Dr. Leena Guptha Weighs In Heart to Heart: Part 1
November 6, 2013
We asked you for questions, and you asked them. Here is an extended transcript to support the live recording of the November 5th webinar, “Dr. Leena Guptha Weighs In.”
A lot of material was covered in the webinar, and so for your convenience, we’ve posted below the questions and answers, including additional information with a few answers in which Dr. Leena expands her response.
Meanwhile, there were too many questions to cover in only one webinar; so please join us in our follow up webinar, “Dr. Leena Guptha Weighs In: Part 2” on November 12, 2013. Don’t miss your chance to hear straight from Dr. Leena, as well as submit any questions you may have for Dr. Leena and NCB through the webinar registration form.
Watch Part 1 of the webinar below:
Questions and Answers:
Jan: Is there an updated document that explains NCBTMB's role for massage therapists?
Dr. Leena: The updates of our activities are on our website; the changes in 2013 being transition to board certification and a more thorough Approved Provider program. We will see through this webinar how we want to reach out to the Certificants to help us find our rightful place and role in the community. In a twenty year history, a lot has happened and I'm not even going to pretend I have all the answers. In fact, in 19 days, I'm just starting to see and hear the questions through this mission of outreach to the profession, asking for help, seeking collaboration with the leaders of all the other organizations – plus expert Think Tanks. I truly believe that we can be what the community wants us and needs us to be through constructive, supportive, solution-based initiatives; and that will truly take a village.
Ravensara: Steve Kirin stated, ‘we have no right to say that something is or is not ‘real’ in the holistic profession.’ What service, exactly, are you charging for in your course evaluation? What is your responsibility to protect clients from misinformation?
Dr. Leena: Massage therapy is a very specialized field, where a client actually allows a professional to enter a space that is very personal. You may have experienced while working that many clients open up their inner sanctums of beliefs and understandings. A experienced therapist may almost “hover” around many different holistic principles and philosophies, so as I understand it, the intent here was for NCB not to therefore be passing judgments on therapies that common wisdom bears of value but science considers “voodoo”. When I took a Masters’ program at the University of Westminster with Leon Chaitow, the scientific approach to complementary therapies was such a point of debate; and almost 20 years later we are still struggling. I can certainly say as an Osteopathic researcher that the validation and scientific basis of even well recognized modalities is challenging to prove, though the foundation has great articles to this end.
So many people take different energy courses, color therapy, aromatherapy, chakra balancing courses and move from manipulating tissue to working with inner self. We know from either our practice or that of others that the healing process is not simply limited to tissue manipulation. This is where these other modalities come into play. Even hospitals request nurses to become Reiki practitioners to better serve their patients; and though the science is not as yet defined, it is considered as continuing education and developing new skills. For my experience as Director of Program Development and Research in conjunction with Hartford Hospital, the hospital president herself had a great interest in this direction.
I’m know that Steve had a much more succinct response which you can hear on the webinar, but this is such a great topic in light of the diversity among therapists and modalities, though more of a philosophical one than an exam board purview. In fact I’ve attended conferences internationally that are just grappling with the healing mechanism and our part in that process.
The fee for service is reflected though perhaps not proportionally to the time taken by the committee and its support staff to evaluate, debate and conclude on the merits of a course. It is my hope however, that the Think Tank will feed directly into this process to elevate standards and provide recommendations on how to satisfactorily evaluate an estimation of 200,000 classes. The funds from the AP program support various things. The people, the building, the supplies and the tools used to review the information.
When one is in business as many of us are, one can understand that the apparent cost on the surface (for example for a massage session) is not necessarily equal to or greater than the costs for the business to provide that service. This amplifies further when we consider owing, operating and managing a school and it is also true for NCB as well. I hope I have done some justice to the question — and perhaps the wisdom of the Think Tank, with decades of experience, can invent or recommend some alternatives.
As far as responsibility goes, it depends on the misinformation. If the information given to the client refers to massage therapy then the ethics committee will review the complaint and take the appropriate action. But, if the misinformation revolves around criminal actions, the client must contact their local law enforcement agency. If the Certificant is convicted, then the conviction should be communicated to NCB. NCBTMB is not a regulatory board, nor does it have the right or authority to criminally convict anyone.
Catherine: Regarding renewals, why don't you require half of the required hours to be hands on training as AZ does? It has been my experience that most therapists do online courses just for compliance reasons but not to really learn how to perform the techniques.
Dr. Leena: This is a great suggestion Catherine, and I love it, but right now I can see from these questions, that even in the programs we do have, we need to do a radically better job in conveying our current requirements, before we even begin to make further changes.
