PART 1: OUR ANALYSIS OF THE GEORGIA REPORT

The report, with which we are concerned, is the "Review of Senate No. 300 which Proposes to Regulate Massage Therapists. October 1997." This Review was drafted by the Georgia Occupational Regulation Review Council.

Senate Bill 300 was designed to regulate massage therapists, allegedly to protect the pubic from harm, and was supported by the American Massage Therapy Association.

We are publishing information  from and about this report because the report provides well-documented evidence that massage is safe. The Georgia senators disregarded the undocumented evidence of harm that the Georgia AMTA Chapter submitted, did their own research, and concluded:

(a) "There is little evidence that unqualified massage therapists have inflicted harm on clients."

(b) "There is no documented evidence of actual harm to the public."

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

Applying the Georgia senators'

Since unregulated massage therapists do not harm people in Georgia, why would anyone expect unregulated massage therapists to harm people in any other state?

which the report provides

1. The Georgia AMTA Chapter, which   supported Senate Bill 300, did not consider unregulated massage therapists a threat to the public safety, health, and welfare because Senate Bill 300 would grandfather in all massage therapists regardless of their training.  

2 The Georgia senators disregarded the potential for harm (which the Georgia AMTA Chapter associated with inadequately trained massage therapists) because they did not consider the potential for harm important. What they did consider important is the fact that no serious harm had actually occurred. 

3. The senators considered harm in terms of  "over one million massages currently being performed [in Georgia] during a one year period." We believe this is the first time that harm has been considered in terms of the total number of massages performed annually.

4. Schatz estimated that the one case of harm (which the senators reported in an adjacent state) occurred in an estimated 19,240,000 massages. (Spiritual Massage Ministry Newsletter. Volume 3, Number 2. 1998)

5. In states adjacent to Georgia, unregulated massage therapists were not considered a threat to the safety, health, and welfare of the public because regulation was  NOT promoted, in those states, to protect the pubic from harm. Instead, regulation was promoted "to obtain credibility, promote professionalism, and get prostitution out of massage therapy."

 The following information is quoted from the Georgia report

Potential for Harm

The applicant group has identified several areas that they believe pose potential harm to the public.

First, they  state that inadequately trained massage practitioners can cause physical harm if the client has medical conditions - such as uncontrolled hypertension or diabetes - which indicate that massage should not be performed. Also, they expressed a concern that an inadequately trained practitioners may not be knowledgeable of the effect of massage on a client.

 Second, the applicant group states that unethical massage practitioners can violate clients sexually and cause psychological and emotional damage.

Third, they indicate that more and more people are seeking the benefits of massage therapy, but cannot identify qualified practitioners in the telephone yellow pages because there is little to distinguish the trained qualified practitioners from untrained persons and/or fronts for illicit services.

FINDINGS

The Georgia Occupational Regulation Review Council is required by O.C.G.A. 43-1A-6 to apply the following criteria when evaluating whether a profession or business should be regulated:

*  Whether the unregulated practice of an occupation may harm or endanger the health, safety, and welfare of citizens of the state and whether the potential for harm is recognizable and not remote;

*  Whether the practice of an occupation requires specialized skill or training, and whether the public needs and will benefit by assurances of initial and continuing occupational ability;

*  Whether the citizens of this state are or may be effectively protected by other means; and

*  Whether the overall cost effectiveness and economic impact would be positive for citizens of the state.

Senate Bill 300, presented to the Council for review by the Chairperson of the Senate Consumer Affairs Committee, proposes to regulate massage therapists. In this review, the Council has assessed, based on the criteria set forth above, whether or not massage therapists should be regulated, and, if so, what is the least restrictive form of such regulation.

Our findings are as follows:

As described earlier, the applicant group cited the following areas that they believe pose potential harm to the general public:

* Physical harm if the client has a medical condition which could be worsened by massage or an infectious disease which could be spread, either of which indicate that massage should not be performed;

* Psychological or emotional damage if an unethical massage practitioner violates a client sexually; and

*An inability for the general public to identify qualified massage practitioners because there is little to distinguish between a trained practitioner and anuntrained person or front for an illicit service in the telephone yellow pages.

However, our review of available information indicates that the number of complaints concerning massage practitioners is very small and, of those complaints cited, many allege sexual misconduct which under Georgia law is a criminal act. Moreover, there is little evidence that unqualified massage therapists have inflicted physical harm on clients.

Instead, there are already other licensed professionals in Georgia who serve persons with medical problems and those professionals are more likely to provide relevant massage therapy services to those individuals as an adjunct to their overall treatment.

Finally, the proposal includes a grandfather provision that would permit all currently practicing massage practitioners, whether [un]trained or performing illicit services, to be licensed. These points are described in more detail in the following paragraphs.

