• MINUTES OF THE MASSAGE THERAPY


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    • Abstract: MINUTES OF THE MASSAGE THERAPYADVISORY COMMITTEECall to order: Mr. Wayda called the meeting to order at 1:07 PM on Thursday, October16, 2003.Committee members present: Dennis Gibbons, MTAC; Rick Greely, MTAC; Deborah

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MINUTES OF THE MASSAGE THERAPY
ADVISORY COMMITTEE
Call to order: Mr. Wayda called the meeting to order at 1:07 PM on Thursday, October
16, 2003.
Committee members present: Dennis Gibbons, MTAC; Rick Greely, MTAC; Deborah
Jewett, MTAC; Mark Melecki, MTAC; Rick Phillips, MTAC
Guests present: Karl Meyer, ITM & OCMTC; Eric Weldele, OMTA-Ohio
Staff members present: Mark Wayda, Shannon Baldwin
I. Minutes Review and Approval
Mr. Greely noted that on page 5, in the first paragraph, “Rekie” should be
spelled “Reiki”. Also, in the same paragraph, “TAC” should be “MTAC.”
Ms. Jewett pointed out that, on page 4, under “Minutes Review and
Approval,” “Ms. Sickmiller” should be “Ms. Jewett.” The same
correction needs to be made on page 11 in the second full paragraph. Also
on page 11, in the second to last paragraph, the sentence should read, “Mr.
Wayda said that the last section, (C)(8), tells the student what the technical
requirements are going to be and that they shall receive that information
from the school.” Mr. Gibbons noticed that on page 13, in the second full
paragraph, that the second sentence should read “Mr. Gibbons suggested
having one instructor with one year experience and one massage therapist
with five years experience. Mr. Phillips pointed out that on page 3, under
“Introduction of New Member,” “Kaufman’s” should be “Nelson’s.”
Mr. Greely moved to accept the minutes as corrected and Mr. Gibbons
seconded the motion. All members voted aye.
II. Report on September Limited Branch and Medical Board Meetings
Mr. Wayda said that the only information from the meetings is that Rule
1-13 went to the Limited Branch and Board and was accepted by both.
The rule changes had been regarding the Remedial Education Programs
and how many hours would be needed and that certain students who failed
the exam would not count against the schools. The hope is that the rule
will be filed around the 14th or 15th of November and would go to hearing
on December 22, but we will let you know.
III. MT Exam
Letter about exam:
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Mr. Wayda directed the committee to look at the e-mail contained in the
agenda packet. Mr. Phillips said he could not read the letter on his e-mail.
Mr. Wayda said that Diane Sater, a former MTAC member, forwarded the
letter to him. He stated that the two big issues that the e-mail raised are
that the student did not finish the exam and took issue with how the exam
was graded. Mr. Wayda reminded the committee that they voted, in
September 2002, to increase the number of test questions to 110, and to
take the recommendation to the Limited Branch Committee, which was
then forwarded to the Board. The number of exam questions is on the
website, has been reported to schools, and was contained in the letter sent
to test takers with the admission ticket. However, such information was
not conveyed in the script read prior to the exam being given, which will
now be done. Also, “continued” will be added to the bottom of each page
of the exam except the last. Mr. Wayda said that there were three more
pages behind the page with the 100th question and only 23 out of roughly
800 test takers failed to answer the question. Mr. Melecki inquired
whether those who failed to answer the last 10 questions all came from
one school. Mr. Wayda said the Board did not track that information.
Mr. Wayda also stated that the individual who wrote the e-mail felt that
the Board staff should have checked to make sure that each student
answered all of the questions on the test. Mr. Wayda said that the Board
would not be taking responsibility for making sure that everyone answers
all the questions.
The individual who wrote the letter missed 25 questions. The first part of
the exam grading process is that the exam is scored and the Board receives
stats on each question. The exam committee runs psychometrics on each
question and is able to determine whether any given question is a good
discriminator. It separates those who truly understand the material from
those that do not. The plan is to throw out a minimum of 10 questions on
each exam, chosen based on the statistical analysis. On the June exam it
happened that the 10 questions were on the more difficult end.
