The Massage Politics Sheet

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27 February 2003

North Dakota Native American Healers Bill Killed

The bill I posted about last Monday was killed. The bill would have allowed Native American healers to massage without attending an approved school and getting a license. The original story had quoted Committee chairwoman Sen. Judy Lee, R-Fargo as saying that "the law was not intended to interfere with cultural activities but to protect the health and safety of the public. She was concerned that passing the bill would be allowing some groups to provide comparable services as licensed massage practitioners, without the training."

People of this mindset have trouble seeing the forest for the trees, believing that all applicable learning must happen in formal schools. The opening quote in my Massage Today Column for March addresses this focus that gets stuck on training rather than learning. As to the public safety concerns, a 1998 article in the Journal of the American Medical Association (JAMA) provides data noting that raw insurance claims for massage practice are about 2 per thousand insured per year. This is less than a tenth of the Chiropractic claim rate and well less than a thirtieth of the medical claim rate. The massage claims that are paid are also a lot smaller in amount.

What's a Small Massage School?

Back in 1997, I wrote an interview with Judith McKinnon (PDF file), founder of the McKinnon Institute, covering her work in modifying California massage school governance. Judith had worked to add short program exceptions to the very rigorous reporting and placement requirements of the full Maxine Waters Reform Act. Because of this interaction, a small private vocational school in California has a very precise definition. It requires a school not to offer programs costing more than $2000 or requiring more than 250 hours nor to offer programs for which the students are offered state or federal financial aid. The great majority of the 193 massage schools operating in California under BPPVE rely on this exception to remain economically viable. They are, by definition, small schools.

 

24 February 2003

California Sunrise Process Questionnaire Now Online

For those interested in participating in the input process, I now have the Sunrise Questionnaire online as a PDF file that the California Senate Business and Professions Committee uses to screen prospective occupational regulation. Knowing what's in this questionnaire and providing independent input to the Business and Professions Committees can go far towards avoiding a Practitioner Exclusion Statute (PES) — a statute that would undercut the viability of many of the California state-approved massage schools and that would exclude many competent practitioners. Just don't Mess — with a PES!

Native American Healers Caught in ND Massage Legislation Net

The Wed 5 Feb 2003 issue of the Grand Forks Herald ran a story on the collision of Native American Healers with the North Dakota massage practice act. A new exemptionbill was introduced in the North Dakota Senate to allow such healers to continue with their traditional practices. It's one more example of a practice act having unintentional consequences. It's also a situation that could easily happen in California with our many Native American tribes. There are good reasons to stick with title protection.

March Ramblemuse Column Now Online

My March column for Massage Today — "Swimming Upstream Toward Effective Practice" is now online. In it, I discuss the creation of training guidelines for different massage subpractices and the guidelines for creating those guidelines.

Rhyming Toward Togetherness

Just don't mess — with a PES!
Run like hell — from a PEL!
We can do better — to work together!

PES — Practitioner Exclusion Statute
PEL — Practitioner Exclusion Law

They both mean the same thing, It's called Exclusion.
Better by far, we should work for Inclusion.

(Okay, so all this political writing is starting to affect my mind. I probably just need a good massage.)

 

23 February 2003

An Example of the California Sunrise Review Process

One of the differences between California and many other states is that California has a "sunrise process" that any proposed occupational regulation must go through. This is a feature shared with Georgia. The purpose of this process is to ascertain that there is a need to protect the public from significant harm and that the proposed regulation is the most expedient manner to accomplish this protection. We can gain some insights into this process by examining a 1999 Senate Business & Professions Committee review of a bill for regulation of interior designers. A consideration this review makes clear is the difference between a practice act and a title act and the motivations for the choice of one over the other.

The following is based on the Assembly policy committee analysis. A practice act confers the exclusive right to practice a given profession, and to advertise one's status as a licensed professional, on practitioners who meet specified criteria related to education, experience, and examination. A practice act is generally thought to be the highest and most restrictive form of professional regulation, and is intended to avert severe harm to the public health, safety or welfare that could be caused by unlicensed practitioners.

A title act, on the other hand, reserves the use of a particular professional designation to practitioners who have demonstrated specified education, experience or other qualifications. A title act does not restrict the practice of a profession or occupation; it merely differentiates between practitioners who meet the specified qualifications and are authorized by law to represent themselves accordingly, and those who do not.

