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How Well Do You Know Your Massage Therapist?

Besides the obvious horrors the recent arrest of Radovan Karadzic dredged up, it was really freaky to find out that the Butcher of Bosnia, murderer of a reported 8,000 men and boys, has apparently for years been practicing complementary medicine in Belgrade under the pseudonym Dragan Dabic.

Among the many questions that popped into my mind: How well do I really know my massage therapist?

If, in fact, I had a massage therapist, I'm pretty sure she would have committed no crimes, let alone the kind of ghastly atrocities attributed to Karadzic. But there are tons of people practicing alternative and complementary medicine in the United States. How do we know if they're all on the up-and-up?

The short answer? We don't.

Whereas physicians practicing traditional Western medicine have to be trained and licensed and are subject to oversight by state medical boards, complementary and alternative medicine (CAM) practitioners in many fields of expertise can pretty much just hang out a shingle and start working with patients. Nor is there any overarching regulatory body with which to check a CAM practitioner's record and credentials.

None of this is to suggest that CAM practitioners are inherently less likely to be good citizens than traditional MDs; nor am I suggesting that every credentialed MD is a saint. All I'm saying is that, in light of the lack of comprehensive oversight, entering into a relationship with a CAM practitioner may warrant an extra dose of diligence.

Michael H. Cohen, Assistant Professor of Health Law and Policy at the Harvard School of Public Health and co-author of this article about CAM credentials, told me yesterday that "The world is basically divided into two groups: MDs and Everyone Else." The latter category, he explained, includes allied health professionals -- such as occupational therapists and physical therapists -- and CAM practitioners. The realm of CAM is further divided between licensed and unlicensed practitioners.

Checking a licensed CAM practitioner's credentials and performance is similar to checking an MD's, Cohen says. Your state regulatory board, like a state medical board, likely has a Web site on which you can look up a practitioner's name to see whether he has an active license and whether disciplinary action's been taken against him. Some will include a database listing malpractice claims, too.

An unlicensed practitioner may still be registered with the state; checking that listing might provide useful information. If your practitioner claims to be "certified," find out what organization issued the certification and, if possible, check with that organization.

The National Center for Complementary and Alternative Medicine (NCCAM) offers tips for selecting a reputable CAM practitioner. And here's something I lifted from the FAQ section of their Web site:

Requirements for licensure vary by type of CAM practice and by state. For some CAM therapies, licensure is required in some states and not in others. For other therapies, there are no formal requirements for practice. You may want to contact a nearby hospital, medical school, health licensing authority, or state medical board for CAM credential and license requirements in your state.

The Directory of Health Organizations lists professional organizations that outline standards of practice for certain CAM therapies and may offer information about the type of training required for a license. Search for the therapy or type of practitioner to find organizations that may be able to assist you.

As an aside, having written recently about Facebook, I was intrigued to find this list of Facebook accounts for people named Dragan Dabic. I haven't mustered the nerve to Friend any of them.

By Jennifer LaRue Huget  |  July 23, 2008; 7:00 AM ET
Categories:  Alternative and Complementary Medicine  
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Helpful info on state licensing practices. Also, great photo op! Thanks!

Posted by: REM | July 23, 2008 9:38 AM | Report abuse

maybe it's cuz you can't license fairy tales?

Posted by: khefera | July 23, 2008 10:20 AM | Report abuse

You can find certified acupuncturists, herbalists and asian bodywork therapists at

The VA Board of Medicine requires that all acupuncturists complete the certification process from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). When you see a Dipl. O.M. that means that they are certified in acupuncture AND herbology.

Posted by: K | July 23, 2008 11:14 AM | Report abuse

I know that Maryland requires all of its massage therapists to be licensed in order to legally practice and charge their clients money.

(Friend of mine recently went through the training process and is working on taking the test to get licensed.)

Posted by: FWIW | July 23, 2008 11:33 AM | Report abuse

If CAM were real it would be explained to doctors and taught in medical school. But CAM cannot be explained rationally, it is magical thinking. There is no science behind it, no valid evidence. Scientific medicine is what has lengthened human life-spans over the last couple centuries. If you don't feel well se your MD.

Posted by: Mike Bonner | July 24, 2008 9:13 PM | Report abuse

I am a massage therapist. Many of my clients come to me after or while they are accessing traditional medical care. This is not to say I can do what a doctor can do. To the contrary; any complementary healthcare practitioner worth his/her salt will work within the scope of their skills and education. I often refer my clients to practioners who can help them more than I.

There are many of us who work very hard honing our skills and education to help our clients get the best possible care. I would say most doctors and patients don't take the time to know "who's who" in the complementary community. My guess is most traditional medical practitioners don't know the difference in massage therapists and yet sometimes they suggest patients "get a massage". I would hope they know the difference between the categories in their state.

For instance, in Maryland there are two levels of massage therapists. The first level is a Certified Massage Therapist (CMT). This practitioner is required to have a higher level of education and is considered qualified to practice in a medical setting and may take referrals from other healthcare practitioners. The second level is a registered massage practitioner (RMP); educational requirements are less stringent and they may work in salons and spas. Both categories of practitioners are required to pass the exam given by the National Certification Board for Therapeutic Massage and Bodyworkers (NCBTMB). This test is quite rigorous and is recognized as the highest standard.

In many countries, Canada for one, massage therapy is part of mainstream healthcare. It is recognized as a viable solution for achieving and maintaining a healthy body. Athletes all over the work also recognize massage therapy and other bodywork modalities as a way to avoid injury and enhance injury recovery.

As for making sure your complementary healthcare practitioner is qualified, I say make sure ALL of your healthcare practitioners whether traditional medicine or complementary, meet the criteria you are seeking. Most are excellent practitioners AND like any profession there are healthcare practitioners who don't meet our needs on any level.

Posted by: Deb Davies | July 29, 2008 11:28 AM | Report abuse

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