The exam committee determined that another 10 questions fell within the
same statistical parameters, and therefore did not do a good job of
discriminating so they were also not counted. No one failed to pass with
the 90 questions counted that would otherwise have passed with the 100
questions counted. Mr. Wayda pulled the individual score sheets for the
writer and another student that Mr. Greely forwarded to Mr. Wayda.
Neither passed at 100 questions or at 90 questions. Mr. Wayda noted that
despite the bad results overall, at least one school had a 100 % pass rate.
Ms. Jewett inquired whether we should respond to the individual who
wrote the e-mail. Mr. Wayda was not sure whether the writer really
wanted a response. Mr. Phillips said that when he received her unreadable
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e-mail that he responded to the writer asking if she could resend it, and the
writer never replied. He believed also that a response is not necessarily
needed. Mr. Wayda did say he would respond by at least telling the writer
that “continued” will be added and the proctor will explain that there are
110 questions.
Mr. Greely said that the student who's question he forwarded to Mr.
Wayda missed passing the exam by one question. He feels that the test
taker should be personally responsible for his or her own exam. The fact
that no one failed that would not have failed using 100 questions goes to
show that the exam was fair and equitable. Mr. Gibbons said he received
inquiries about who at the Medical Board should receive calls. Mr.
Wayda said members should refer individuals with specific exam
questions to Carolyn Mack.
Council of Schools recommendations on textbooks, exam structure:
Mr. Meyer said the Council is not yet ready to present.
Focus groups for test bank:
Will be covered at a future meeting.
IV. Rule 4731-1-23, Distance Learning
Mr. Wayda said he did some research on distance learning and ethics. He
said he can do more. Also, the staff looked into synchronous v.
asynchronous hours and found that the breakdown is not really an issue in
distance learning. Mr. Wayda has a contact at Ohio State, Professor Chris
Zirkle, who confirmed this. Professor Zirkle has a very impressive resume
and Mr. Wayda will distribute that at some point. Professor Zirkle is
happy to help us with distance learning issue and will come and join us
when he can. He has a PhD in comprehensive career and technical
education. Mr. Melecki said we are teaching less technical skills than
relationship skills. Mr. Wayda said he believes it is both- the hands-on
skills and the ethics/relationship issue. Mr. Greely said he can teach the
appearance of technical skills, but the specifics of giving a massage cannot
be taught at a distance. Mr. Phillips said that at some schools the hands-on
training is not even being taught.
Mr. Wayda directed the committee to look at pages 17 and 18 of the
agenda packet. He stated that the committee has discussed (C)(4) in the
rule; MTAC changed the language to say “documented training or
certification” in distance learning instruction. Also, the bulk of the
discussion has focused on (C)(7): MTAC wanted to have a portion of the
ethics hours requirements to be during the hands-on instruction. Mr.
Wayda added the second sentence: “Of the minimum of twenty-five hours
of instruction in ethics required in rule 4731-1-16 and 4731-1-09 of the
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Administrative Code, a minimum of ten hours shall be taught during the
hands-on instruction.” The curriculum rule says that you have to teach
twenty-five hours, ten of which are in a stand alone course.
Mr. Greely and others had voiced that many massage therapy schools do
not teach ethics in a separate class because, as massage is being taught,
ethical issues are more appropriately brought up at that time in a more real
life context. Mr. Wayda asked if the committee knows how it would like
to see the ten hours taught. Mr. Melecki asked, with a distance education
model, how programs could really be sure that an individual is fit to be a
massage therapist? Mr. Wayda said that there is no zero risk, just like
there is no zero risk in a brick and mortar school. The real issue is where
is the balance between safety and distance learning. What the staff is
finding out in the brick and mortar schools is that they usually spend a
maximum of two hundred hours in close contact with their students. Is
two hundred hours enough to assuage committee concerns? Mr. Meyers
asked out of how many total hours is two hundred hours? Mr. Wayda said
seven hundred and fifty.
Mr. Phillips said he believes two hundred is fine, and it would actually be
difficult to do more in distance learning. Mr. Melecki said he feels the
twenty-five hours of ethics, with ten being hands on, is a good plan. Mr.