Beyond simply fulfilling the requirements of the sunrise questionnaire, the answers must demonstrate the need for the proposed regulation.

Need for State Regulation not Established. The sponsor and author have fulfilled the requirement that proponents of new regulatory programs complete a "sunrise" questionnaire. However, the document, though voluminous, has failed to establish that there is any serious public harm-health or safety or serious economic-from an absence of regulation of interior designers. As the Legislative Analyst's Office notes in a 1997 report to the Legislature, state intervention in a marketplace is warranted only when there is a significant potential for public harm.

Finally, those proposing the regulation must demonstrate that they represent the profession as a whole.

In addition, it is not clear that the entire profession supports further regulation. For example, only about a fourth of the individuals who potentially may be affected by the bill (3,200 out of 12,000 total practitioners of the occupation) have chosen to participate in the existing private certification program.

Given the explicit nature of the sunrise requirements, it is clear why they act as a deterrent and hurdle for occupational regulation. It is also clear why consensus within the profession is an imperative if a bill is to succeed in journeying through the legislature. A quick search of the Bureau for Private Postsecondary and Vocational Education reveals that they supervise 193 massage schools throughout California. The AMTA national website lists 28 schools in California, including two colleges that wouldn't be under the BPPVE. If a bill can not be coined that acts to respect and benefit the efforts of all that practice and teach within California, from the 100-150 hour starters to those with multiple thousands of hours, then the result shall only be more acrimony and a bill that likely dies a death in committee from our own internal conflicts. If we wish to work together, it's not in our own interests to pursue passage of a practitioner exclusion Statute (PES). Remember that phrase, practitioner exclusion, you're likely to hear me use it a lot more in days to come if attitudes don't change.

 

22 February 2003

Assemblymember Kehoe Introduces AB 1388 — Call It the Massage & Bodywork Registration Bill

Assemblymember Christine Kehoe has introduced the first cut at California state governance of massage. You can view the text and subscribe to email updates online. There is both good and there is also unacceptable wording in the current bill. The authors have not yet understand that support requires a bill that benefits us beyond the AMTA mindset.

The good and commendable news is that the wording is that of a registration bill with a wide scope of practice. Please contact Kehoe's office in support of this feature. This is a much better choice that that of a practice act. Only those choosing to be covered under the bill will be affected.

Now comes the news that, in it's present form, will cost the bill my support and gain it my active opposition. In Section 4606, AB 1388 leave setting of hours of training and other eligibility requirements up to the commission it establishes. It also stipulates that, beginning in 2004, passing of a certification exam like the National Certification Exam (NCE) of the current NCTMB will be required.

We must make it clear that the provisions that lead to 500+ hours are unacceptable. The bill authors need to understand that provisions will be actively opposed and potentially kill the bill if they would negatively impact schools and students following the modular / incremental path to training, i.e. smaller blocks of education interspersed with actual practice. Taking requirements for the NCE and similar exams out of the state law both respects diversity in learning styles and neurological organization and places these exams in their appropriate role as voluntary marks of accomplishment and aids to interstate portability.

Note that this is only initial and interim wording. It does not (yet) speak to superseding local laws or to zoning commensurate with other health care and personal care professions. There is still time to work with Kehoe's office to commend that it is a registration act and to condemn the provisions making eligibility a whim of seven people and instituting what will be at least a 500 hour requirement. Please read the bill yourselves and send in your comments.

California State Senator John Burton Introduces SB 907 — Licensing of Naturopathic Physicians.

Yesterday, SB 907 was introduced by John Burton. The act would create California licensing for naturopathic physicians. Massage is included within the scope of practice.

 

21 February 2003

Kehoe Chief of Staff Clarifies Initial Timetable for CA Massage Regulation Bill

This morning, Michael Miiler, chief of staff for Assemblymember Christine Kehoe, clarified the legislative timetable for the massage regulation bill to be introduced today by Assemblymember Christine Kehoe.

There are several deadlines along the legislative process. Bills must be introduced by February 21, heard by the first policy committee by May 2, heard by the fiscal committee by May 30, and out of the house of origin by June 6. Then we start over again in the Senate. All of these hearings involve a vote of a committee or the Assembly.

Considering that the language of the actual bill is as yet unknown, this timetable leaves precious little time to place a bill out for review and comments by those practicing in California.

