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24 December 2003
A Christmas Greeting through the Centuries
In the Celtic tradition, there is great power in times that are neither this nor that — times that are betwixt and between. In such times, the gates between the worlds are not as strong, allowing magic to roam freely upon the Earth (e.g. The Stolen Child; Tam-Lin (1) and (2); Thomas the Rhymer). The very ambiguity and chaos of such times alludes to great potential for change and the opportunity for renewal and new beginnings (the Chinese ideogram for crisis combines both danger and opportunity). It is a time for reaffirmation and commitment to paths of value to our personal and community lives. |
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In the northern hemisphere, we are in the time between winter solstice
[Alban Arthuan ("The Light of Arthur") or Yule] and our celebration
of our calendar new year. It is the time when our days are shortest yet
also when
once again they begin to lengthen, bringing hope for returning warmth and
the rebirth of spring. The vulnerability of the cold and dark also prompt
us to turn to each other in community and support — forgiving old
wrongs and reaching out in new connection. For those in the far south there
is also
promise — the promise that days becoming too long, hot, and bright
will
give way to times of cooler breezes, quieter contemplation, and less raucous
togetherness. It is a time, I believe, for reaffirming our connections
with those
most close to us (see Jalal-ad-Din Rumi, The
Fairest Land) with hugs,
cuddles, and caresses and
a time for reaching out to bring more positive
touch and gentle kindness to our
greater communities and world.
It seems a time for me to again thank those of my electronic communities for their ear and voices that have given me the pleasures of camaraderie and discussion. As part of that, I want to share the following, taken from a greeting from Fra Giovanni to a friend in 1513 and more recently published as a notecard by the Christmas Revels:
I Salute You!
There is nothing I can give you which you
have not; but there is much that, while I
cannot give, you can take.
No heaven can come to us unless our hearts
find rest in it today.
Take Heaven.
No peace lies in the future which is not hidden
in this present instant.
Take Peace.
The gloom of the world is but a shadow;
behind it, yet within our reach, is joy.
Take Joy.
And so, at this Christmas time, I greet you,
with the prayer that for you, now and forever,
the day breaks and the shadows flee away.
The above is part of a letter that was written by Italian architect and scholar Fra Giovanni Giocondo to his friend, Countess Allagia Aldobrandeschi on Christmas Eve, 1513.
23 December 2003
Playing the Tactile Touch
I spent part of today playing at the San Francisco Exploratorium, the museum of science, art, and human perception. Part of the day's play and exploration were in the Tactile Dome, a geodesic dome divided into thirteen chambers of passages, ramps, and slides which one traverses in total darkness (advance reservations required). The surfaces within the dome are designed to present a large variety of tactile experiences from velvet to bubble wrap. What more could a tactile professional want than to play with the experience and perception of touch itself?
The Toy in the Cereal Box
A fellow participant on one of my email lists recently noted that stressed and desserts are reverse anagrams of each other and, also, that a bit too much of both are often present during the holidays. You'll have to handle the dessert surplus yourself, but here's a tip for releasing some shoulder tension. Eric Franklin, in his recent book Relax your Neck, Liberate your Shoulders, advocates placing a pair of soft balls under your armpits and then proceeding with computer work or work about the house for around five minutes. Use whatever slight pressure is needed to hold the balls in place. When you remove the balls, you may find that your shoulders have considerably relaxed. The secret is Sherrington's second principle of Reciprocal Inhibition (RI): "When contraction of a muscle is stimulated, there is a simultaneous inhibition of its antagonist. It is essential for coordinated movement."
21 December 2003
The Shortest Day; The Longest Night
I pretty much did my main solstice greeting yesterday, so scan down a bit for that. However, last night the email summaries via Bloglet weren't working, so this is also a heads-up for the email subscribers to the Massage Politics Sheet now that the Bloglet connection is working again. The official passing of the solstice is at 11:04 p.m. PST tonight.
This time also brings to me reflections of the Swedish side of my ancestry and the celebration of Lucia Day. Some years back, when I was first learning Scandinavian Dancing, the class I was in did a small Lucia Day dance performance and celebration at the local library. Here are more pictures and music and a picture, and description of Lucia Day celebrations. Note that in the pre-Gregorian calendar, 13 December was the shortest day.
Perhaps it was inevitable that my perceptions of massage practice have been heavily colored by my times of learning and of play within the communities of Scandinavian and Scottish Country dancing and music. The ties of rhythm, flow, play, and connection have long ago taken me over. The Massage Politics Sheet is now at it's first anniversary. It is partly the passion gained from dance and music that has fired this purely pro bono effort. Many thanks for your ears and time. May you all have a wonderful solstice and a merry Christmas filled with song, dance, old friends, and new beginnings.