Greely asked if we would want to have the ten hours in a stand alone class
or pieced together from other classes? He felt that from his research the
best way to impact ethical decision making is through exclusive ethical
teachings. Mr. Wayda said that, going back to the curriculum rule, the
Limited Branch committee wanted twenty-five hours of ethics, and that
Mr. Greely had said ethics is not taught separately in most massage
therapy programs. How has that been dealt with in the schools? Mr.
Greely said his school is unique in that it has a stand alone ethics class, but
there are also occasions when opportunities arise in other classes to teach
students ethics in real life situations.
Mr. Greely asked how you could really count the hours of separate class
time in which ethics are discussed? He feels a stand alone class is an
easier way to deal with the situation. Mr. Phillips agreed. Mr. Melecki
pointed out that you really cannot legislate class discussions in non-ethical
classes, but the two hundred hours face-to-face contact with students helps
to insure that some dialogue will occur concerning ethical decisions. Mr.
Wayda said the concern is that a teacher has to stimulate such
conversation, and unfortunately, some may not be motivated to do so.
Mr. Melecki said there seems to be a division line between the legislative
rule and the learning objectives framed by the Council of Schools; the
Board can mandate the teaching of ethics and the Council can determine
that each school should cover boundaries, informed consent, etc. Mr.
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Wayda said the Board wanted ethics to cover sexual boundaries and
chemical dependency issues, among other topics.
Ms. Jewett said she is comfortable with two hundred hours. She said she
might want to add that ten hours should be face-to-face ethics time,
because the other hours will probably be taught via computer through
hypotheticals. Mr. Greely asked how you document an ethics discussion
in another class. Mr. Melecki said the schools would probably have to
plan their curriculum according to the ten face-to-face ethical hours. Mr.
Wayda said that he would guess schools would have a ten hour ethical
class and then in the Massage I curriculum set aside a day to cover issues
that arise in clinic.
Ms. Jewett asked if the ten hour requirement would be in the hands-on
portion, where an hour a day would be spent during the massage course to
talk about any ethical issues; or whether a day would be spent at the start
of the residential intensive to deal with ethics. Mr. Wayda answered that
right now the rule is written to the former, although the school could
choose to do a stand-alone class. Mr. Wayda asked the committee
whether it is better to teach ethics in a stand alone course or to teach ethics
during other hands-on classes and document until 10 hours are achieved?
Mr. Phillips said that it is not a bad idea to do a stand alone ethics course.
Mr. Wayda then asked what is more important: that you are having an
interactive conversation about issues or to learn the general ethics
concepts. Mr. Greely said the concepts can be taught over the Internet,
however, when ethical dilemmas are discussed, peers should be able to
interact in person to discuss that portion. He felt that schools may
document on-line hours through a computer program and in-class hours
should be set in the school curriculum up front. His concern is that a
school may have a stand alone class for 10 hours, but how do you
document the informal discussion that takes place during massage classes.
Mr. Phillips said an instructor could sit down after each class and
document how much time was spent on ethics in that class. Mr. Greely
pointed out that it is unlikely that instructors will do such. Mr. Phillips
asked if the instructor has to discuss ethics at the end of class, if that is in
their curriculum, even though an ethical situation occurs at the beginning
of class. Mr. Wayda said that at some point instructors must be given
leeway.
Mr. Melecki suggested that in 4731-1-19 (C)(7), the last phrase be
changed to say “a minimum of ten hours shall be taught in a dedicated,
interactive manner during the hands-on instruction.” Mr. Greely said that
an instructor cannot insure that a certain type of ethical issue will come up
in a classroom. Mr. Wayda said that the Medical Board approves the
schools in advance, so it is difficult for the Board to guarantee exactly how
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each class will be taught. He said that a school just has to show that it has
scheduled time to cover ethics. The committee members said that they
approve of the language suggested by Mr. Melecki.
Mr. Wayda said that all schools are held to the curriculum rule. Mr.