There Is No  Documented Evidence

In response to a staff inquiry on behalf of the Council, the Governor's Office of Consumer Affairs researched their files for the past nine and one-half years for complaints against massage practitioners.  However, they found no record of any such complaints, indicating that there were so few complaints that the Office did not establish  separate coding for massage practitioners. Similarly, contacts with Better Business Bureau offices ) ~around ~the state resulted in finding no documented complaints against massage practitioners during the year ending July 9, 1997.

The applicant group indicated that there is a potential for a massage practitioner to cause physical harm to a client if the client has undisclosed or unidentified physical problems. In their submission of information to the Council supporting regulation of massage therapists, the applicant group provided copies of a number of anonymous, individual complaints lodged against individual massage practitioners. In addition, the applicant group orally described several other instances in which physical harm was believed to have resulted from a massage.

This  information, although helpful, does not suggest that widespread harm is resulting from massage therapists being unregulated for two reasons.

First, many of these complaints alleged improper sexual advances which under existing state law is a criminal offense. Therefore, a legal remedy already exists for these type of complaints.

Second, the total number of complaints and other incidents cited is quite small when considered in comparison with the number of massages performed in Georgia in a year.

Representatives from the applicant group estimated that there are probably 1,000 massage practitioners in Georgia and that each practitioner performs an average of 20 massages per week. This information translates into over one million massages currently being performed during a one year period.

Individuals Who Are Most Susceptible to Being Harmed Are More Likely to Be Served by Other Licensed Professionals

Individuals who have medical problems or physical disabilities are more likely to be under the care of a physician and utilize the services of other licensed professionals that include some, if not most, of the services performed by massage therapists. Based on information provided to the Council, physical therapists and chiropractors may include massage as an element of their treatment to a patient.

The Proposal Would Not Address

As proposed, all massage practitioners who are currently providing massage services would be eligible to be licensed under a grandfather clause in the bill without having to meet any educational, training or experience requirements.

This means that any massage practitioner who is inadequately trained or who renders illicit services under the guise of massage therapy could be licensed just as any other massage practitioner, simply continuing the current situation.

The Practice Of Massage Therapy

Based on information presented by the applicant group and other research, it is evident that there is a body of knowledge with which practitioners need to be familiar to be most effective in rendering their services. In addition, there are many different techniques that may be employed in the practice of massage therapy. Therefore, specialized training appears to be needed.

At the same time, there are mechanisms which permit the general public to differentiate between trained, qualified practitioners and other practitioners. First, there is a voluntary national certification program administered by an independent, non-profit organization through which massage practitioners may obtain professional certification. Second, there are at least two professional organizations which qualified massage practitioners may join.

Both organizations have an impressive code of ethics to which members must adhere. By confirming that a practitioner is certified by the non-profit organization and/or is a member of one of the professional associations, a prospective client currently can select a qualified massage practitioner.

OTHER  STATE PROGRAMS

Neighboring southeastern states that currently regulate massage therapists were surveyed as to why they chose to regulate massage therapists and the number and nature of complaints received and disciplinary actions taken to date.

The reasons for regulation most often mentioned were that the industry brought the proposal to the legislature to obtain credibility, promote professionalism and get prostitution out of massage therapy.

As to complaints and disciplinary actions taken, the State of Florida reported receiving 199 complaints in 1993-1994, 228 in 1994-1995 and 199 in 1995-1996. They also reported 3 revocations, 1 suspension and 7 probation decisions in 1993-94; 2 revocations; 1 suspension and 1 probation decision in 1994-95; and 2 revocations, 3 suspensions and 3 probation decisions in 1995-96.

The nature of most of the complaints in Florida was described as continuing education violations, violations of sexual misconduct and establishments with sanitation violations. Most of the other southeastern states' regulation is quite new but their staffs indicate that to date they have received few complaints and have taken few disciplinary actions.

Only one state reported receiving a complaint that a therapist had injured a client. The nature of complaints most often cited in these states was practicing without a license and sexual misconduct.

EPILOGUE

That government is best which governs least, because its people discipline themselves. 

Thomas Jefferson

Liberty is always dangerous, but it is the safest thing we have. Henry Emerson Fosdick

There is no subjugation so perfect as that which keeps the appearance of freedom, for in that way one captures volition itself. Jean-Jacques Rousseau

I  assume you have all seen my first report on the Arizona Coalition, which appeared in the Massage Law Newsletter (Vol. 15. No. 4. 2000). My colleague Mary Brewster and I are writing additional reports about the Arizona Coalition, which will be in the Massage Law Newsletter and in the Massage Humor newsletter, both of which are  available on the internet You can keep abreast of what we publish by periodically checking our web site <www.healingandlaw.com>.

Mary and I welcome your questions concerning what we publish about the Arizona Coalition, and will answer them provided that you in turn answer our questions about what the Arizona Coalition is doing, and why. If you disagree with anything we write about the Arizona Coalition, we invite you to let us know what you disagree with, and why; and give us permission to publish your comments in the Massage Law Newsletter on our web site.