Panel Announced for the 4 March "Future of Massage in California" Meeting

De Anza College Massage Program coordinator Jeffrey Forman announced today the panel for the previously announced 4 March 2003 meeting at De Anza College on The Future of Massage in California. The panel will include:

  • David Palmer- President, TouchPro Institute of Chair Massage.
  • Chris Voltarel- California Chapter President of the AMTA.
  • Burt Boss, General Manager of Soma Therapy in Palm Springs, California.
  • Keith Eric Grant Ph.D. Instructor at the McKinnon Institute and columnist
    for Massage Today.
  • Les Sweeney - Vice president of the ABMP.
  • Jeffrey Forman, Coordinator of the De Anza College Massage Therapy Program.

Parking permits will be available at the door for those who request them. Parking permits will not be mailed, however, if you park in parking lot B and proceed west to the conference room. Jeff can give you a permit to place on your dashboard. If you prefer not to bother, it will cost you 8 quarters to buy a permit from one of the vending dispensers. To request a permit or if you have any questions contact Jeff by e-mail or by phone (408-864-8910).

Here's the online campus map. After the panel discusses the agenda topics there will be time for questions and answers. If the future of massage is of concern to you, come and contribute to the discussion.

 

18 February 2003

Massage Licensing Bill Deadline Nears

This Friday (21 Feb) is the deadline for the introduction of new bills for the 2003-2004 California legislative session, including the massage licensing bill to be introduced by state Assemblymember Christine Kehoe. If you have enjoyed and benefited from taking classes at a small massage school with modular certificate programs, it's especially important to let Kehoe's office know now that you don't want to see a 500+ hour licensing program.

According to a California Alliance of Massage and Bodywork Schools (CAMBS) news mailing, they have spoken to Kehoe's chief of staff, Michael Miller. Miiller confirmed that a bill will be introduced by 21 February and that the final language will be inserted shortly thereafter. Mr. Miiller can be reached by email at Michael.Miiller@asm.ca.gov (the double ii is correct) or call him at 916–319–2076. Express to him your concerns and your desire to be kept informed. CAMBS also noted that another Kehoe spokesperson said the bill will go through several committee meetings and will be voted on by the Assembly by 6 June 2003. This timetable leaves no time for review and change to create consensus about any final language among California practitioners.

Two Events for Your March Massage Political Meeting Calendar

Jeff Forman, who runs the massage program at De Anza College in Cupertino, has organized a meeting on massage regulation on Tuesday 4 March 2003 from 6:00- 9:30 PM in conference room B. This is a follow on to a meeting he held last fall. Topics on the agenda include:

  • Minimum competencies/ Educational Standards for Massage /Bodywork
    practice and how to measure them
  • Ethical standards for the profession.
  • A tiered system / variable levels of practice
  • Further clarification of the implications that the California health
    and Freedom act has for massage therapists

If you have concerns about what others may be planning without your input, try to attend.

A meeting on state regulation is scheduled during the California AMTA's Massage and Bodywork Convention on Saturday 22 March 2003 from 3 to 5 PM at the Doubletree Hotel in San Jose. The meeting will by moderated by AMTA-CA governmental relations chair Beverly May with Mary Griffin, the AMTA-CA's lobbyist. Anyone can attend the meeting at no charge.

A Place to Discuss Opposition to Licensing

Massage Practitioner Robert Flammia, onetime head of the Golden Gate AMTA unit, became disillusioned with the AMTA when they dropped the former Massage Entrance Exam (MEE) to take up the National Certification Exam (NCE). The change was made without putting it to a vote of the membership. Flammia's underlying point about the old and new AMTA was that a change in entry requirements that stood to drastically change the background and attitude of those entering the profession was actually made, without referendum, by a very, very small minority. After ten years, those who did not gain entry to the AMTA via a 500 hour program or the NCE are a small remaining minority of the membership. Those who didn't fit the new paradigm or didn't accept it never became members after the change over. It's a lesson that even member organizations, by use of procedure rules and hierarchies of control, can insulate themselves from their members. There's a good discussion of the use of such tactics in meetings in The Control Game.

These days, Flammia is an active opponent of state licensing. He's resurrected the old California Federation of Massage framework and under its name is hosting a discussion group opposed to licensing. You can subscribe on the web or by sending an email message to Cal_Fed_Mas-subscribe@yahoogroups.com

 

17 February 2003

Assemblymember Christine Kehoe to Introduce California Licensing Bill

Reliable industry sources have it that a placeholder massage licensing bill will be introduced by San Diego Assemblymember Christine Kehoe (Speaker Pro Tempore, Democrat, 76th district) . The initial language will likely be just for a study, but the real purpose is simply to get a bill introduced before the deadline.