Greely said we are only changing that of the required hours, 10 hours must
be hands on. Mr. Wayda said that the conditions are being made clearer
because in this proposed rule, there are potentially fewer hours being spent
with students. He stated that this discussion did not come up when the
curriculum rule was discussed and the Board has already approved it. He
believes it is not necessary to change it now.
Mr. Gibbons asked whether, in subsection (C)(4), the documented training
or certification for instructors needs to include continuing education. Mr.
Greely pointed out that there is no requirement for continuing massage
therapy education in the state of Ohio. Mr. Melecki asked why there is no
requirement. Mr. Wayda said that there is no specific statutory
requirement for continuing massage therapy education.
Mr. Greely asked if the scope of massage therapy is in the Administrative
Code or the Revised Code. Mr. Wayda said the scope is in the
Administrative Code. Mr. Melecki asked if that makes any difference?
Mr. Wayda said it can, and that is why the Board staff is looking into the
issue of continuing massage therapy education. Mr. Greely said it may
behoove massage therapists to have their scope in statute. Mr. Wayda said
that it would be a great topic of conversation for the next AMTA-Ohio
meeting. Mr. Wayda said he would be comfortable sending the rule, with
the addition, to the Board for approval. Mr. Gibbons made a motion for
approval of the distance education rule, with the additional language in
subsection (C)(7). Mr. Greely seconded the motion and all member voted
aye. Mr. Wayda said that he will see if Professor Zirkle has any useful
information for the committee’s edification.
V. Sales Tax for Massage Therapy
Letter on tax issue:
Included in the agenda is a letter that was sent to President Browning. Mr.
Wayda said the letter states, essentially, that the Board obviously is not
doing a good job of representing massage therapists, otherwise massage
therapists would not be taxed. Mr. Wayda pointed out that the Board does
not represent massage therapists, rather that is the job of the AMTA-O.
The Board regulates massage therapists. Mr. Wayda said that at the end
of the Board's response to any letter like this received by the Board, it is
pointed out that the AMTA-O is the appropriate organization to pool
resources with to try to influence desired changes.
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Mr. Wayda asked the committee to look at the second to last paragraph in
the letter- the language that physicians do not understand or are not
qualified to make referrals for massage therapists. Mr. Melecki and Mr.
Wayda said that the writer was inaccurate because physicians are the most
qualified providers of all health care professionals. Mr. Greely asked
where this person was when AMTA-Ohio was trying to get the language
changed. Mr. Meyer added that AMTA-Ohio tried hard to get the
information to the legislature regarding the difference between a masseuse
and a massage therapist.
Mr. Greely asked Mr. Weldele where the situation lies now. Mr. Weldele
said that a bill has been proposed to eliminate the sales tax on auto towing.
He is keeping tabs on who supported this most recent proposal and he is
working to garner support for a bill to eliminate taxation of licensed
massage therapists. Mr. Weldele said that he doesn’t know if the Medical
Board would be willing to do so, but a letter with the Medical Board’s
view on the matter may go a long way with certain representatives. He
said that individual licensed massage therapists should contact their
representatives and that AMTA-O is sending out postcards in order for
massage therapists and their clients to mail them to individual
representatives to educate them.
Mr. Melecki said that there is a market disadvantage to massage therapists
because the Department of Taxation can more easily track massage
therapists than other massage providers, so massage therapy services are
more likely to be taxed than other massage providers.
Creating list of “similar services” to forward to Department of
Taxation:
The Department of Taxation asked for a list of phrases that would help it
identify those professions that should be taxed under massage and “other
similar services.”
Ms. Jewett offered a list that she prepared:
Rolfing Reflexology
Trager Shiatsu
Acupressure On-site/chair
Cranial-sacral Neuromuscular
Touch for health Deep tissue
Ortho-bionomy Myofascial release
Equine massage Energy based techniques
Reiki Therapeutic touch
Healing touch Pranic healing
Polarity
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Anything with the name massage in it, such a geriatric massage or
orthopedic massage or spa stone massage or thai massage
Mr. Wayda commented that the Board has come to the conclusion that
rolfing is a type of massage and, in fact, is therapeutic. Therefore, to Rolf
in Ohio requires an LMT license. Ms. Jewett said trager is a form of
rocking. Mr. Melecki said that there is a book called “Discovering the
Body’s Wisdom” by Merca Knaster, which reviews the types of bodywork
available. This book should give a good list of what types of massage
there are. Ms. Jewett said the very popular type of massage is reiki,
however many providers do not charge for it but may welcome tips. Mr.