This question serves as very good critique. As my late mother always used to tell me, all knowledge is good. Of course I'm saddened to hear that hands-on professionals would not evaluate their development needs and take courses that they need to further their skills. In some professions we have to literally justify why we have taken certain CPD (Continued Professional Development) and how it advances us in clinical practice. I must say that my experience has been that the massage therapists I know and have come to meet over the years through the chapters and at conferences are the reverse, they far exceed the approximately 12 hours a year.
Susan: Will the change help with reciprocity? Are we going to start pushing for a tiered license, spa tech, therapist, etc.?
Dr. Leena: Very good question, Susan. It makes me think about my son, a cardiologist. By the time he qualified, more super specialization and board certification changes came into being — even while he was still doing his fellowship, board certification changes occurred. He took his boards last week.
Certification, post licensure is a very dynamic and evolving process. Super-specializing and reciprocity continue to be issues as states have varied requirements. We are not the entity tooled to push tiered licensing, our focus is certification, approved providers and schools — but through outreach I really want to know what the profession wants and needs from the National Certification Board.
Lori: What is NCBTMB doing to get massage listed as covered expenses for health insurance?
Dr. Leena: We would have an indirect role here, as gate keeper of standards — those standards being related to board certification and continuing education requirements as well as practice hours. But, we have no direct role so far. Perhaps we should think about this which would require another collaborative Think Tank, or multi-stakeholder effort.
Typically, an exam board and an approved provider entity focus on education and membership organizations focus on needs of the members. NCBTMB is not actually an association; we are a credentialing certification body — but I'm all eyes and ears if this is the direction that constituents and Certificants believe is the role of a credentialing board, then we can certainly support and collaborate with healthcare initiatives.
Bambi: I am interested in hearing the new direction of the board and how it will continue to serve the massage therapy profession. Why should I continue to choose to maintain a Board Certification with your group vs. another?
Dr. Leena: Our new direction is to reach out to our community, through webinars, surveys, seeking help in Think Tanks, etc., and we will require more volunteers in order to revamp and retool to be what the profession wants us to be.
Choosing a higher credential is voluntary; it can distinguish the more qualified therapist from an entry level therapist. It shows a commitment to the profession and the consumer. Just like the medical profession uses and recognizes the board certification credentials, in our profession we are at the earliest stage of this process. Board Certification creates a career pathway that usually provides a gateway to specialty certification.
Also, I am actually not aware of any other group that has a board certification in massage therapy and bodywork.
Michelle: As a NYS LMT health professional, what benefits can you provide me? When I previously respected your organization and paid to recertify, why would no one return my phone calls after they received my money when I had questions about filling out forms...
Dr. Leena: This is completely unacceptable and should never have happened at all, I agree. Please accept my apologies. I was informed there were challenges with phone lines and emails….and then the office became overwhelmed. I'm advised that a new phone system and operational procedure is in place and these challenges are fixed.
As for the benefits of Board Certification, these are tied typically to attaining a higher credential and in healthcare professions provide an avenue for further specialization. In NY we sponsor AP providers and issue certificates accordingly. NCB will work with any of our Approved Providers to sponsor them to teach continuing education for NY Massage Therapists as long as their courses and credentials follow NY guidelines. There is a $25 fee attached to becoming sponsored by NCB because this organization must send out all of the certificates once a class is complete. We have a dedicated staff person who handles this for NY providers.
Anne: What does it mean to be Board Certified? I don't need to know what info I have to give you, but why does it matter anymore if I am Board Certified?
Dr. Leena: Board Certification is a higher credential than licensure. As I mentioned, it’s a commitment to the profession and to the consumer. Board Certification allows a more advanced therapist to distinguish themselves from a from an entry level therapist. It is modeled on the medical profession, the next step in creating a career pathway for our profession. Board Certification requires advocacy from the Board, the Stakeholders and the Certificants to disseminate these values, just like it has been in the history for both old and new medical board certifications.
Vivian: Just wondering how NCB will handle providers who have ‘organizations’ of other providers?
Dr. Leena: We are accepting organizations as Approved Providers in the new program effective as of October 1, this year and, yes, there can be an overlap. Small organizations may prefer to simply use individual providers. If you are an organization that strictly hires current Approved Providers, you can let your organizational approval go. However, if you hire a mixture of current Approved Providers and also other professionals that may not be in approval status, but teach information that is within the massage therapy, you might prefer to be an organization. If you decide to remain an organization, you and the Approved Provider can decide who is in charge of the documentation of the courses that you will be sharing.