Someone who does not run toward the allure of love, walks a road where nothing lives. — Jalal ad-Din Rumi (1207-1273 CE)
20 December 2003
So the Shortest Day Came, and the Year Died.
For a number of years now, I've shared with friends and companions a few of the songs and poems that I've come to associate with part of my own observance of the winter solstice. Part of these have come from the collection of performances of the Christmas Revels, including our own local San Francisco Bay Area Revels. This last has long been a favorite seasonal venue for a number of my Scottish Country Dance friends.
A few year back I sequenced the tunes and made web pages for the Abbots Bromley Horn Dance and the haunting tune and lyrics of The Land Beside the Sea. I've also included some of the mythology of the dying of the old year and the rebirth of a new year in my column Myth and Magic.
Another recurring part of the Revels celebration and of my personal celebration has been in the contemplation and sharing of Susan Cooper's poem to celebrate the deeper social and community meanings of the solstice to those in northern climes. With all of you who have followed my words during this past year, I share this poem yet again.
The Shortest DaySo the shortest day came, They lighted candles in the winter trees; And when the new year's sunshine blazed awake And so do we, here now, A poem written for the 1977 Christmas Revels by Susan Cooper |
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14 December 2003
AMTA-CA Requests That AB 1388 be Tabled in Committee
According to an email sent by Beverly May, governmental relations chair for AMTA-CA, they have requested that AB 1388 be held in the Assembly Committee on Business and Professions. If this is done, AB 1388 as such is dead. There is a slight possibility that a new bill could be introduced in 2004 and a much more likely possibility for a reintroduction of a bill in the 2005-2006 legislative session. The AMTA-CA statements I have seen base their request on the current state of state affairs.
Due to the political and fiscal chaos in the state resulting from the recall and budget crisis, we feel it is not the best timing to try to get legislators attention. In addition, we want more time to develop a better bill, with more input.
Judith McKinnon and I were in Sacramento last Thursday, lobbying several members of the Assembly Committee on Business and Professions against AB 1388. Lou Correa, chairman of the Committee, intends to hold an informational meeting on AB 1388, likely in March 2004. Even with the bill tabled, additional letters are still important input for this meeting. Keep the pressure on. The informational meeting will likely have substantial impact on legislative consideration of any reintroduced bill. According to Correa and his Principal Consultant David Pacheco, such informational meetings are a common follow up to a regulatory bill displaying lack of consensus within the affected profession.
Also according to David Pacheco, letters to Lou Correa are currently three to one in opposition to AB 1388. They started out mainly in favor of the bill and recently have been running four to one against it. Pacheco pointed out a stack of letters on AB 1388 about eight inches thick. While the AMTA-CA announcement doesn't note the balance of letters, in all likelihood it contributed as much to the AMTA–CA decision to table the bill as did the affairs of the state as a whole. The differences of opinion represented in the licensing attempt and letters are certainly the motivation for Lou Correa to hold an informational hearing to clarify for the Assembly the situation within the massage profession.
Many thanks for your time, efforts, and participation in shaping the future of massage training and practice in California. Also my personal thanks for those who have read, contributed, or acted upon what I've written in The Massage Politics Sheet. We are at the anniversary of when I first decided to redesign my personal web pages to implement the MPS. The anniversary of my first posting will be on 23 December. Whatever these pages have accomplished couldn't have happened without your help. For that help, I am both very grateful and deeply humble. I will continue to do my best to provide information and resources on the politics of massage.
…Keith
07 December 2003
Of Meetings and Position Papers in Response to AB 1388
First off the mark, there will be an AB 1388 legislation update meeting on Wednesday, December 10, 7:30 p.m. at the McKinnon Institute (SF East Bay). Now is the time for input, since the state Assembly will be acting on this bill in January. Protect the future of massage and bodywork in California as well as the future of your own practice. Come to the meeting and learn when and whom to write, email, or call.
I've been quieter than normal lately, partly working up several short position papers with more to come. Here's the current list:
- Working for a 21st Century Model for Complementary and Alternative Healthcare
- Taking a Closer Look at the NCE
- The not Quite Existing CCSP
- Onerous Local Regulations aren't Pervasive
- One Scope of Practice
These deal, respectively, with promoting the use of SB 577 (the California Health Freedom Act) rather than AB 1388, not mandating use of the NCE, and lack of an objective justification for differentiating scope of practice between 250 and 500 hour tiers in AB 1388.
