Whitney Lowe is a continuing education provider, an author, and offers an online certification program in orthopedic massage. He wrote this guest editorial for MASSAGE Magazine on the topic of the Federation of State Massage Therapy Boards’ (FSMTB) new proposed continuing education approval program. On April 11, FSMTB Executive Director Debra Persinger told MASSAGE Magazine the new program is going into a pilot phase soon and could launch shortly thereafter if it does not require another round of technological attention

Our profession has seen its share of infighting among individuals and organizations. We have also seen great models of collaboration and mutual benefit.

Recent collaborations of the major professional organizations led to the creation of two very important projects for our profession: the Massage Therapy Body of Knowledge and the Entry Level Analysis Project.

For some time it looked like we were on the road to a great period of partnership and teamwork.

However, it seems that period has hit a speed bump with a major initiative from the Federation of State Massage Therapy Boards (FSMTB) to get into the process of approving continuing education (CE) programs for state licensure renewal.

I have been a CE provider for more than 20 years. I have also worked independently with state boards on various issues, and am a former board member of the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB), so I understand the challenges and issues that crop up around this process from multiple angles. I have also spoken with leadership at both the FSMTB and NCBTMB about this issue to fully understand their perspectives.

I am quite distressed about the way this event has evolved and think it is a really bad idea for a number of reasons. For one, if we were to lose the NCBTMB, we would lose our primary path to validating advanced and specialty credentialing on a national scale, as the NCBTMB offers board certifications. (Disclosure: The NCBTMB and Lowe’s Academy of Clinical Massage have entered into an agreement to provide a Clinical Rehabilitative Massage Specialty Certificate Program.)

We could also lose the ability to have massage therapy represented in key organizations like the Academic Collaborative for Integrative Health, which requires the profession to have a separate national certification board.

And for individual massage therapists, this second approval process could also translate into greater confusion, greater efforts to verify approvals and increased costs associated with maintaining and acquiring CE hours.

First, to fully understand how this initiative emerged and how it will impact the profession, it is helpful to have a better understanding of organizational history.

an original ideaThe Original Idea

The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) was founded in 1992  when a fraction of states had licensure for massage therapists.

The original idea for the NCBTMB was  to help move our profession forward by becoming a voluntary certification board. The  voluntary national certification  would designate the massage therapist’s specialized knowledge or skills, which would help  in their professional development.

This is what voluntary certification boards do in every health profession.

However, as the decade progressed and we moved into the early 2000s, the legislative landscape for massage therapy changed, and we saw explosive growth of the profession. This rapid growth strained the existing systems.

Licensure portability and nationwide standards had become a major point of interest, and it seemed an easy solution to let the nationally developed test, the NCBTMB’s National Certification Exam for Therapeutic Massage & Bodywork, be used as a licensure test for states.

This test was a big win for states because they  did not have to spend  money and resources to create their own exam. It was also a big financial gain for the NCBTMB as its exam became the sole method of licensure entry for most massage therapists.

However, the downside of that development was that the NCBTMB lost its initial focus as a voluntary credentialing organization because everybody had to take its test for licensure.

growing dissatisfactionGrowing Dissatisfaction

As time progressed, there was growing dissatisfaction with the NCBTMB’s role as a purported voluntary certification board, but at the same time it was becoming the mandatory portal for licensure examinations. This led to the development of the FSMTB in 2005.

For a number of years, two national exams existed for entry-level licensure, but the trend was clear: There was a preference in the profession as well as from the state licensing boards that the Massage and Bodywork Licensing Exam (MBLEx), administered by the FSMTB, was the preferred exam for entry level licensure.

During this time, the NCBTMB was also having a number of highly publicized internal organizational and operational struggles.However, good things can often emerge out of challenging times, and this (struggle?) appeared to be one of those situations.

one moveOne Move, Then Another

With the MBLEX becoming the dominant entry-level licensing examination, the two organizations began having talks about how they might work together collaboratively in the future with the FSMTB focusing on entry-level licensure and the NCBTMB focusing on voluntary credentialing and continuing education.

That made great sense. At the October 2014 member board meeting of the FSMTB, the NCBTMB surprised many in the profession by announcing that they were going to exit the entry-level licensing process and focus their attention on their voluntary board certification credential and their emerging program of specialty certificates.

That move put the NCBTMB back on track with its original mission as a voluntary credentialing organization that can focus on validating skills and abilities that are above the minimum entry-level requirements for licensure.