The bill introduction is the result of lobbying by AMTA-CA. They now have an entry as a lobbyist employer, under their California corporation name of California Massage Therapy Association (CMTA), having hired the firm of Mary Griffin as their lobbyist.

Although there is no real language associated with a bill yet, those concerned about the form a bill might take should send their input (as I have done) to Kehoe. Her address, email address, and a contact webform are on her website linked just above. I believe that Kehoe should hear from a wider diversity of massage practitioners and opinions than are likely to be represented by the CMTA lobbyist.

Massage Licensing Could Limit the Choices in California Massage Schools

The effects of a licensing law could be far reaching, not just limiting individual abilities to practice interspersed with continued learning, but affecting the types of initial training available. I personally teach in a program oriented around 100 to 150 hour modules. My students often come with considerable job and life experience and are making career/life transitions around meeting other responsibilities as parents and workers. Some are moving into massage full-time but others are planning on practicing massage part-time as a fulfilling addition to their other tasks. Many are taking classes on a pay-as-you-go basis, rather than wanting student loans. For a student who can only manage six hours per week, each 250 hours represents a year of hard work around other demands on their time and energy. Still, they keep coming.

If, for example, a 500 hour licensing law passed, schools such as where I teach would lose their economic niche. Most students would need financial aid, bringing in Title IV federal education requirements for accreditation and programs of more than 600 hours to 720 hours (for Perkins grants). The many small massage schools in California would be faced with either growing to accommodate the larger programs and class sizes needed to retain economic viability, closing, or shifting to teaching workshops for nonprofessionals. Larger schools also move into a different class of oversight by the Bureau of Private Postsecondary and Vocational Education. It's well worth thinking deeply if the resulting loss in educational diversity is worth the convenience of following the cookie cutter approach promoted by the AMTA in other states. California has its own unique history in the development of the massage profession and massage techniques. I think California deserves its own answer to massage governance and I will continue to work to see that happen. Please do what you can. It's in our hands! Literally.

RSS Feed Added

Rich Site Summary (RSS) is a lightweight XML format designed for sharing headlines and other Web content. For those using an RSS aggregator to collect their news, I have added an RSS headline file to this site at <http://www.ramblemuse.com/blogger/mps.rss>. I have also subscribed this RSS feed under Bloglet so that readers can subscribe to email notification of my updates. There's a subscription form at the bottom of the navigation bar to your left.

 

01 February 2003

Education Tax Credits

My thanks to a knowledgeable reader for pointing out an additional nuance to massage training and tax laws contained in the Taxpayer Relief Act of 1997. The 1997 law added both a lifetime learning tax credit and a deduction for interest on student loans. These are only for postsecondary education to improve skills or to enter a new field and are also only for training programs that qualify for federal financial aid, basically limiting the impact to initial massage training at colleges or accredited private postsecondary vocational schools offering training programs of 600 hours or more. Still, the tax credits could affect your choice in comparing the economic and practice benefits of different training programs. Here's some sources to find out about these tax benefits.

Letter to California State Senators Burton and Figueroa Regarding SB77

Apart from minor tailoring particular to each State Senator, the following is a copy of the letter I mailed last Friday to Senators John Burton and Liz Figueroa regarding SB77.

Dear Senator,

I am writing to express a concern about SB77 (Burton, Physical Therapy) which is now before the Senate Committee on Business and Professions.

SB77 appears to be a modernization of the language defining the practice of physical therapy and an acknowledgment of the abilities of physical therapists to diagnose within their domain. This is well and good. Unfortunately, and inadvertently I hope, the inclusion of therapeutic massage and soft tissue work as an intrinsic part of the very definition of physical therapy produces an ambiguity in the physical therapy practice act that might be construed to limit the practice of therapeutic massage as a separate and independent profession with an overlapping scope of practice.

Section 2630 of the Business and Professions Code contains the following exemption language:

The administration of massage, external baths, or normal exercise not a part of a physical therapy treatment shall not be prohibited by this section.