Weldele said tips are not taxable, but if the provider would not let the
person receiving the reiki walk out the door without tipping, then they are
charging for their services and they are therefore taxable.
Mr. Phillips said that body work should be on the list as well. Mr. Wayda
asked if reiki is a massage procedure encompassing touching of the body.
The committee members said that it depends on the provider, but it is part
of the training. Mr. Gibbons asked whether this taxation bill is a
renewable bill. Mr. Weldele said it is part of a biennial budget, which is
reviewed every two years. Not every part of the bill is reviewed
necessarily, though. A new bill proposing the statute be changed back
would have to be approved in order for a change in taxation to occur.
Mr. Gibbons asked if the Alexander technique should be on the list. Mr.
Melecki said it is more of a teaching technique. Ms. Jewett asked if
Gilchrist technique is in that same vein. Mr. Melecki said many times it
encompasses no touching of the body, so is not appropriate for the “other
similar services” list.
Mr. Wayda asked if some of these techniques would be advertised. The
committee members believed they would not be advertised in the phone
book necessarily, therefore the list will be helpful in identifying such
practices to the Department of Taxation. The committee members said
that they feel comfortable with the list as changed. Mr. Wayda said he
will tweak the list and give it to the Department of Taxation and let it
know that if anything specific comes up that it is welcome to ask MTAC
any questions.
VI. Rule 4731-1-05, Scope of Practice
Use of titles:
Mr. Wayda asked committee members to review the proposed rule 4731-
1-05, subsection (C). He stated that the language is taken from the statutes
where it talks about how different practitioners are allowed to identify
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themselves. Mr. Melecki said the language sounds find, and he said he
agrees that L.M.T. is the best way to identify licensed massage therapists,
because they otherwise could be confused with medical technicians if
identified as M.T.’s. Mr. Wayda asked if AMTA-O has a position
regarding how massage therapists should be referred? Mr. Weldele said
that they usually designate them L.M.T.’s and suggested that there should
be a penalty for those who use the same initials without being licensed
with the Medical Board as massage therapists.
Mr. Greely said that he believes there is a law that you must practice under
your own name; for example, you could not name your business
“Reynoldsburg Massage.” Mr. Gibbons pointed out that you are always
practicing under your own name. Ms. Baldwin said that legally your
practicing under your name as a licensee. Mr. Wayda pointed out that in
4731-1-03 (G) of the OAC, there is language that states “No person
holding a certificate to practice any limited branch or branches of
medicine shall conduct such practice under any name or title, either as an
individual, company or concern, that is misleading.” Mr. Melecki pointed
out that a business name of “Vandalia Massage Therapy” could be
misleading if some massage technicians (unlicensed in massage therapy)
performed the massages.
Ms. Jewett asked if under (C), massage therapists should be using L.M.T.
as a designation and asked if the Medical Board would also be doing so?
Mr. Wayda said yes. Mr. Phillips asked if M.P., for massage practitioner
would be another possible designation? Mr. Wayda said that massage
practitioners are unlicensed and therefore the designation would not be
appropriate for a licensed massage therapist to use.
Display of certificates/multiple certificates:
Mr. Wayda said that the language in (E) is taken from the statute on
physicians displaying of certificates. Mr. Greely asked if the language
should include carrying of the renewal card if you are more of a transient
vendor. Mr. Melecki asked if it needs to be an original copy? Mr. Wayda
said yes. Mr. Greely said that the original certificate should be displayed
at the primary place of business and the wallet card should be carried
anywhere else business is done.
Mr. Gibbons asked why it would not be acceptable to display color copies
if there is more than one place of business? Mr. Wayda said that it is
related to the wording of the statute; the original copy is the instrument
that gives one the authority to practice. Mr. Wayda said that the Medical
Board will provide a second original certificate if the original is lost or
destroyed. “Multiple places of business” has not been interpreted by the
Board as a situation warranting the issuance of a new original certificate.
