To publish information on both sides of a controversial issue is good journalism. It is essential for progress. We therefore periodically invite individuals, with whose positions we disagree, to provide information for publication in the Massage Law Newsletter. This enables our readers to more clearly understand the other side.
The Massage Law Newsletter has published two reports on the controversy over the expanded scope of practice which the College of Massage Therapists of British Columbia (CMTBC) requested. We now invite two individuals, who favor the increased scope of practice, to present their views on specific issues in the controversy.
To: George K. Bryce, Chair, Scope of Practice Committee. CMTBC
I am writing about the following comments in the 8-page letter you kindly sent me on August 20, 1998. In that letter, you wrote:
"I very much hope that massage therapists in British Columbia do not harm their patients! If there were a significant number of reported cases of RMTs who had hurt their patients, as a public representative I would be concerned that the CMTBC had thus failed to meet its statutory mandate to protect the people.
"The College is made aware of only a few complaints of harm caused by RMTs. In my view, this is at least a partial confirmation that the College is achieving its mandate... The College has also developed educational programs designed to address those fortunately rare instances when the College has received sustained complaints from the public against an RMT."
The problem with harm is that many people consider it a serous problem but are unable to provide well-documented evidence that it is. Mary Brewster recently reported a case history of alleged harm which was not confirmed. (Reader Forum. Massage & Bodywork. page 4, June/July. 1999.)
My research indicates that people are more likely to be harmed in automobile accidents as they drive to and from their massage therapists, than by their massage therapists. This is also indicated by how little harm RMTs cause (reported in your August 20, 1998 letter) and how little harm non-RMTs allegedly cause (reported in Massage Law Newsletter. Vol. 10. No. 1.)
We would therefore appreciate your providing additional information, requested below, about the harm caused by RMTs, to which your letter refers. Please give us permission to publish your reply in the Massage Law Newsletter.
1. Do you use the terms hurt and harm synonymously? If they have different meanings, what are their different meanings?
2. With respect to your use of the term significant, what is the minimal number of cases of harm, caused by RMTs, that you would consider a significant number?
3, How many RMTs have harmed how many people over what period of time, and how serious were the injuries that RMTs caused.
4. What well-documented information do you have about the harm, allegedly caused by non-RMTs, that is comparable to the information about harm caused by RMTs, requested above?
3. If you do not have the well-documented information, requested in the previous two questions, how do you justify the alleged need for the Health Professions Council to grant CMTBC's request for an expanded scope of practice to protect the public from harm by allegedly inadequately trained non-RMTs?
The reason for establishing professional requirements, such as CMTBC's 3000-hour training and its examination, is to protect the public from harm by allegedly incompetent practitioners.
1. How does CMTBC define and objectively measure competence in evaluating RMTs and non-RMTs?
2. If CMTBC cannot objectively measure competence, how can CMTBC determine whether a practitioner is incompetent?
3. What well-documented evidence do you have that RMTs, who have CMTBC's present 3000-hour training, are more competent that RMTs who have CMTBC's former 2200 hour training?
4. If the RMTs with the 3000 hour training are more competent, how much more competent are they?
5. If RMTs with the 3000 hour training are equally competent or less competent, how does CMTBC justify the alleged need for the 3000 hour training?
6. Why does British Columbia need a 3000 hour training when Ontraio is getting along very well with a 2200 hour training?
7. What well-documented evidence do you have that CMTBC's written examination measures, reflects, or predicts the competence of RMTs?
8. What well-documented evidence do you have that (a) CMTBC's 2200 hour training was inadequate to protect the public from harm, and (b) CMTBC's 3000 hour training adequately protects the public from harm?
9. How does CMTBC respond to the questions about competency in Beth Maloney's letter of April 3, 1996? Beth Maloney is the Registrar of the College of Physical Therapists of British Columbia. Her letter was that College's evaluation of CMTBC's 1995 proposal to expand its scope of practice.
Thank you for providing this information.
To: Suandy Mitchell. President, Massage Therapists Association of British Columbia MTABS)
We would appreciate your providing the information, requested below, for publication in the Massage Law Newsletter.
Why are RMTs in British Columbia com-pensated by the Medical Services Plan when RMTs in Ontario are not compensated from public funds?
What well-documented information does MTABS have about comparable patient populations (with pain and dysfunction) which are treated by Registered Massage Therapists (RMTs) in British Columbia and in Ontario?
In British Columbia, RMTs are compensated by the provincial Medical Services Plan for treating patients whom doctors refer to them. In Ontario, patients either pay for massage therapy themselves or may be compensated by their Health Care Insurance.
Ontario may therefore be a good control to determine whether the public, in British Columbia, benefits from the Medical Services Plan which compensates RMTs for treating patients whom doctors refer to them.
What well-documented information does your College have on the rate of recovery and/or the extent of recovery of patients whom doctors refer to RMTs for treatment in British Columbia, compared to the rate of recovery and the xtent of recovery of the comparable patient population treated by RMTs in Ontario.
If there is no such well-documented infor-mation, how does MTABC justify the compensation which RMTs in British Columbia receive from the Medical Services Plan?
The information in such a survey may also indicate whether British Columbia needs the 3000 hour training. Ontario requires only a 2200 hour training.
Aside from the above, I was shocked at the harassment and intimidation of non-RMTs, reported in Massage Magazine. pages 117-124. November/December, 1998.
How does MTABS justify such harassment and intimidation? How many well-documented case histories does MTABS have for people who have been harmed by non-RMTs in the last five years in British Columbia; and how serious the harm was?
I am pleased to know that not all RMTs agree with the harassment and intimidation. Some support non-RMTs, and believe they have a right to practice their modalities. (See the Massage Magazine article referred to above).