However, there was another surprise at that same meeting.

Just after the NCBTMB’s representatives made their announcement that their organization was exiting the licensure exam process, an FSMTB representative announced that the FSMTB was starting a program to get involved with approving CE for licensure renewal.

I have spoken with a number of state board members who were at this board meeting, and they said they were not aware that the FSMTB was having discussions with the NCBTMB about improving the CE approval process and ways in which the two might work together on this.

They stated that they were asked to vote on this issue (FSMTB’s new CE approval process) without having a good understanding of what was going on or appropriate time to consult with their entire state board group about the ramifications of this vote. The FSMTB leadership states that people were given advance notice about this prior to the vote. To me the whole situation doesn’t smell right.

For the next two years, both organizations had discussions about collaborating on CE approvals. The FSMTB has indicated that member boards have challenges that are not currently being met by the existing NCBTMB Approved Provider Program, so they have continued moving forward with the development of their own CE approval program.

If that proposal moves forward that means there may soon be a completely new set of approvals that CE providers must face.

oppositionExpressed Opposition

Now, back to the reasons why I am distressed about the way this has evolved—and why I think it is a really bad idea for a number of reasons:

  1. The FSMTB asked NCB to give them $100 to $125 per provider per year to pay for technology aspects of the approved provider program. NCBTMB currently charges providers $225 every three years (essentially $75 per year). In an August 2016 letter to the FSMTB board of directors, the NCBTMB noted that the requested fee share would cause close to a 100-percent increase in cost for approved providers. That cost would have to be passed on to the providers and then possibly to individual students.
  2. CE providers would also have duplicate applications and duplicate organizational approvals to maintain, which would cost significant time, money, and effort without any real clear advantage.
  3. The FSMTB has stated that some needs of their member boards are not being met by the NCBTMB’s CE Approved Provider Program. The NCBTMB has proposed solutions to get those issues handled. It seems far more reasonable to attempt to address the state board’s needs through the existing system’s solution than try to fix the problem with a totally new and unproved CE approval process.
  4. The FSMTB has proposed a plan that involves extensive data sharing from licensees to its database, which some sources say may be illegal in some jurisdictions.
  5. There have been legitimate complaints about the wide array of subjects in courses that were approved by the NCBTMB for continuing education in the past. This is likely one of the concerns of the FSMTB’s member boards.

However, the NCBTMB has recognized this issue and implemented significant changes for a much more rigorous approval process for CE courses. There could easily be a process where states designate certain course topics or content areas that are approved for CE credits for licensure if they did not want certain topic areas included.

  1. Approving courses for CE credit is a challenging issue. Currently the FSMTB has no process in place to approve courses or instructors and there has been some indication that the FSMTB would put greater reliance on post-course feedback surveys to determine the quality of CE offerings instead of approving things up front. This is highly problematic for numerous reasons.
  2. There have also been recent discussions and proposals by the FSMTB to create CE classes that are mandatory for license renewal and only offered by the FSMTB. This proposal is a clear self-serving conflict of interest, and it really makes me question the motivations of the FSMTB for getting involved with CE approval. Is this really in the best interest of the profession?
  3. National organizations including the American Massage Therapy Association and Alliance for Massage Therapy Education have expressed strong opposition to the idea of the FSMTB implementing another CE provider program. This program could be highly detrimental to the overall business structure of the NCBTMB.

ce approvalA New Wheel is Not Needed

It seems like a no-brainer for the FSMTB to continue working on improving the entry-level licensure process and working in conjunction with the NCBTMB to make its existing CE approved provider process meet the needs of their member boards.

Let’s not reinvent the wheel.

We have an organizational structure in our profession that can best address the needs of the wide variety of stakeholders in the profession. The NCBTMB has had 25 years of experience of dealing with the CE approval process.

Is it perfect? No. Is there room for improvement? Certainly.

However, it makes much more sense to improve this existing system with infrastructure and experience in place than to start from scratch and create a whole new set of problems and financial burdens for professionals and educators alike.

Related Content: “New Massage Continuing Education Plan Met with Opposition”

A guest editorial represents the opinion of its author and is not intended to represent the viewpoint of MASSAGE Magazine.

whitney loweWhitney Lowe directs the Academy of Clinical Massage, and is the author of Orthopedic Assessment in Massage Therapy and Orthopedic Massage: Theory and Technique. He teaches continuing education in advanced clinical massage through the academy, and offers an online certification program in orthopedic massage.