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This also cuts down on fraud since someone could request a new
certificate or make a copy of his or her own to give to an unlicensed
person to display.
Mr. Phillips said that it is not illegal to display a copy for clients’ comfort
if a massage therapist works sometimes in a different office, as long as the
original is displayed in the primary place of business. Mr. Wayda said he
does not believe that to be true since there is presently no requirement that
massage therapists must display their certificates. Ms. Baldwin said that
since: there is not a requirement for a massage therapist to hang his or her
certificate; the original gives the authority to practice and in the spirit of
hampering fraud, the display of a certificate copy, even if for the comfort
of the client, is not the most prudent decision. She also said the language
should be included in the rule that a massage therapist is required to carry
his or her renewal card when working off premises.
Mr. Melecki said that the advisable thing is to have the certificates
displayed for the public. He does not imagine that there are too many
individuals holding themselves out as massage therapists. Mr. Meyer said
that Florida requires that all massage therapists put their licensing number
on all identifying paper work or marketing items. Mr. Wayda said he will
work on language and either e-mail it out or bring it back next month.
Mr. Wayda said that the Board staff sent a draft of this rule to the OPTA
and one of OPTA’s suggestions was to add a (4) under (F) “Prohibitions”
regarding joint mobilization. Mr. Wayda asked Mr. Melecki if that is a
term of art and, if so, what it means. Mr. Melecki said chiropractors and
osteopaths manipulate joints, and physical therapists mobilize joints,
which means the external application of force through a joint capsule.
Mr. Greely asked if a joint mobilization of the shoulder could simply be
trying to assess laxity of the shoulder? Mr. Melecki said the way that the
massage therapy rule is described, passive joint movements, stretching and
compression are all techniques that would be used in joint mobilization, so
you would create an unenforceable conundrum within the rule. Mr.
Greely said that massage therapy joint movements could be construed as
joint mobilization. Mr. Melecki said that the rule was written to be
phrased as “passive joint movements” largely on the prompting of
physical therapists who wanted resisted joint movements removed despite
the fact that massage therapists have been taught for the past 100 years to
do resisted joint movements without any harm, as far as he knows, to any
individuals.
Further, Mr. Melecki stated that he believes the fear among physical
therapists could be that opening up therapeutic exercise and resisted joint
movements to break up adhesions to injured joints by massage therapists,
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when applied in certain ways, could lead to further injury. Mr. Greely
asked if it is a standard of practice issue? Mr. Melecki said yes, he just
finished writing a book on the use of muscle energy technique, which is a
lightly resisted joint movement technique, and the target market is soft
tissue therapists, which is largely physical therapist assistants (not in
Ohio) and massage therapists. And when taught properly, it is very
helpful. It is used to mobilize soft tissue, not to mobilize joints.
Mr. Melecki thinks the rule is inclusive enough. Can a massage therapist
do something to harm someone and not be covered by this rule? Of
course, you cannot cover every situation. If you put in joint mobilization,
you have put yourself into a conundrum; in real world, face-to-face
situations with clients, you have made a meaningless statement and taken
a chunk out of what a massage therapist can do. The techniques of joint
mobilization are specific manual therapy approaches that address the
joints, and using all the techniques can be described as stretching,
compression and passive joint movements. Ms. Jewett asked if it comes
down to intentions? Mr. Melecki said yes.
Mr. Greely asked if he has a patient that has had lateral epicondylitis, and
there is some scarring, and he tries to mobilize the joint to break up the
adhesion in the elbow- in the normal physiological range of motion,
manipulating soft tissue- is that a joint mobilization or a joint movement?
Mr. Melecki said the textbook definition of a joint mobilization is a skilled
manipulation of the joint. More technically, the difference between what
massage therapists do and what physical therapists do, is the distinction
between osteokinematics (bone) and arthrokinematics (joint). For
example, for a frozen shoulder, as a massage therapist (no referral for
physical therapy), he would take the client’s arm through the full range of
motion and maybe even do some long axis stretching through the bone.
