Issue link: https://www.massageandbodyworkdigital.com/i/72312
WHAT'S UP IN CANADA? Looking deeper, it's a long and complex road to similar regulation in the remaining seven provinces and three territories, and success is not guaranteed. For instance, a 1999 report by the Office of the Professions of Quebec states, "The Ministry for Education considers that massage does not represent any danger to the public." Though there are lobbying efforts from within Quebec to establish a government-sanctioned regulatory body, it's clear the government isn't leaning that way since public protection is job one for legislators. Not all legislators are convinced provincial regulation is necessary. THE EDUCATIONAL NUMBER "We're looking to have a national standard," says Damon Marchand, president of the Canadian Massage Therapy Alliance (CMTA). The CMTA is made up of provincial associations in favor of a minimum twenty-two hundred-hour massage education for unregulated provinces, the establishment of regulatory colleges, and mandatory continuing education. In nonregulated provinces, CMTA associations set a common code of conduct and in many ways mirror the goals and language of the regulatory colleges. Adherence to those standards is enforced only by membership, not by governmental constraints. In the absence of regulatory colleges, the rules can be a patchwork very like the situation in the United States where individual municipalities set the guidelines for how much education is required to practice massage therapy. For instance, Sherwood Park, Alberta, only requires a business development permit, while just down the road, the city of Edmonton requires a criminal record check and two hundred fifty hours of training from a recognized school. In British Columbia, the educational standard is three thousand hours. Though "functionally" we talk about three thousand hours, "we prefer to talk in terms of competencies," says Doug Fairweather, president of the College of Massage Therapists of British Columbia (CMTBC.) "The three thousand-hour standard is the minimum time it takes to learn those competencies." In Ontario, it takes two to three years to learn the competencies necessary to write the provincial registration examinations to become a massage therapist. Ontario used to have a twenty-two hundred-hour time-based standard, but changed to a competency-based system in 1993. Regulated or not, it's clear massage therapy is growing in numbers of therapists and improving in how it is perceived by the public. A study published by the Fraser Institute found that nationally, massage leads the complementary therapies with 19 percent usage. The research states: "On a provincial basis, Alberta saw the largest increase in the use of alternative therapies in the year previous to the 2006 survey (68 percent compared to 54 percent in 1997), followed by Ontario (55 percent compared to 50 percent in 1997), and British Columbia (64 percent from 60 percent in 1997). Quebec and Saskatchewan/Manitoba both experienced a 1 percent increase, moving from 44 to 45 and from 58 to 59 percent respectively, while Atlantic Canada experienced a decrease in the use of alternative therapies, falling to 39 percent in 2006 from 45 percent in 1997."1 According to Doug Alexander, editor of the online magazine Massagetherapypractice.com and a teacher at Algonquin College in Ottawa, newly-trained physicians are much more open to what we do. After twenty-two years of practice, he's seen a lot of changes in the perception of the profession. "Massage therapy started off very alternative [catering to] people who tended to live outside the norm," he says. It's commonly acknowledged that thoughts and feelings can affect physical health and now alternative is mainstream. "We were ahead of the wave." ADVANTAGES OF REGULATION The common impulse to regulate the profession is to protect the public. "I can easily get into resenting regulation though I am a proponent of regulation," Alexander says. "[Regulation] helps accessibility and I do want massage therapy to be part of the world. Massage therapy is a very safe intervention." But, Alexander says, regulation is a good thing because it provides oversight when therapists violate the relationship of trust with clients. Alexander points to deep vein thrombosis as an example of a health threat for which therapists must have higher levels of training to recognize. Though harm can be hard to prove, when working with patient groups that have pathologies, you could do things that could do harm, Fairweather says. Beyond the safety of the public, regulation to such high standards also creates a clear identity and a level of assurance of quality of what the public will receive, he says, as well as enhancing the confidence of third- party insurers and health professions who refer to massage therapists. Another spur to regulation is tax exemption. If a total of five provinces become regulated by colleges, the Federal Ministry of Finance has said they will exempt massage therapists from paying the Goods and Services Tax—currently 5 percent of their fee. 54 massage & bodywork january/february 2008