My concern stems from the observation that since, therapeutic massage is now intrinsically part of the definition of physical therapy under SB77, that there could result a conclusion that only physical therapists be allowed to practice the therapeutic aspects of massage in California . I believe that the resulting conflicts would be a disservice to both the professions of physical therapy and massage therapy. I believe that, if SB77 is to be passed, it should be amended to strengthen the exclusion language of Section 2630. It is in the spirit of last year's enactment of SB577 (complementary and alternative health care practitioners), to clarify that the physical therapy sections do not limit the separate practice of therapeutic massage and soft tissue manipulation.

These considerations are of particular importance as the practice of massage therapy has evolved to work effectively and safely with minor soft tissue injuries, athletic facilitation, and issues of long-term health and flexibility maintenance. In the last year alone, at least three significant books on orthopedic and clinical massage have been published by major health care publishers:

Clay, James, 2002: Basic Clinical Massage Therapy - Integrating Anatomy and Treatment, Lippincott Williams & Wilkins, ISBN: 0-683-30653-7.

Hendrickson, Thomas , D.C. , 2002, Massage for Orthopedic Conditions, Lippincott Williams & Wilkins, ISBN: 0-7817-2287-X.

Lowe, Whitney, 2002: Orthopedic Massage - Theory and Technique, Mosby, ISBN: 0‑723‑43226‑0.

My background in these areas is that of being head and senior instructor of the sports and deep tissue massage program at the McKinnon Institute in Oakland , where I have been teaching since 1992. I also write a column on the practice of massage for Massage Today (http://www.massagetoday.com). During the past decade, I have researched extensively into issues of massage governance and diversity of learning styles. My additional education is as a physicist, well-grounded in scientific methodology and literature research. I have authored a white paper reviewing issues of massage governance. This review was used as a major basis and motivation for the Oct/Nov 2002 issue of Massage & Bodywork, the publication of the Associated Bodywork & Massage Professionals (ABMP).  Additionally, I was asked to write an article for this issue on my views of massage regulation, certification, and diversity. The words and references of my white paper might be a useful resource to your or your staff should further issues of massage governance arise.  I maintain this document online at <http://www.ramblemuse.com/articles/masg_governance_rev.pdf>.

Thank you for you consideration of my concerns about SB77.

Sincerely,

Keith Eric Grant, Ph.D.

 

28 January 2003

SB77

As of this morning, SB77 has been sent to the California Senate Committee on Business and Professions. See below for why this may be important to massage therapists.

Title Acts, Practice Acts, and Deductions for Education

The IRS (Internal Revenue System) lets you deduct expenses for education that improves skills in your current profession. They don't, however, let you deduct expenses for education that prepares you for a new profession. Because of this, minimum requirements for entering practice can have a big impact on the cost of massage education.

Just about all local and state regulations require you to complete a certificate program from a state approved school before being able to enter practice. So, whatever the length of the program or programs that first qualify you, you can't start claiming deductions until you already have that qualifying certificate in hand. From a tax perspective, it's not to your advantage to sign up for a single program that extends in hours well beyond what you need to start practice. A better strategy is to qualify first and then continue your education.

If you live in an area that lets you practice after 100 hours of training, you can take your 100 hour certificate program, start practicing, and keep taking classes on a tax-deductible basis. Let's say you take another 400 hours over the next couple of years. If you live in an area that mandates 500 hours, you can't claim any of that program as a deduction. The difference between these scenarios is the deduction of the cost of 400 hours of training. It doesn't stop there, however. Let's consider what occurs should to decide to extend your bodywork skills by training in trademarked specialties like Rolfing, Feldenkrais, or Trager. Is this education deductible? It may well depend on the laws under which you practice whether these trainings are part of a continuum of bodywork into which ou have already entered or legally defined as separate professions.

Tax deductions create another reason to advocate for title acts (limiting use of a professional title) covering massage rather than practice acts (limiting who does specific techniques). With a title act, you basically decide if what you are doing is under the title (within reason). A practice act, by its very nature, has to more closely define what is under the act and what is exempted. It is this specific exemption that the IRS could question in an audit -- i.e. Does this training you are claiming fall under your massage therapy practice license? If you are in a state with a practice licensing act, you would generally have to answer no, because the Rolfing, Feldenkrais, and Trager organizations have usually seen to it that their practitioners are exempted, thus forming the basis of disallowing the claim. I doubt that such a claim would attract an audit, but could be questioned if you were being audited randomly or for other reasons. A title act does not need to carry such a specific exemption, mentioning scope only in terms of bodywork activities, thus the general extension of your bodywork skills would apply.