This is not, in the technical terms of physical therapy, a joint mobilization,
rather it is a passive range of motion. However, if he put his hand right
over the joint and pressed the humerus back into the table so that the
acromion and the humerus come into contact, now his attention is focused
on the surface of the joints with the intention of stretching the ligaments
and popping adhesions as a physical therapist. Or, he could take the
shoulder and press down on the shoulder, with his hand in a very specific
place on the shoulder, as a physical therapist. He said that it is a
distinction that this rule would not adequately discriminate.
Mr. Melecki asked Mr. Greely how long he has been teaching. Mr. Greely
said he has been teaching massage therapy for a long time. Mr. Melecki
then asked how much of what Mr. Melecki just spoke about did Mr.
Greely understand? Mr. Greely said that, because he has worked in a
physical therapist environment, he actually understood the concepts. Mr.
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Melecki asked how many massage therapists just coming out of school
would understand, and the committee members said none.
Mr. Wayda said that in massage therapy, as well as in the practice of
medicine, intention is part of the definition. There is a two-part definition
of scope of practice: (1) the actual techniques that you use, and (2) the
purpose for which you use them. “For the purpose of” is the intention part
of the definition. The difference, in part, between the procedures that
massage therapists and massage practitioners do may not be discernable to
the layperson, but the reason that they are done is where the difference in
scope lies- the massage therapist is doing so for therapeutic reasons.
Mr. Phillips asked about an individual who works at a chiropractor’s
office as an assistant who does filing in the office, among other things, but
also works there as a massage therapist. Is that allowed? Mr. Wayda said
the Board’s advice is that the parameters must be clearly drawn to clients
of what hat the individual is wearing at that time. The individual must
know his or her scope of practice extremely well. Billing is also an issue
because the licensed medical individual whose office it is could be billing
fraudulently and the massage therapist would be implicated as well.
Mr. Wayda asked, generally, how the committee feels about the scope
rule. Mr. Melecki said an idea is to include a sentence in (F) saying, “as
used within this rule, soft tissue manipulation does not include graded
forces being applied across specific joint surfaces for the purpose of
intentionally breaking adhesions.” The committee members decided to
add the above language as (F)(4). Mr. Wayda said he is going to work on
some language for the wallet cards and e-mail that to committee members
and take the rule to the Board in November. Mr. Gibbons made a motion
to move forward to the Board for rule making and Ms. Jewett seconded
the motion. All members voted aye.
VII. Review of New FAQ’s for MT Subweb
Working “under” a physician’s license:
Mr. Wayda said that this FAQ deals with unlicensed persons performing
massage under the license of a physician. The delegation rules are
attached because they are implicated in the answer. The answer is that
therapeutic massage is the practice of a limited branch of medicine and
cannot be done by people who are not licensed. Therapeutic massage
cannot be delegated under the present statute and rules. The crossover
between therapeutic and non-therapeutic is difficult to regulate in a
physician’s office. Mr. Wayda stated that he believes that some
physicians may “delegate” the performance of therapeutic massages under
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the physician’s license, which is not permissible. Mr. Melecki said that he
believes it is more of an issue in a chiropractor’s office.
The committee members believed that the FAQ looks good. Mr. Wayda
said that he would pass it by other staff attorneys as well; Ms. Baldwin has
already reviewed it.
Report of non-compliance with sales tax law:
Mr. Wayda said that during the last meeting the committee discussed the
competitive disadvantage when professionals who are required to do so do
not pay taxes. Such individuals should be reported to the Department of
Taxation. The committee members said the FAQ looks good.
X. Miscellaneous
The Board’s website has changed from http://www.state.oh.us/med/ to
http://www.med.ohio.gov/ Mr. Melecki asked whether a visitor to the
old website will be forwarded to the new website address? Mr. Wayda
said that you will be redirected for about three months.
Mr. Gibbons made a motion to adjourn and Ms. Jewett seconded the
motion. All members voted aye.
X. Adjournment
The meeting adjourned at 4:17 PM.
I certify that these are true and accurate minutes of the October 16, 2003
meeting of the Massage Therapy Advisory Committee.
____________________________
Mark Wayda (for the Committee)
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