Gayla: The NCBTMB is obviously floundering under immense criticism from the evidence based community. Is NCBTMB willing, in any capacity, to begin the vetting of non-massage related courses and instill requirements for minimal scientific support in curriculum?
Dr. Leena: Thank you for your very thoughtful opinion and solution rolled into one. The NCBTMB is willing in any capacity it can to begin vetting courses. If you take a look at the APCE blog, you can see the call for a Think Tank to address this very matter. It is my hope that the Think Tank will consider evidence based classes, science classes, research classes and other categories of approved provider courses in their consideration.
Jessica: Moving forward with Dr. Guptha, how will NCBTMB really be helping MTs use their Board Certification besides just a title? I need to know that not just any CE course is being approved; we need to be taken seriously.
Dr. Leena: Great question, Jessica. The value of Board Certification will require a collaborative effort among stakeholders to promote value, as it is done in other healthcare professions. I see this as an opportunity to collaborate, but it is incumbent on each and every one of us to educate our clients and the public on this new higher credential, just as it was done when national certification first came in to being.
I am an advocate of quality education and spent years as an ACICS evaluator. I agree with you 100%, and this is why internally we have created an audit process within the new AP program, and externally I'm seeking a Think Tank to address this very issue. It is very serious, no question about it.
Laura: Are we supposed to establish our credibility in the medical field and ability to participate in insurance reimbursement through the ACA with classes like ‘Shapeshifting’ and ‘Creative Healing with the Flower Devas’ approved by our National Board?
Dr. Leena: Thank you Laura for bringing this to my attention. As I reflect on my own provider application of the 90's I think that an audit process or Think Tank for evaluation was needed from day 1. I cannot say why that was not there 20 years ago, but I can say today we are seeking a Think Tank of experienced approved providers and stakeholder representatives to make recommendations and develop guidelines to review thousands of classes and categorize them in accordance with that wisdom. I imagine this will require a volunteer workforce to then follow and implement the recommendations of the Think Tank.
Kelly: Why has the Board decided on this new 750 hour requirement? Why are they not grandfathering in MT with years of experience?
Dr. Leena: The NCBTMB minimum requirements were originally 500 hours. Throughout the continental united states, requirements differ from no requirements up to 1000 hours of education. Since many states still have only the 500 hour requirement listed in their statutes, we could not go straight ahead and raise the standards to 1000 hours right away. So, as the first board certification in the profession we have chosen to start with an intermediate number of hours with the longer-term vision of adding specialty; and this is another area for surveys, discussion and outreach.
If you have years of experience and have taken 750 hours of education from your school, continued education or accredited college courses and you can demonstrate 250 hours of practice — you can be grandfathered in.
Doreen: Why do I have to pay $85 fee to transition to Board Certification when I am not due to renew until 2015? Isn't NCBTMB and Board one in the same? I don't feel we should be assessed this fee. We already paid our renewal fee.
Dr. Leena: The transition would add another two years to your longevity, so it would become 2017. You do not have to renew until your renewal date. I know that hundreds of people have grandfathered in early, but you can either wait until 2015, or you do have the choice to renew earlier. You will only have to pay one fee of $85, no matter which route you choose to take. If you renew now, your renewal date will move to 2017. If you choose to wait until the actual date, that’s fine too.
I became Board Certified early because I want by clients to see that I am Board Certified. I want my clients to know that I have attained the highest credential in the field and in doing so, I want them to spread the word to seek out a Board Certified Massage Therapist.
Barbara: Why has it become more difficult to not only certify with the NCB, but also become a CE provider in a time when most of us have been hit hard by the economy and natural disasters?
Dr. Leena: Hello, Barbara. I am not sure if it is more difficult as such, or if it is just that we are raising our standards to a higher level with Board Certification and being more through with Approved Providers.
The standards of certification have increased to represent a higher credential and the AP program has changed to take a step towards auditing for quality — however, that aspect is still requiring a radical look from the developing Think Tank. I would certainly welcome all hands on deck in the clean up here.
Continue the conversation with us on Tuesday, November 12, 2013 from 1pm – 2pm CST for Dr. Leena Guptha Weighs In…Part 2 where we’ll continue to answer your questions. Please submit your questions on the registration form.
Are you interested in being part of the NCBTMB APCE Think Tank or part of the volunteer force following the guidelines and recommendations from the Think Tank? Send an email to firstname.lastname@example.org and put CE THINK TANK in the subject line.