An Undue Burden: A Licensed Massage Therapist Explains Barriers in State Licensing Law

The following letter by Becky Wells, a Licensed Massage Therapist from Omaha, was submitted to the Legislature's Health and Human Services Committee as part of LR228, an interim study of state massage therapy licensing. 
 

Dear Chairman Riepe and members of the Health and Human Services Committee:

I am not able to attend the upcoming roundtable discussion on the requirements for initial licensing for Massage Therapists in Nebraska, and would appreciate the opportunity to give my input.

My name is Becky Wells, and I have been a Licensed Massage Therapist in the State of Nebraska since 2004. I received my education and training at Omaha School of Massage Therapy from March 2003 to January 2004, and became fully licensed in February of 2004.

I have maintained my licensure in compliance with the laws of the State of Nebraska by earning no less than 24 continuing education credits in approved studies every two years and by remaining a professional in good standing within the state. I have worked in a number of settings, but the majority of my career has been as a self-employed solo practitioner in Omaha.

I am in agreement that the initial requirements for Massage Therapy occupational licensing should be reduced from the current 1,000 classroom hours to 500-700. Allow me to outline my reasons why. The argument against such a reduction is that vital education will be eliminated and therefore public safety will be at risk.
 

The course load for massage therapists in Nebraska includes Theory and Practice (of Swedish Massage), Anatomy and Physiology, Kinesiology and Pathology; all subjects which must be learned with proficiency in order to be able to carry out a therapeutic massage session. Also in the current course load are such classes as Eastern Medicine, Wellness, Fitness, Nutrition, Hydrotherapy, Ethics and Business. None of these classes are essential to the safety of consumers.
 

Eastern Medicine involves such practices as Reflexology, Reiki, Healing Touch and Myofascial Release. These practices are not based in science, but require a belief system in order to effectively administer them. Eastern Medicine should be optional and offered as an addendum to the required learning or as continuing education for future relicensing. While they are legitimate modalities of Massage Therapy which can be practiced with integrity by those who hold those beliefs, forcing massage students to have up to 100 hours of class time learning them and being required to be proficient in them would be like forcing those in medical school to have an entire semester learning Faith Healing and Old Wives Tales, and to be proficient in those practices and beliefs.
 

Wellness, Fitness and Nutrition teach basic anatomy and physiology which massage therapists already learn in those classes. These are “filler” classes which simply re-emphasize certain aspects of anatomy and physiology, but applying those things in a different way. The ways in which they are applied fall outside of the scope of practice of massage therapy in the State of Nebraska. Massage Therapists are not licensed to diagnose or treat conditions, or to advise in or teach wellness, fitness or nutrition. In my 84+ hours in Fitness Class, we went to a local fitness center and exercised. This was my “education” in Fitness.
 

In my Nutrition Class, we talked about healthy eating, including guest lectures about veganism, organic cooking and the cell memory of animals which have been slaughtered. Since these classes have nothing to do with the practice of Massage Therapy and, in fact, fall outside of the scope of practice for Massage Therapy in the State of Nebraska, they should not be included in the required education for initial licensing.
 

Hydrotherapy is the practice of using water, water soaked materials or water heated materials in the practice of massage therapy. Among the practices learned in this class are spa pedicures, application of hot packs, hot stone massage, vichy showers, nasal irrigation and ear candling. All of these therapies are adjunct therapies to basic Swedish Massage and are not required in order to carry out a safe massage treatment session. Many aspects of spa pedicures and nasal irrigation fall outside of the scope of practice for Massage Therapy in the State of Nebraska. While these classes would be appropriate for continuing education, they should not be required education for initial licensing.
 

The training received in ethics and in business is far longer than necessary at over 60 hours for each class. Ethics is a required continuing education course every two years for Massage Therapists in Nebraska. It is taught in two hours. The business course teaches several different avenues of career development, which also is unnecessary for initial licensing. Teaching Nebraska’s basic jurisprudence in regards to Massage Therapy would meet the requirements for teaching the legal aspects of practicing Massage Therapy and guarding public safety. Licensed Massage Therapists can take the jurisprudence course as a part of their continuing education every two years. It is a two hour course, including a test.
 

In summation, we need to look only to our neighboring states to see the effects of more realistic and practical initial educational requirements for licensing. Nationwide, prospective massage therapists take the same basic competency exam for state licensure. (For most states the MBLEx, Massage and Bodywork Licensing Exam, provided by The Federation of State Massage Therapy Boards, is the standard by which initial proficiency is measured.)
 

Are the rates for successfully passing the initial exam higher in Nebraska due to the higher education requirements? Are there fewer incidents of reported massage malpractice in Nebraska compared to other states? Those are the important questions to answer. The fact remains, however, that the current Nebraska educational requirement for initial licensing is an undue burden on prospective and operating massage therapists, making Nebraska less competitive in attracting qualified Massage Therapists, and provides no clear or tangible benefit to the citizens of the State of Nebraska.

Becky Wells, LMT
Omaha, Nebraska