 

25 January 2003

SB77 (Burton; Healing arts: physical therapy) is a bill newly introduced (1/22/2003) into the California Senate redefining physical therapy. Since the act includes mention of therapeutic massage and soft tissue mobilization as practice,s it could have impact on the non-PT practice of therapeutic massage. The analysis for the bill also mentions the unlicensed practice of PT as a misdemeanor.

The existing (and remaining) physical therapy act has a partial exemption of massage

"The administration of massage, external baths, or normal exercise not a part of a physical therapy treatment shall not be prohibited by this section."

It is not clear, however, that this exemption would sufficiently exclude

(3) Manual therapy, including soft tissue and joint mobilization or manipulation.
(4) Therapeutic massage.

as would be listed in the new definition of physical therapy practices and as commonly included in the practices of clinical massage. The key consideration is the interpretation of the phrase "not a part of a physical therapy treatment". Bill author John Burton's webpage has his address, phone, and an online feedback form. Express your concerns.

As an alternative viewpoint to consideration of licensing and certifications as means to credibility, I've been considering the process of creating guidelines for effective practice within different subpractices(venues) of massage. This is an outgrowth of thoughts on guidelines written at the end of December in this space. The purpose of such guidelines would be to offer guidance and a place to begin considerations as an employer or student rather than as inflexible cutoff criteria. At this point, I've gotten as far as listing some subpractices that I can see along with brief descriptions. Any comments or feedback any of you have are welcome. I'm working on an expanded discussion of this theme of guidelines and subpractices for my March Ramblemuse column in Massage Today.

Subpractice Description
Chair Basic touch, stress management, & relaxation. Applicable to public settings
Clinical/Orthopedic Range of motion, tendinosis treatment, injury recovery
Emotional Reconnection Working with issues of grief and marginalization
Geriatric Life quality enhancement, sensory stimulation, interpersonal connection
Hospital-Based Pain and anxiety control, nurturing of the sick in a medical setting
Infant/Pediatric Parental bonding, nurturing, sensory/emotional development
Postural Improvement of  muscle balance; freeing of fascial adhesions
Prenatal/perinatal Increase of comfort  and  emotional support
Psychoneurological Integration Aiding sensory integration with ADHD, autism, high sensitivity
Relaxation/Wellness Stress management, nurturing, and interpersonal connection
Spa Modalities Nurturing, pampering, skin health
Sports Facilitation of athletics and movement; normalization of hypertonicity
Trauma/Abuse Recovery Emotional recovery, somatic reassociation, building touch trust

 

10 January 2003

Every once in a while, something comes my way that captures the opportunities we have for working together to better our world, if we can but both respect our diversity and see our commonalties. This musing by Larry Warnock (namaste157@yahoo.com), creator of the massage program at Tufts University, struck me as the encouraging theme on which to begin 2003. It captures both a sense of respect for our diversity (present and continuing) and the need to work together to educate others and assist each other.— Keith

Some of us have 100 hours of training or less; some of us have 1200 hours or more; some of us are new at massage; some of us have been doing massage for years; some of us do relaxation work; some of us do trigger point work; some of us do post-operative scar tissue reorientation; some of us have Ph.D's; some of us have GED's.

Most of us are woman; some of us are men; some of us are certified and licensed; some of us are not; some of us call ourselves massage therapists; some of us call ourselves cranial sacral therapists; some of us call ourselves sportsmassage therapists.

Some of us work in spas; some of us work in chiropractor's offices; some of us work in health clubs; some of us work in hospitals; some of us work in our homes; some of us work in our own offices.

If there is one thing we have in common, it is diversity. Given the above and even more of "some of us are…" do any of us think that there is a glimmer of hope that someday...maybe not soon, but someday we might find a way to coalesce and define a consensus; a common voice; a public voice; a voice that rings true in the community?

Could we begin to form small groups of diverse members of our profession regardless of affiliation? Could those small groups join together in bigger ones? Is there the tiniest hope that we could lead the movement or maybe a newbie, with passion and conviction? There are things we have in common. Can these common things be the foundation for a manifesto or a document to teach licensing boards, medical people, consumers, regulators...what and who we are as a profession? There are a lot of us. AMTA and other organizations aside…is there a place for a grass-roots, professionally-driven, volunteer guild? Could it work? — Larry Warnock

 

Copyright by Keith Eric Grant — The RamblemuseSM — Last revised Tue 27 May 2008

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