In addition, here are pre-addressed envelopes (#10 — 4.125" x 9.5") to the Assembly Committee on Business and Professions, their consultant, and Christine Kehoe, the author of AB 1388. All of these are Acrobat PDF files. If you haven't installed the free Acrobat reader software, click on the yellow rectangle in the navigation bar at the left.
18 November 2003
Sending Your Thoughts to Sacramento
I noticed that the current issue of California Currents, the newsletter of AMTA-CA, has a couple of pages urging members to send letters supporting AB 1388. This request is well within their prerogatives. Consider for yourself, however, whether or not you feel sufficiently represented by AMTA-CA perspectives. If you are opposed to licensing or if there are particular issues you want considered, it's high time you yourself sent your thoughts to Sacramento.
The place to send letters or email right now is the Assembly Committee on Business and Professions, with copies to your own Assemblyperson and to AB 1388s author, Assemblymember Christine Kehoe. Be sure to include your name and address at the end of your letter. The body of the letter does not have to be long and complex. If you oppose AB 1388 and are in favor of practice under last year's health freedom act, SB 577, something like the following would suffice.
Dear Assemblymember,
As a member of the Assembly Committee on Business and Professions, I am
requesting that you oppose AB 1388. I believe that last year's SB 577,
the health care freedom act, took the right approach for the future in
defining unlicensed health care in the California Business and Professions
Code. Therapeutic massage is part of this definition of unlicensed health
care. I believe that it is premature to enact new massage regulation
without allowing time for this important change in paradigm to take full
effect. Thank you.
If you support the concept of licensing, but believe that it is important to preserve the unrestricted scope of practice for the 250 hour tier and to stay away from mandating the National Certification Exam, a letter like the following would suffice.
Dear Assemblymember,
As a member of the Assembly Committee on Business and Professions, I am
writing you regarding AB 1388 and the regulation of therapeutic
massage. I wanted to let you know how important I feel it is that the
entry level 250 hour tier retain an unrestricted scope of practice, as
it has in the September amendment to AB 1388. I also wanted to let
you know how important it is that neither tier mandate the use of the "National
Certification Exam" (NCE). The NCE has a place, but only as a voluntary
certification. If either of these conditions were to be violated, I would
urge you to oppose the bill. Thank you for your consideration.
Add a brief few lines about your own practice of massage and why it is important to you. That's all it takes, folks, to be a participant in shaping the future of massage in California.
For those of you in other currently unregulated states, the same considerations apply in opposing or shaping any submitted bill. In currently regulated states, the regulating board serves at the pleasure of the legislature. In many states there is a periodic "sunset" evaluation of if the regulation is still needed and if the board is functioning appropriately. You can provide input to this review. If you don't know where to send such input, one of your own legislators can help you find out the correct office.
The way to have an effect is to get those letters or emails out the door. The way to increase your own effect, is to get friends and colleagues involved.
15 November 2003
CAMBS Promotes Portability of Transcripts
CAMBS, the California Alliance of Massage and Bodywork Schools, has announced its commitment to encouraging portability of training hours between member schools. This was an important item of discussion at the 7-8 November semiannual meeting. It's a policy that can only act to benefit students throughout California. We live in a mobile society in which people often have to relocate with family to follow job opportunities. Kudos to the CAMBS member schools for recognizing the importance of this issue.
14 November 2003
ABMP Creates a Valuable Resource
ABMP has purchased the rights to the massagetherapy.com domain. While they maintain their own site mainly for member services, they are pushing this new site into being a public resource. Over past articles from Massage & Bodywork have been edited to remove unnecessary jargon and been made openly available. The current focus area is on pregnancy massage.
CAMBS Makes AB 1388 Sunrise Response Available for Review and Comment
The California Alliance of Massage and Bodywork Schools (CAMBS) has added several documents to its library section and implemented a guestbook to its website in its ongoing efforts to insure that massage schools and individual practitioners throughout California are given an opportunity for review and comment on all pertinent AB 1388 documents.
The library now includes both the introduction and main body of the sunrise application submitted by Beverly May and AMTA-CA to the Assembly Committee on Business and Professions. This document is required to be submitted by anyone proposing new regulations. The purpose is to justify the proposed law and to prove the need for it. Until now it has been very difficult to get a copy, so it is another coup for CAMBS that they are able to provide this. It is very important to read it as soon as possible as the B&P committee is currently reviewing it. Any concerns you have about the information included in the sunrise application should be sent to the B&P Committee and to the Governor as well as to Assemblymember Christine Kehoe. Please also use the CAMBS guestbook for comments.
