fact that two governmental agencies, in Georgia and Quebec, have reported their  research which revealed that harm does not occur. As a result, Georgia and Quebec have not enacted laws to regulate massage therapists to protect the public from harm.

Since there'ss no harm in Quebec and in Georgia, I do not understand why anyone would assume there is harm in Pennsylvania or anywhere else.The Pennsylvania Coalition for Licensure (PALC) has promoted licensure to protect the public. In its own words:

1. "Licensure is first and foremost to protect the public from harm."

2. "State licensing will ... create educational requirements for that public protection."

3. "We are working to create a bill which protects the public from harm."

But the officers of PALC have not replied to my requests for well-documented evidence that supports PALC's reason for promoting licensure.

Others who have promoted state regulation to protect the public from harm and for any other reasons, have not provided well-documented evidence that regulation is needed for those reasons.

Your letter of  October 22, 1999, William, was motivated by my two reports. These reports are concerned with the lack of well-documented evidence that justifies the need for state licensure, and with PA-AMTA's promotion of licensure.

Your letter did not provide any well-documented evidence that justifies the alleged need for licensure in Pennsylvania or for PA-AMTA's promotion of licensure.

Your letter also did not provide any well-documented evidence which justifies your allegations about me. Nevertheless, I am responding to your letter to "foster" [what AMTA refers to as] "the exchange of ideas."

Please give me permission to publish your  letter and your answers to the questions in this report, in the Massage Law Newsletter. The Newsletter, which is available on the internet <www.tiac.net.users/maryella/>  will make our "exchange of ideas" readily available.

Your letter is very different in tone and content from Dr. Griff D. Pitts' response to a letter I wrote him. Dr. Pitts is Director of the Commission on Massage Therapy Accreditation (COMTA).

My letter to Dr. Pitts asked questions about COMTA, comparable to the questions in my two reports about state regulation. Dr. Pitts' reply included the following comments:

"Thank you for the keen interest which you have shown in regard to the credibility of the Commission. We commend you for the insight which you have demonstrated and the issues upon which they focus." (COMTA NEWS - The Official Newsletter of the Commission on Massage Therapy Accreditation. Summer, 1999)

Other issues

In my research, I found that no well-documented evidence  that harm, sufficient to justify state regulation, had actually occurred. But I did find well-documented evidence that such harm had not actually occurred. This raised the following question

1. Why is state regulation still being promoted since there is no well-documented evidence to justify any reason why it is needed?

2. What well-documented evidence justifies national certification and the accreditation of massage schools?

3. What well-documented evidence is there that national certification and school accreditation assure hands-on competence?

4. How is hands-on competence defined and objectively measured? This question is important because hands-on competence is what allegedly  protects the public from harm

5. How much harm and what kinds of harm are associated with each contraindication?

6. What harm and  how much harm has been caused by state regulation, national certification, and massage school accreditation?

I was again astonished, this time, to find no adequate research, in these above-mentioned areas, reported in the massage literature.

Opinions are no substitute for

well-documented evidence

Many people, who  disagree with me about state regulation, simply express their opinions that I am wrong. But they have not replied when I asked them for well-documented evidence which justifies the alleged need for state regulation. I even offered to publish whatever information they would submit in the Massage Law Newsletter.

I am not interested in arguing about different opinions. I am interested in discussing different positions that are based on well-documented evidence.

Without well-documented evidence that justifies the need for state regulation to protect the public from harm or for any other reason, that need is only an alleged need because it rests on allegations which are unsubstantiated. If the allegations were substantiated by well-documented evidence, the need would be a real need, not an alleged need.

How and why I am involved

in state regulation?

To clarify what I do and why, I reiterate what I wrote Retta Flagg in 1994. "My objective with respect to state massage laws has been to do research on this highly controversial issue; and document the proverbial 'other side,' with which many massage therapists are unfamiliar.

"If I have published anything that is incorrect, I shall not only publish a correction or retraction, but will also cite or refer to the evidence which proves that I was inaccurate." (Massage Law Newsletter. Vol 12. No. 4) This has always been my position.

There's only one way to

 prove I'm wrong

Just provide well-documented evidence that validates the reasons why so many people have promoted state regulation in so many states for so many years.

