SURVEY RESULTS REPORT
The results of the massage program governance survey are in! An overwhelming majority of CMT’s and RMP's of almost 9 to 1 responded “yes,” the massage therapy regulatory program should be governed by an independent body of massage therapists (such as a Board of Massage Therapy). If the reasons given could be summed up in one statement, it would be, “Massage therapists want to be overseen by their peers, not by another group.” At the same time, the results were tempered by concerns about fees. A slight majority responded “yes,” they would favor a separate board if creating one meant fees had to be raised. Those willing to pay an increase said they would pay $75-100 more (based on the average of the responses).
The survey was undertaken by the Massage Therapy Advisory Committee (MTAC) as part of a mandate by the Board of Chiropractic Examiners (Board) to study the possibility of a more independent governance arrangement for the massage therapy profession in relation to the Board. The MTAC did the survey fairly early in the process to be informed about opinions and ideas before making any decisions.
Despite the calamitous February snowstorm that slowed the mailing and cut into the response time, 548 surveys, about slightly more than 26%, were returned. The return rate ensured that the response was statistically significant. To the question on whether an independent body of massage therapists should oversee the massage regulatory program, 473 (86.3%), said “yes” and 75 (13.7%) said “no.” To the question on whether a separate board would be favored in the event a fee increase were required, 282 (51.5%) said “yes”, 266 (48.5%) said “no”. The survey also included some open-ended, more subjective questions so that respondents could explain their positions.
The most common reasons given by those who replied “yes” to the question on whether to have an independent board could be summarized as:
· massage therapists have the best understanding of the issues;
· a professional group should be overseen by its peers, therefore massage therapists should be overseen by massage therapists;
· a health care profession should not be regulated by another profession, with many giving an analogy such as, “it makes no more sense for dentists to be overseen by occupational therapists than for massage therapists to be overseen by chiropractors,” or questioning rhetorically, “chiropractors would not accept being overseen by massage therapists, so why would massage therapists accept being overseen by chiropractors?”;
· the current system implies that massage therapists cannot govern themselves, but they can; and,
· the massage therapists’ community is strong enough to stand on its own and is large enough to sustain its program.
While the majority of those who replied “yes” gave “positive” rationales, some stated “negative” rationales. These can be summarized as:
· chiropractors have a conflict of interest in regulating massage therapists;
· chiropractors do not understand the massage therapy profession, therefore they are not qualified to oversee massage therapists;
· competitive motivations or negative attitudes concerning massage therapy may negatively influence how chiropractors and the Board oversee massage therapists;
· the Board has communicated with massage therapists in a rigid, overbearing, or punitive manner, and does not provide satisfactory service, e.g., “I have the impression that the Board treats us as second-class citizens”.
The negative comments were balanced partly by a comparatively smaller number who made “positive” comments about the Board’s performance and their relationships with chiropractors.
About two-thirds of those who replied “no” stated their rationale was primarily concern that an independent board would lead to higher fees. As for other reasons, the most common were:
· being associated with a recognized, reputable group such as the chiropractors is desirable, we need medical backing;
· there do not appear to be problems between the Board and massage therapists, a separate board is not necessary; and
· mistrust of massage therapists overseeing the program for a variety of reasons, such as not enough qualified people to serve, will have ulterior motives, not experienced enough.
Another survey question was, “What are possible positive or negative outcomes of having an independent board?” The following are representative of the responses given (positives outnumbered negatives):
+ an independent body could better regulate the needs and demands of massage therapy
+ the massage community will be more responsive to an independent board
+ the public will less likely be confused by a differently named oversight board
+ better governance, better communication, decisions made with more care and interest
+ massage therapy issues will receive the attention deserved
+ more informed about massage therapy, governed by peers
+ would be tougher in upholding the law
+ more positive, respectful tone
+ would be a step in bringing about legitimacy of massage therapy within medical community
+ clearer, more meaningful, more appropriate regulations consistent with massage therapy
+ there are no negatives, only positives (this appeared to be the most frequently given response)
- too many massage therapists are not current or experienced in the field
- there may be a higher fee
- less experience with legislation
- may be less perceived as “real” health professionals
- might be difficult to find qualified massage therapists to serve
- being governed by the Chiropractic Board is more prestigious to the public
Concerns about fees were widespread, although the intensity of these concerns varied widely from mild to intense. Those more opposed to an increase include mainly those who feel the fees are too high already and those who feel their earnings are insufficient and/or work part-time. They explained often that paying fees for state certification, association membership, insurance, national certification, and continuing education is becoming burdensome. Those who strongly support an independent board, but are concerned about higher fees said a clear, rational explanation about fees would be helpful.
The MTAC is planning next to invite comments from the associations and organizations that are part of the massage community in Maryland. The MTAC is also analyzing budgetary information and is working on developing more accurate estimates of what fees would be required in order to fund the program if it was independent from the Board.
Thank you to the CMT’s/RMPs that responded to the survey. Your input will be very helpful to the MTAC in guiding this project.
FOOTNOTE OF THE BOARD OF CHIROPRACTIC EXAMINERS:
At its request, the Board/Commission Fiscal Officer, Ms. Linda Beyer, conducted a fiscal cost analysis of prospective fee increase if a separate massage board were instituted. The analysis estimated that the biennial fee would increase from the current $200.00 to approximately $350.00 - $390.00. This estimate is based on past and existing direct and indirect logistical, personnel and disciplinary costs and numbers of certificate/registration holders. The estimate and all fiscal factors will be further refined as this analysis and process continues.
J. J. Vallone, J.D.
Executive Director