Editors Note: Even though this is somewhat dated it shows the struggle of reflexologists in finding their legal niche.
Kunz, Kevin and Kunz, Barbara, Reflexions, Vol. 19, No. 2, Spring/Summer, 1998, p. 1
Push has come to shove for reflexologists in six states and one major city as reflexologists' right to practice has been challenged on an unprecedented level this spring.
The lack of official sanctioning for professional reflexology practitioners has resulted in three veteran reflexologists being put out of business in Florida and Los Angeles. Reflexologists in Alabama and New Hampshire face the challenge of conforming to massage law requirements. Reflexologists in Tennessee are back to work after negotiating to continue practice. In New Mexico and Pennsylvania, reflexologists are actively working with state officials towards regulation of reflexology.
Times have changed and reflexologists are swept up in those changes. Reflexologists, and other alternative practitioners, across America are being required to obtain official governmental sanctioning to continue their practices.
Why all the interest in regulating bodywork recently? It's five years after the landmark Eisenberg study and the marketplace has had five years to decide how to deliver the bodywork product to the one-third of Americans reported to have tried alternative health therapies.
The real issue is who will provide reflexology services to the American consumer. Indications are that the "integration" of traditional medicine and alternative medicine means that referrals from doctors, insurance payments, and jobs in medicine will go to licensed health practitioners.
The times have changed in a number of ways for a number of reasons:
1. More and more states are licensing massage practice. Reflexology is typically not mentioned in legislation but is included by massage boards that form after enactment of the massage law.
2. States and cities are cracking down on "paper mills" and credentials issued by them. States and cities that have regulated reflexology as a practice of massage with easily achieved requirements are demanding that reflexologists provide proof to certify professional competence. (Two hundred hours of instruction are now required in Los Angeles)
3. States, such as Pennsylvania, California, and Florida, are insisting that reflexology educators register their schools as required of a provider of adult education. (In New Mexico, for example, any school that provides more that 20 hours of instruction must meet the state's school's requirements.)
4. Some reflexologists have not confined their professional work to reflexology. Some have strayed into the areas of work licensed to other professions. Complaints about reflexologists providing colonics and massage services without licensing are not uncommon in discussions with massage therapists across the country. Observers of such work have come to the conclusion that all reflexologists practice with no standards.
5. The reflexology community has failed to make known and practice within existing standards.
6. A change has been made in language describing massage practice. The newer laws define massage as "superficial or soft tissue manipulation." States with longtime massage laws (New York and Florida) have changed their laws to such definitions as well.
AMTA: The American Massage Therapy Association has changed its scope of practice: "AMTA defines the Scope of Practice of its members as follows: Massage or massage therapy is any skilled manipulation of soft tissue, connective tissue, and/or body energy fields with the intention of maintaining or improving health by affecting change in the relaxation, circulation, nerve responses or patterns of energy flow.
"Massage or massage therapy may be accomplished manually with or without the use of the following: movement, superficial heat or cold, electrical or mechanical devices, water, lubricants or salts."
Florida: The change was accompanied by the placement of the Massage Board under the auspices of a medical quality assurance department of the state government rather than the former consumer affairs department.
A change in the definition of "massage" by Massage Boards has broadened the scope of massage practice to include "soft tissue manipulation." This is seen to define a technique utilized by a variety of therapeutic professions. Reflexology and massage are thus categorized as licensed therapeutic services.
New York: Previously, reflexology practice was included as a massage-licensed profession as part of an attempt to control prostitution by requiring licensing of all who "touched" another professionally. Now reflexology practice is included in the massage-licensed profession as an attempt to direct insurance payments for reflexology and any bodywork to the "Massage" category of an insurance form.
According to a brochure (dated 11/88) released by the SUNY, State Education Dept., Division of Professional Licensing Services and titled "Massage," Article 155 of the Education Law, a. "Definition of the Practice of Massage: The practice of the profession of massage is defined as engaging in applying a scientific of activity to the muscular structure of the human body by means of stroking, kneading, tapping, and vibrating with the hands or vibrators for the purpose of improving muscle tone and circulation."
Therapeutic reflexology practice is now allowed in Florida and New York for those who possess massage licensing. The administrator of the New York state Board for Massage is defending current state educational requirements as sufficient. An introductory reflexology course is required of the massage licensed individual to certify his or her competence in therapeutic reflexology. The state of New York maintains no over-sight, requiring instead that the practitioner take on the responsibility of being adequately educated. It is the responsibility of the consumer to verify practitioner credentials.
Massage-licensed individuals in Florida now have exclusive rights to provide therapeutic, medical reflexology services. Nurses and cosmetologists are not allowed to provide therapeutic massage or reflexology services. Professionals in these fields are usually exempted in massage practices acts. Recently, however, the New York state Massage Board had also acted to limit cosmetologists in massage services.
The number of states licensing massage is climbing quickly. Twenty-one state legislate massage with legislation pending in Mississippi and New Jersey. Recently formed Massage Boards have acted immediately, encompassing reflexologists in Alabama and Tennessee.
Reflexologists argue that their First Amendment rights are being abridged. Court cases have found that the right to privacy includes the right to determination of what procedures are applied to one's body. An extension of the legal argument is that the right to choose who provides the procedure is included. The fact that the reflexologist, practicing his or her health belief system has been told to become licensed as a massage practitioner infringes on the individual's right to be provided reflexology services of his or her choice.
Reflexologists further argue that the state has not acted to regulate reflexology in a manner common to all professions, that the state has created a consumer hazard by officially sanctioning any massage-licensed individual as a provider of reflexology with no reflexology experience or education required.
Massage therapists argue that they are required to follow rules and reflexologists can do anything. They cite the examples of the reflexologist who provides reflexology and colonics as a service or the reflexologist who provides massage without licensing or another who operates a business without paying state sales taxes.