And provide well-documented evidence that the public is  better served by massage therapists in states which regulate massage therapists than in states which do not. For example, what well-documented evidence is there:

1, that enough allegedly inadequately trained massage therapists have caused enough sufficiently serious harm in enough people, with contraindications, to justify the need for state regulation to protect the public health, safety, and welfare?

2. that state regulation does indeed protect the health, safety, and welfare of the public in states which  regulate massage therapists?

3. that the written national certification examination objectively measures hands-on competence and therefore protects the health, safety, and welfare of the public? Please define hands-on competence, and explain how it can be objectively measured.

4. that massage therapists who pass the national certification examination are more competent than those who fail?

5. that massage therapists with 1,000 hours of state-regulated training in Texas are more competent in hands-on work than massage therapists with 250 hours of state-regulated training in Nebraska?

6. that massage therapists who graduate from schools accredited by the Commission on Massage Therapy Accreditation are more competent in  hands-on work than massage therapists who graduate from schools that are not accredited by COMTA?

7. that state regulation and local ordinances have significantly reduced prostitution? If so,   where, and to what extent has that reduction occurred? 

My position on state regulation

is based on research 

1. I believe people, who promote state regulation, have a responsibility and an obligation to provide well-documented evidence that state regulation is needed to protect the pubic safety, health, and welfare.

2. I am opposed to state regulation that is imposed on practitioners, who don't want to be regulated, because there is no well-documented evidence which justifies the alleged need for compulsory regulation of all massage therapists for any reason.

3. I believe there is no need for state regulation because there is no well-documented evidence which justifies any alleged need.

4. I believe massage should be deregulated, in those states which now have regulation, because there is no well-documented need for regulation for any reason? (Massage Law Newsletter. Vol. 5, No. 2)

Pennsylvania needs

a Sunrise Law

I believe that people who are opposed to state regulation of massage therapists should not have to provide well-documented evidence that it is not needed. Sunrise Laws, which many states have, put the burden of proof on those who promote health care legislation. They are the ones who are required to provide well-documented evidence that:

1. The unlicensed profession is a serious danger to the public health and safety.

2. State licensing will adequately protect the public health and safety.

3. No other means will adequately protect the public health and safety.     

The Pennsylvania Chapter of AMTA would do the public an important service by promoting a Sunrise Law. Promoting state regulation of massage therapists, who do not harm people, is not  in the public interest.

I am not  opposed to all regulation

I support the self-regulation/title protection in the Canadian provinces of Ontario and British Columbia because:

1. It provides regulation for those who want it, but does not impose regulation on those who don't want it. What can be more democratic?

2. It rules out monopoly control. What can be more democratic?

3. It permits unregulated massage practitioners to use the term massage in advertising, but they may not use the title Massage Therapist.

4. It restricts use of the protected title Massage therapist to those who have complied with  regulatory requirements. The public and insurance companies can therefore identify massage practitioners who have and have not complied with regulatory requirements.

5. It is not designed to protect the public from alleged harm because there is no harm from which the public needs to be protected. This is why self-regulation/title protection permits unregulated massage practitioners to do massage and use the word massage in advertising.

Why hasn't the PA-AMTA board informed members about this self-regulation, and surveyed them to determine how many are interested in this self-regulation?

Inadequate PA-AMTA member

 support for licensure

State regulation has been the most highly controversial issue for PA-AMTA. The board wants licensure, but many members do not. After having invested more than $50,000 to promote licensure over a five year period, the board was still concerned about inadequate member support for licensure.

After Senate Bill 1171 was introduced in October, 1997, the board was concerned about inadequate active member support for Senate Bill 1171.

`The late Barbar Mikos published a "Cry in the Wilderness" in The Balanced Body (December, 1997) pleading for more member support for Senate Bill 1171. 

After  Senate Bill 1171 died in committee, the board attributed the death of Senate Bill 1171 to inadequate member support.

An August 10, 1998, statement from the PA-AMTA  board informed  members that, "It would be futile to spend more time and money" [promoting licensure] "without the full support of our membership."

