Permission to Practice

Stamp

Namaste

A few years ago I shared the link http://www.ttparliament.org/hansards/hh19980306.pdf which advises that on Friday March 6, 1998 the Bill regarding the Massage Therapy Association of Trinidad and Tobago and matters relating thereto (e.g. the issuance of license) were read in the House of Representatives for the first time. The document goes on and on about with no reference to how or when license will be instituted.

The silence is then broken in December 31, 2010, with the Massage Therapy Association of Trinidad and Tobago appearing on page 21 of a long list of Omitted Acts of the Laws of Trinidad and Tobago. http://www.legalaffairs.gov.tt/omitted_acts.pdf . As at December 31, 2015 this remained the case.  I am not a Lawyer so I cannot explain how it appears on this list while simultaneously being used to regulate Therapy practices. To date, despite many more Massage Therapists having graduated from several schools across the nation, I remain unaware of a change in the situation, but I continue to be asked about the need for licensure.  Maybe the majority practice without such because we do not need such.

It is understood that the purpose of laws is to promote the unfoldment of the potential in each human being by protecting the innocent from the guilty, providing equal treatment for all, and protecting the rights of individuals from unruly mobs. However, sometimes the actual effect of some laws is the exact opposite of their stated goal. For example, in health care, education, and other fields, some laws may stifle innovation, protect outdate and often harmful practices, and protect the status quo.

As far as I know, the legal regulation of the healing arts is based on the conventional paradigm of the disease entity model in which one is either healthy or one is diseased. When you’re ill, you go to see a licensed allopathic doctor who diagnoses, treats, prescribes for, and hopefully cures the disease mainly through the use of drugs and surgery.

Massage Therapy falls outside this category and is more of a whole systems approach. It recognises that one’s health is always changing in response to internal and external conditions, so that symptoms and diseases are not primary, but rather whole system responses to stress, imbalances, and/or lowered vitality. Thus, even when the imbalance results for trauma, one must honour the whole system in order to restore it to harmony.

There has been talk in some quarters that the Medical Association should assume responsibility for Massage Therapist through administration of a nation examination and issuance of license to those who are successful. Thus ensuring we are governed my law. If the point is to regulate therapists, or to feel regulated, then both are already being done. Some therapists achieve their sense of legality by working under the supervision, and often under the same roof of a medical practitioner. Some work alone or in a group, not under the supervision of a licensed person, and emphasized that they are not engaged in a regulated activity. Others, being the majority, become certified by a legitimate accrediting or certification agency as one who is not practicing medicine. Case closed.

Oh, not really. The case remains open for there is expressed concern by some that the public is unsafe with unlicensed therapists in the market place. It is true that advantage can be taken of the sick and debilitated, but it is not necessarily true that licensing is the way to control this problem. We need to understand that occupational licensing laws are not really the laws that protect the public as is claimed. Think of it. Any therapist, licensed or unlicensed, is subject to criminal laws against fraud, or negligence if is person is harmed. Thus it is the criminal laws that protect the public from incompetent and unscrupulous therapists.

As an aside, maybe now is a good time to do some research into whether we are considered Allied Health Professionals. Though it is not a substitute for high standards of work and ethical behaviour, professional liability insurance, also called malpractice insurance, can provide protection from mistakes in treatment.

A closer look at licensing can be quite revealing. A license is permission to do something that is otherwise forbidden. It is a government privilege that is bestowed in return for giving up personal power.

Healing restrictions. Many gifted persons cannot, for different reasons, complete medical schooling and obtain license to practice. If the public is forced to patronize only those who have such permission, it deprives these gifted individuals from sharing their skills. Basically, it keeps potential therapists out of the job market.

Shielding. Having experienced medical care over any period of time one notices that licenses give doctors and hospitals an aura of respectability and often the arrogance can result in mistakes and shoddy work. What prevents the same from occurring among therapists as they cling to their sense of distinction at being licensed?

False expectations. Licensing generates high expectations of the public and gives them a false sense of security that a particular therapist can cure them. When this does not happen, there is anger and frustration, especially when it is learnt that the unlicensed therapist that they did not go to is having greater success with clients.

Quality of care. A licensed therapist is no longer responsible just to his/her client. Loyalty is divided and the licensing board comes first if he/she wants so stay in practice. Anything that come between the therapist and client tends to lower the quality of care.

Tends to tyranny. It is to be noted that licensing boards possess police power. This is tough given that their members are not elected by the public, and ordinary citizens must abide by the decisions of the licensing board. The possibility of tyranny is in no way exaggerated.

Police power. Apart from what is stated above, if one violates a licensing law, either by operating without it or failing to uphold the rules governing the license privilege, once is subject to prosecution under civil or criminal laws. For this reason a major purpose of licensing is always control.

For some, license is something to be proud of as it is regarded as a symbol of distinction, a mark of official achievement, greatness and superiority. Doctors often hang their licenses prominently and proudly on the wall, in part for this reason. Some licensees are required to display their licenses, which help to reinforce the false idea that a license means that one is a superior practitioner.

If I may return to the concept of safety, it accepted that many people feel insecure inside and look to outside authorities to help them feel they are safe and doing the right thing. We can see why they believe licensing is essential to prevent fraud and chaos, and that the masses of people cannot decide for themselves which therapist to visit, so they must be told by licensing authorities whom to patronize.

The psychology of control shows us that people do not like to feel out of control, and when they do, instead of examining why that feeling exits, they then to project outside of themselves onto authorities such as the government, so that the appearance of outside control becomes a substitute for feeling in control within.

One who trusts and loves oneself has no reason to ask for permission from the government to be a therapist, educator, or anything else. A bureaucrat living miles away is hardly in a position to judge the quality of one’s work. It would serve us better to understand the emotional reasons for desiring licensing, and maybe we will realize that giving our power to external authorities is rarely helpful in the occupational realm.

Certification is favourable because it sets standards, educate therapists, and help the public decide which therapists to patronize. It is a statement or declaration that one has completed a course of study, passed an examination or otherwise met specified criteria. It also implies that one has a right to work. And, because it is given by a private agency, it can be withdrawn at any time if the one who is certified acts irresponsibly.

We have to wonder why Massage Therapists need to be licensed when professionals like Nurses and Dietitians are registered. Registration is similar to certification, and both are considered alternatives to licensing as they do not increase the power of the state over the population. I would say let the therapy industry continue to be operated as is. There are many levels and types of therapy available, which are necessary because not everyone enjoys the same type of care. Innovations are permitted, the competition keeps therapy prices in check, and whoever helps people the most prosper. Pretty decent.

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