Tossing the Lowball
There's increasing indications that the AMTA-CA, in attempting to gain concurrence for their own goals for AB 1388, may be borrowing a popular and very effective persuasion technique used by car salespersons.
The AMTA has a long tradition of pushing for massage licensing with a minimum of 500 hours and the national certification exam attached. In California, however, they have been faced with a situation in which both the ABMP and CAMBS are adamant about having, at maximum, an entry level of 250 hours — a level corresponding the the upper level of the CAMBS hour recommendations for entry level training. Although AMTA-CA has been working with a coalition of organizations, indications are increasing that they have neither changed attitudes nor their traditional goals.
The early indications were simply the insistence of a 500 hour tier, undifferentiated by scope of practice, to the current wording of AB 1388, despite that tier adding nothing to exemption from local regulations, the supposed motivation for the bill. Additionally, now that the sunrise questionnaire response is available via CAMBS after much stonewalling, examination of the sunrise response shows continual reference plus supporting documentation on the national certification exam. Now, there's been a push for restricting the scope of practice of the 250 hour tier. Finally, only this week, a key bill author essentially referred to the bill as a 500 hour regulation with a 250 hour tier added. So, is there a discernable strategy within the AMTA-CA actions?
To understand what I believe is occurring, first read Throwing the Lowball by social psychologist Robert Cialdini. He details one of the techniques favored by car salespersons.
One tactic that enjoyed popularity among the staff is called by a number of names but for our purposes can be referred to as lowballing or throwing a lowball. Although the technique had certain variations, the crucial feature was invariant: The customer was given a price substantially below the amount at which the salesperson intended to sell the car in order to induce the customer to agree initially to the purchase—hence the “lowball” title.
Then consider the offer of a 250 hour bill with full scope of practice
and
no NCE -- but all we want to do is add an (unnecessary) 500 hour tier on
top. There's the offer with the incentives of no scope of practice
differentiation and no NCE. I believe the second tier was added knowing
that
it was problematic to support it. That problem was one I have pointed out
previously and accordingly pushed hard for a differentiation on experience
(e.g. the 250 hours) without scope changes or NCE. So first they have to
get commitment to the deal.
Now comes the lowball: first change the scope of practice of the lower
tier,
because (sure enough) "the boss (in sales vernacular)" won't go for the
deal. Get people to agree on that. Then the final step: add the NCE to
the
upper tier because the differentiation still isn't clear enough. Folks,
there's already plenty of groundwork laid down for that in the sunrise
response. If anything, legislators should be asking "why aren't you
requiring NCE" after that prep-work. We need to tell them.
The error in the AMTA-CA strategy is that there are enough practitioners and organizations willing to kill the bill entirely rather than concur. Despite AMTA funds and a paid lobbyist, AB 1388 will be extremely difficult to pass against significant opposition. In pursuing their separate goals, AMTA-CA is gambling that they can get the whole pie without getting the entire bill dumped. Pushing beyond the 250 hour tier may cost them dearly. In terms of underlying attitude and understanding, they still haven't gotten it that there is an active massage community out here beyond them. It may just be that some lessons of attitude, openness, and respect have to be learned the hard way, before we can progress forward together.
I believe that the scope of practice issue and the issue of requiring the national certification exam strike close enough to people's core/gut issues that they will respond. Holding the line on these issue is crucial to avoiding the lowball. As Cialdini notes, lowballing is an amazingly effective technique of social influence. Don't buy the product at an inflated price.
As always, don't simply believe my words. Review the facts, read AB 1388 and its supporting documents, and make up your own minds. Please, however, be involved in the future of your own practice. Being a submarine is not a good option. AB 1388 carries a penalty with it of a fine of up to $5000 and/or not more than one year in jail.
10 November 2003
Will AB 1388 limit your scope of practice to wellness and palliative work?
Apparently the group of eight authoring AB 1388 have run into a bit of a problem. In writing recommendations for the September revision of AB 1388, they added the second 500 hour tier on top of the lower 250 hour tier. Partly this was done for interstate portability. To a large extent, however, I believe that the second tier was added to create a marketing distinction for those in the AMTA paradigm that could be used in lobbying spas and other employers of practitioners.
The problem that has developed is that the second tier has little to distinguish itself from the first tier. Comparing eligibility requirements set by the NCBTMB with the CAMBS upper level 250 hour recommendation, the differences boil down to about 60 hours of anatomy and physiology and 200 hours of training that must "be related to massage and bodywork". I've put together a position paper detailing why I very strongly believe that a scope of practice differentiation is not warranted. Feel free to draw on this for your own communications with others.