Additional evidence of the low level of member support for licensure is the relatively few reports in the PA-AMTA newsletter The Balanced Body from members who favor licensure. In the April, 1999, issue, editor Nick Claxton  wrote:

"I would love to see more article, letters or other contributions from members. The board decided earlier this year to reduce the number of editions of The Balanced Body  published each year from four to three, because there has not been enough material to warrant publishing more frequently. It would be good to receive more input from members, on the above topic or others, and need to increase the number of editions again to accommodate the rush of material." Let other members know how you see your profession ...." The "above topic," to which Claxton referred, was not licensure.

This raises questions

1. What well-documented evidence is there that the board now has "the full support of our membership" for another senate bill ?

2. How do you explain the inadequate member support for Senate Bill 1171?

3. How do you explain the low 6% response to "the last survey" to which the board referred in its August 10, 1998, statement?

4. What was that survey, and what were the results of that  survey?

6.  How do you explain why the board did not tell members what that survey was for, and what the results were?

How the results of the two surveys

should be analyzed 

Since there were two surveys, it is important to determine whether the data reveal a trend; and, if so, what is the trend and is it significant? If the trend is significant, it may provide information that is more important than simply knowing the percent of respondents who favored licensure in each survey. The board did not comment on any trend.

My two reports reveal that there is a trend. The trend is the decrease in the percent of members who favor licensure, among those who responded to the two  questionnaires, compared to the increase in total membership. Moreover, the trend is significant because of the magnitude of the decrease and the magnitude of the increase.

This trend reveals that, while the board was spending money to promote licensure, the percent of members who indicated they favored licensure was decreasing.

Questions about the trend

1. How do you explain the decrease (from 54% to 21%) in the number of members who responded to the 1993 and 1997 surveys?

2. How do you explain why the percent of members - who indicated that they favored licensure - increased only 4%, while the PA-AMTA membership increased 246%?

3. How do you explain why the percent of members who indicated that they favored licensure on the questionnaire increased only 4% over a five year period

Since you disagree with my analysis of the results of the two surveys and with my conclusions, how do you analyze the results of the two surveys and what are your conclusions?

Why I oppose state regulation

I have already pointed out why I support the self-regulation/title protection in the Canadian provinces of British Columbia and Ontario.

I am opposed to any state regulation which violates Constitutional law  and U.S. Supreme Court decisions that:

1. protect freedom of speech (including commercial speech) and freedom of the press, and

2. prohibit discrimination, inappropriate governmental interference in lawful business, unfair labor practices, restraint of trade, and monopoly control; and  which violates the "right to work" provisions in the United Nations' International Bill of Human Rights.

The end of the road

My (re)search for reality in state regulation led me to Yip Harburg who referred me to "The Wizzard of Oz." To get there, I went "Over the Rainbow" to the enchanted castle where the witch of state regulation had been dematerialized. 

There I discovered so many unregulated massage therapists with so many kinds of training, who have been massaging so many people, with so many contraindications, so many times, for so many years with so many well-documented benefits but with so little if any well-documented evidence of harm.

Who am I?

I am. Therefore I think. - A.Schatz

I am a senior citizen, a retired university professor, a minister, a dowser, and a scientist who has been doing research for more than half a century.

In 1943, when I was a graduate student working for my Ph.D. degree, I discovered streptomycin. This antibiotic was the first effective treatment for tuberculosis, for bubonic plague also known as The Black Death, and for other infectious diseases for which there were then no effective treatments.

My wife Vivian and I enjoy camping. For the past 20 years, we have been camping in August at Ricker Pond Campground near Groton, Vermont.

I was the Associate Instructor and Director of Research in a massage school for several years. I have taken workshops in Feldenkrais, Trager-work, Alexander Technique, CranioSacral Therapy, Foot Reflexology, and Therapeutic Touch.

I do spiritual healing, and do research on the role of subtle energy involved in spiritual healing and bodywork.

I edit and write much of the Massage Law Newsletter, the Journal of Spiritual Bodywork, the Spiritual Massage Ministry Newsletter, and the Massage Humor newsletter.  For references to my publications in other periodicals, see Vol. 8, No 1. of the Massage Law Newsletter

I have been doing research on massage/bodywork, for almost 20 years, and on state regulation since the middle 1980s.

I oppose state regulation now for the same reasons that I  opposed state regulation in Pennsylvania in 1988, 1989, and 1997.

I have authored and co-authored three books, and several hundred articles. Sixty or more of these articles, including  Letters to Editors, are concerned with massage/bodywork, state regulation, national certification, school accreditation, and related subjects

The Arkansas State Board of Massage Therapy  approved my seminar, Introduction To Therapeutic Touch, for Continuing Education Credit.

