While I agree (and have written on) on the the low incidence of physical harm I do believe there are areas in which training ought to be provided across the board. These include cervical arterial dissections (CAD), deep vein thrombosis, and signs of stroke. I also believe there is value in ensuring that practitioners are aware of universal precautions. I don’t believe that the truth that there will always be bad apples implies that there is not benefit in requiring refreshers on ethics, boundary issues, employer/supervisor responsibilities, sexual harassment, and seeking needed help when the practitioner themself is under life changes and stresses. I see the above as the kind of issues that the states should be requiring both at entry-level and on a recurring basis. These are also the areas of public protection to which I believe the states should confine their interest. I see the MOCC proposal as one step in this direction.

Some indication of massage-related board and insurance actions can be gleaned from the massage therapist records of the public use file of the National Practitioner Data Bank (NPDB).

As much as I would personally like to see massage therapy accepted in the general realm of mainstream health care, we aren’t there yet and presently aren’t anywhere close to getting there. We do not have anywhere near the same standards of education and clinical practice required of other health care professions, and the evidence of any actual physical harm to the public is very minimal. State boards (and the FSMTB) tend to keep the general public in the dark with their statistics. I have served on a state board and so have you. How many times have you seen complaints on actual physical harm–stacked up against the number of licensees–and it comes out to a very small percentage. In the five years I was on our board, there was only one such case, and we have licensed 11,000 + people.

As far as ethics violations, those happen in every profession, and in spite of the best efforts, they continue to happen. Last year at the FARB (Federation of Associations and Regulatory Boards) conference, representatives from every realm of medicine and from professions as diverse as social work and funeral homes got up and spoke about their own issues with that. There will always be SOME unethical people, and this plan isn’t going to stop that. Nothing ever will. People who are going to act badly are going to do so no matter how many classes they are forced to take.

Instead of forcing the issue of therapists who have been practicing for years having to prove “maintenance of core competencies,” at every renewal, I would prefer to see this effort directed at creating these types of modules for entry -level massage schools and the states requiring it there–before people are ever turned loose on the public. I don’t think it serves the public to have people who have been practicing for years having to take a no-fail exercise on Ethics 101.

What a theory also helps do is guide one away from fitting data by some arbitrary collection of parameters into some form of representation in which the parameters have a “physical” meaning. I’m thinking here of modeling something like the growth of aerosol particles in saturated air, in which the underlying theory would be a diffusion and the model would include factors like particle radius, chemical compositions, …

I’m also interested to see that the word “theory” doesn’t appear anywhere here. I’ve always taken the word “theory” to be roughly synonymous (for many purposes at least) with the word “model.” A theory, like a model, is a simple representation or approximation of a complex reality. Anyway, I find it useful to think of them that way.

Chris.