There is little of significance to motivate two tiers that is specific to benefiting California consumers. I've previously offered that this could be partly alleviated by requiring 250 hours of experience for the second tier.
If the 250 hour tier were eliminated in an attempt to keep the 500 hour tier, both the California Alliance of Massage and Bodywork Schools (CAMBS) and the ABMP would strongly push to immediately kill AB 1388. It is unlikely that the AMTA sponsors could overcome this combined opposition. If the 500 tier were eliminated, the sponsors would be ignoring their own special interest. This is unlikely. As a way of differentiating the tiers, the AMTA sponsors have apparently started work on language that would restrict the scope of practice of the first tier to wellness and palliative work. There are still some issues of egalitarian attitude that they apparently have been slow to learn.
If AB 1388 passes, the resulting board is likely to end up oriented towards the 500 hour tier, politics being what it is. If language restricting scope of practice is included, rights to claim treatment just gained with the passage of SB 577 could well be lost for a majority of California practitioners.
My opening question of "Will your practice be limited to wellness and palliative work?" may well depend on your individual willingness to voice an opinion. If you think that a few expressions plus or minus don't count, think back to the 2000 presidential race. Are you willing to place your career options at the mercies of a well-funded AMTA lobbying and letter writing campaign?
If you want your opinion to count, please express your views on scope of practice and AB 1388 as a whole to the Assembly Committee on Business and Professions and to your own assemblyperson. With AB 1388 currently under sunrise review and needing to clear the assembly by the end of January, there will be few better opportunities. For those that prefer regular mail, here's predone envelope pages for the B&P committee and the bill author (Christine Kehoe).
04 November 2003
Scope, Exemptions, & Controlling the Turf
Out of the blue, today, I received comments on AB 1388 from medical practice management consultant, Jerry Green, JD. Green has some thought-provoking comments on scope of practice, exemptions, and turf ownership.
I had previously commented on the ill-advised usurpation of the term bodyworker in the current version of AB 1388.
Right now, AB 1388 reserves the generic term "bodyworker" for use by the upper tier. It strikes me as a bit or arrogance to attempt to protect a term already in widespread use for diverse bodywork methods. There are a lot of different methods out there, even by a simple catalog.
Green goes further into this area, legitimately framing it as "an attempt to control the schoolyard". His thoughts on needing a self-consistent explanation of circumstances for exemption are refreshing. It takes exemptions beyond a random laundry list. Even better than a sound basis for exemption would have been to have avoided writing a practice act for techniques that are too inherently safe to intrinsically require restriction.
Another area of deep concern is the definition of scope of practice. Green correctly focuses on this as defining professional identity. AB 1388 defines massage (and also, interchangeably, bodywork) as:
the application of a system of structured touch, pressure, movement, and holding to the soft tissues of the human body with the intent to enhance or restore the health and well-being of the client.
Note that this definition does not speak to moving bones and joints on the way to facilitating normalization of soft tissues. Such conderations would apply in using post-isometric relaxation techniques of even in positioning a joint so that a muscle could be worked in a deep tissue sense while it is already lengthened (see Art Riggs's excellent deep tissue book and videos). We might think that this is obvious, but recent experience with state boards is not reassuring to this assumption.
If this is not exactly the kind of stuff you would write home about, it quite likely is the kind of stuff on which you should express your opinions to the California Assembly Committee on Business and Professions. The scope and name of what you practice in the future may well depend upon your action now.
The Toy in the Cereal Box
The nonpolitical tip for today is on a new book that I'm in the middle of. The book is Terry Orlick's Embracing Your Potential — Steps to self-discovery, balance, and success in sports, work, and life. It's a new release brought out by Human Kinetics and looks to have some very practical material on setting goals and keeping focused to gain achievement and enjoyment.
While I'm in book mode, another recent Human Kinetics release is Sandra Cerny Minton's Dance Mind & Body. It's a nice overview of body awareness, movement, and the use of space and tempo.
02 November 2003
Does the New Jersey Experience Bode Caution for Pennsylvania?
Having recently commented on the patronizing treatment of the massage profession in the proposal issued up by the New Jersey Nursing Board, I can only wonder if Pennsylvania licensing proponents are also so eager for a licensing act as to sell their souls in a Faustian agreement.
Given the recent New Jersey proposal, the appearance in NJ is that the regulation of massage has been placed in the hands of a nursing board not particularly amiable to the normal breadth of practice of massage. With Pennsylvania considering licensing under the PA nursing board, the operative phrase may well be "let the buyer beware".
Massage Politics Entries for September and October Archived
The MPS entries for September and October have been moved into their own archive file. There's also a link to the archive index page on the navigation bar to your left.
