MISCONCEPTIONS ABOUT PROGRAM
REVEALED BY SURVEY
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The survey revealed that misconceptions about fees and other aspects of the program abound. Many respondents indicated they do not know enough about the issues involved or how the regulatory program works. Accordingly, the MTAC wants to begin addressing these misunderstandings and helping CMT's/RMP's be more informed about the program.
The most frequently mentioned claims were probably that the fees paid by other health care professions in Maryland are much lower, or that CMT/RMP fees are higher than in other states that regulate massage. However, in Maryland acupuncturists pay $525 every 2 years, chiropractors $600, dentists $415, occupational therapists $259, counselors $200, physical therapists $300, optometrists $600, psychologists $350, podiatrists $850, social workers $200, and electrologists $500. Registered nurses, cited by many, pay $90 (HCACC fee, which we pay too, not included), and hygienists $185. Fee levels are apparently influenced strongly by numbers of people. The fees paid by nurses are lower, at least in part, because over 40,000 nurses are licensed. With the number of CMT's and RMP's growing steadily, massage fees also could be favorably affected. Concerning fee comparisons with other states, massage therapists in 6 states pay higher biennial fees than Maryland’s, in 6 states pay the same fee, and in 15 states pay less, so Maryland’s fees are actually in the mid-range. Please note that fee information (except NY, OH) was obtained from web sites, and not all were clear about whether fees were annual or biennial. |
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Some other misunderstandings related to fees included:
n Complaints about expenses, such as national certification renewal, the cost of insurance, and continuing education – These are not under the program’s control;
n Costs could be reduced if there were less perks for the Board or MTAC or if volunteers were used more – The Board and MTAC are unpaid volunteers. MTAC members receive only a stipend of $45 a day and Board members $100 a day, plus travel expenses, for meetings that often take up a half a day or longer;
n Part-timers could pay prorated or sliding scale fees or those living in rural areas could pay lower fees – These are examples of actions that the State and DHMH do not allow, so these are not available options;
n If it gets too expensive, you can skip renewing – A CMT or RMP is legally mandatory to practice massage in Maryland, it’s not optional;
n There would be start up costs for a new board or that a new board would create a whole new infrastructure – Probably not as much as some assume as the work that would need to be done would be comparable to now and the structure would be similar. The main effect might be due to shifts in economies of scale.
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During a recent briefing to the MTAC about the massage program’s budget, a DHMH budget analyst responded to a question about why the CMT/RMP fees are what they are by explaining: 1) all costs of running the massage program must be paid via fees, there is no State “subsidy;” 2) many costs, such as staff salaries and certain operating expenses are set by the State, not the Board or MTAC; 3) State accounting rules require we keep a reserve of 25% of annual operating costs that, like everything else, must be funded via fees; and 4) our investigatory and disciplinary costs are relatively high because, to a great extent, we must contend with criminal enterprise more than other health care professions. Indeed, the surveys indicate that many CMT's/RMP's do not realize how much time and effort our investigator, the Board, MTAC, and other staff expend on countering vice-related activity operating under the cover of massage.
Several respondents complained about certain requirements, but misplaced responsibility for their creation. For example, a small number had strong objections to the 60 credit higher education requirement for CMT's, or the practice restrictions on RMPs, believing they were created by the Board or MTAC. However, these were established by the legislature, not the Board or MTAC. Similar questions were raised about whether decisions were made by the Board or by the MTAC. The MTAC serves as an advisory body regarding the regulation of massage, however, final decisions are always at the discretion of the Board.
Some returned surveys had suggestions that cannot be carried out because they are simply not possible. For example, several suggested CMT's should elect a future board. This cannot be done because all regulatory boards are appointed, not elected. One likely reason is boards are responsible to protect the public, not to represent the interests of practitioners, so boards are accountable ultimately to publicly elected officials rather than practitioners. Others want the Board/MTAC to provide services that are not within the scope of a regulating body, such as to help with finding grants, promote the profession, or conduct research on the benefits of massage.
Please let us know if there are other aspects of the massage program that you would like explained.