 I have given workshops for massage therapists and others in Arkansas, Connecticut, Florida, Massachusetts, Maryland, Minnesota, Pennsylvania, Vermont, and Washington, D.C.

My undergraduate degree is in Soil Science.  My Ph.D. is in Soil Microbiology and Biochemistry. I have no master's degree.

I was a university professor for 35 years, and have been doing scientific research in a wide variety of areas for more than half a century.

These areas include dental caries, fluoridation, temporomandibular joint disorders, infectious diseases (caused by viruses, bacteria,  fungi, and parasites), cancer, atherosclerosis, multiple sclerosis, methods of teaching science, the role of biological weathering in soil formation and soil fertility,  etc., in addition to massage/bodywork, state regulation, national certification, school accreditation, etc.

As a scientist, I am concerned  about  the harmful impact of science and technology on people and on the environemnt, and about the social responsibility of scientists.

My work in Chile

My wife, our  two daughters, and I resided in Santiago, Chile, for three years (1962-1965).

During that time, I was a Professor at the University of Chile. I taught and did research with colleagues in the Faculty of Philosophy and Education, the Faculty of Chemistry and Pharmacy, the Faculty of Agronomy, the Faculty of Medicine, and the Faculty of Odontology (Dentistry).

 I was a member of the Rectoria (the Administrative staff of the Rector of the University of Chile), I worked on the reorganization of the University of Chile, and was involved in research projects in the Chilean Ministry of Education, Ministry of Agriculture, and Ministry of Health.

I collaborated with people in UNESCO  and the Food and Agriculture Organization (FAO), who were working in Chile.

My work included research in soil science, cancer, and the ancient Incas in Peru.

The University of Chile awarded me the honorary title Miembro Academico. I was also  named an Honorary Member of the

Scientific Society of Chile

Chilean Society of Obstetrics and Gynecology

Chilean Society of Pediatrics

Chilean Society of Urology

Chilean Society of Diseases of the Thorax  and Tuberculosis

Odontological Society of Concepcion.

Other recognition elsewhere

Medals

The Rutges  University Medal awarded for the discovery of streptomycin.

Gold Medal (Grand Prix Humanitaire de France)

Gold Medal (Prix Paracelse Medaille d'Or) from the Institit d'Humanisme Biologique. Paris

Gold Medal (Grand Prix Alexis Carrel) from the Academie Internationale d'Humanisme Biologique. Paris

La Medaille dite "du Sceau des Nautes" de la ville de Paris

La Medaille de la ville de Maymac. France

Medal from the Universidad Nacional de San Antionia Abad del Cuzco. Peru

Honorary degrees and titles

Doctor Honoris Causa. Universidade Federal do Espirito Santo. Brazil

Doctor Honoris Causa. Universidad Nacional de San Antonio Abad del Cuzco. Facultad de Agronomia. Peru

Professor Honorario. Universidad Autonomia de Santo Domingo. Facultad de Ciencias Medicas. Dominican Republic

Consejero. Universidad de Bogota "Jorge Tadano Lozano. Colombia

Honorary membership

Argentinian Dental Circle

Stomatological Society of Greece.

 ACKNOWLEDGEMENT

I am fortunate to have an excellent editor who has known me for a long time. She has a good scientific background, knows how I think, is thoroughly familiar with the subjects I research, and has always been readily available on short notice. She is my wife Vivian.

I am also fortunate to have Mary Brewster as my good friend and collaborator since 1992. Mary's knowledge, insight, and analytical mind have been most helpful. Mary is our Associate Editor, and puts our reports on our website.

Mary and I are grateful to many people in the U.S. and in Canada who keep us informed about what has been happening with legislation in their areas, and give us other information which has been helpful.

Mary and I thank all those who communicate their appreciation for the research we do, and encourage us to continue.

I thank William A. Phillips  for his  October 22, 1999, letter which  fostered our "exchange of ideas." According to the AMTA Bylaws, one purpose of AMTA is "to Foster ... the exchange of ideas."

_________________

If anyone considers anything in this report inaccurate, let me know what is it and why it is considered inaccurate. I will publish such comments. 

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