The benefits of therapeutic touch have been documented and reaffirmed in countless medical studies. At a time when bodywork seems to have finally won the respect and recognition it deserves, the California massage industry may be severely curtailed by proposed legislation for state licensure. We asked Judith McKinnon, founder of the McKinnon Institute (longtime OPEN EXCHANGE lister), and one of the field's recognized pioneers, to share her concerns.

OPEN EXCHANGE: You have worked for over three decades in the field of therapeutic massage as practitioner, school administrator, and legislative advisor in Sacramento. What are your thoughts on the proposed legislation for state licensure?

Judith McKinnon: I think the legislation is a major issue and stands to change the field of massage for everyone. AB 1388 aside, I am opposed to licensure. There will be major restrictions put on massage businesses, practitioners, training programs, and the clients who are receiving massage. It will severely limit who enters and who remains in the field. My opposition also comes from the criteria to require licensure for a profession. Licensure is a 'practice act' intended to avert harm to the public. It is the most severe form of regulation that can be introduced. There is sufficient evidence on the national, state, and local level indicating massage therapy poses no harm to the general public. A Med-line citation of massage-related injuries from 1965 – 2003 indicated only 11 cases in over 12 million citations. The safety of massage is also reflected in the actual cost of liability insurance. With massage on the rise nationally, our liability insurance has not significantly increased in ten years! The portion of insurance premiums that goes toward liability coverage is about $65 per year. What other profession can boast such a figure?

OPEN EXCHANGE: If there is no issue of public safety, why do you think licensure is being proposed?

Judith: Some people believe that it may eliminate what they feel are inappropriate procedures set by cities for obtaining business licenses. In fact, state licensure would not eliminate these local fee requirements, nor affect zoning laws. Also, there are those who believe that standardized training would increase the credibility of massage therapy and allow for practitioners to accept insurance payment for treatment. The overwhelming majority of massage done in California is for relaxation and stress reduction and does not require insurance billing. By standardizing training, the field would lose much of the diversity and uniqueness that makes California well-known for producing new modalities and cutting edge bodyworkers. Therapists also think that with state licensure they will be able to move from state to state without problems. This just isn't true. There will always be states that require more training or specific training from their schools. So, to think state licensure in California will help mobility is simply unrealistic. The American Massage Therapy Association (AMTA) has funded the introduction of AB 1388 into the Legislature with Assemblywoman Christine Keogh as the sponsor. AMTA has been a major player in introducing legislation nationally. Schools that already have large accredited programs might stand to benefit, simply because small schools would most likely be put out of business—at least temporarily. In the long run, though, the flexibility and creativity that make California massage schools so unique and popular would diminish.

OPEN EXCHANGE: The state has just implemented SB 577, another ordinance that regulates non-licensed practitioners. Doesn't that make AB 1388 redundant?

Judith: Yes, it is redundant. Massage falls perfectly under statutes of SB 577. Effective Jan 2003, SB 577 recognizes specifically those practicing alternative/complimentary health care that avoid diagnosis, treatment and invasive treatment practices. With the inception of this innovative legislation, it seems ludicrous to implement further regulation of the field of massage. Licensure will only slow down entry into the field and create more fees and paperwork for practitioners. This is unnecessary, illogical, and a waste of everyone's time and energy. The field regulates itself as it is. Clients continually show that massage is worthwhile and safe by paying for services out-of-pocket. If someone likes a certain therapist, they go back. It doesn't depend on what regulation the practitioner is in compliance with—it has to do with their quality of work.

OPEN EXCHANGE: It sounds like overregulation might actually make touching illegal, or at least drive a number of practitioners out of the field. Can you tell us a little about how you have been involved in earlier attempts to implement licensure in California?

Judith: I have been in the field for thirty years now and involved in fighting the threat of licensure for over twenty. This is the second attempt to institute licensure in this state. The first time AMTA tried to push licensure through was in the late 70s. They tried to require 1000 hours of training to practice massage. At the same time, Physical Therapists were only required to complete 950 hours of training. In the 90s, I served on the Physical Therapy Examining Committee as a Gubernatorial Appointee. I witnessed the difficulties the entire field encountered in dealing with mandated requirements, which slowed down everyone's entry into the work force. Because of bureaucratic delays in the licensing process for physical therapists, clinics and hospitals experienced a debilitating shortage.

OPEN EXCHANGE: Tell us why you are so personally committed to fighting new regulatory legislation.

Judith: I feel strongly that the field of bodywork is unique and cannot be boxed into existing rules for any type of state regulation. I would not have begun in the field if it were a licensed profession simply because I am dyslexic and would have been intimidated by the test taking. At the time I trained, the requirement in California was 70 hours. There were a lot of us trained and working with similar qualifications and not hurting anyone for decades. Indeed, we paved the way for both massage and many other Complimentary Health practices to blossom.

OPEN EXCHANGE: How does licensure differ from other types of state regulation?

Judith: Licensure is the most restrictive type of regulation. Professions that are licensed imply a risk of harm to the public, which is the criteria set by the state for licensure, and show overwhelming evidence that procedures stand to harm recipients. For example, MD's, physical therapists, estheticians and dentists are licensed. Even nurses are not licensed. They are registered, meaning their duties pose less potential harm than those of licensed practitioners in any field. What the proposed legislation for massage therapy implies is that practicing massage requires similar regulation to those practicing medicine.

OPEN EXCHANGE: It does seem overkill. What does the field stand to lose?

Judith: Licensure would inevitably move training programs toward a standardized format, decreasing the individualized components of each school and creating practitioners that were trained uniformly. Standardization of massage training programs would inherently reduce the diversity and essence, and chase out the talent that currently makes the field so vibrant. The field of massage has flourished because of the contribution from thousands of unlicensed practitioners. Why fix what isn't broken?

OPEN EXCHANGE: With the field of bodywork being as broad as it is, with dozens of various modalities, are there any provisions for grand-fathering or exemptions?

Judith: There has been conversation regarding grand-fathering. As far as exemptions, a few schools of bodywork have requested exemption from AB 1388 such as Reflexology, Polarity Therapy, and Feldenkrais. Other disciplines have not, such as Acupressure, Shiatsu, Craniosacral, Visceral Manipulation, and Lymph Drainage. However, the important point for me is that we will get to a point where there are more people slated for exemption than governed under the licensing act. This seems unjust and unrealistic. We should be coming together to discuss the field of bodywork as a whole within Complimentary Health Care.

OPEN EXCHANGE: Where is AB 1388 at now?

Judith: AB 1388 will be reintroduced into the Assembly in January 2004.

OPEN EXCHANGE: What can people do?

Judith: Write a letter to your legislative representative expressing your stand on AB 1388. Write to the Assembly Business and Professions Committee urging them to vote no on AB 1388. Talk to people you know who may be affected by this bill and help educate them. After deep consideration, I cannot in good conscious see any reason for licensure. Ultimately, it will be up to all of us to create the direction the field will take.

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