RMTAO Response to Suggested Reforms

In early January I sent a letter to the Registered Massage Therapist Association of Ontario (RMTAO) outlining my concerns of several chronic deficits in operations http://massagetherapistpractice.com/letter-to-rmtao-fortune-favours-the-bold/.  In June I received a response from the RMTAO that I’ve pasted below with my additional comments.

I’m hoping you’ll read the response below, gather your thoughts and respond directly to the RMTAO.  Find a list of the directors and staff at https://secure.rmtao.com/about/association_contacts or email direct at info@RMTAO.com.

Dear Mr. Dillon,

 Thank you for your letter received January 1st, 2013. The Board values the input it receives from members. It is through this ongoing input that we can understand the needs and concerns of our members and better address the issues facing our profession. We encourage all members and non-members to communicate their thoughts to us.

The RMTAO continues to strive for increased communication from its members. There are a number of exciting initiatives in development that we hope will indicate that the voices of the members have been heard. You may have noticed one of our initiatives recently which was a short survey was sent to all members. We hope that activities like this will allow members the chance to express their valued opinions.

You raise several issues in your letter that we would like to address. Firstly, you suggest that the cost of membership to the RMTAO be increased significantly and that the current model is not financially viable. At the most recent Annual General Meeting, the association’s Executive Director Bryn Sumpton presented the 2012 financial report in which he indicated that the RMTAO is currently operating at a surplus and that membership continues to rise. Both facts indicate financial viability and sustainability.

Thank you, RMTAO board members, for responding to my letter.  You are correct I suggest the RMTAO raise fees four-fold, to be in line with other RMT associations, so the RMTAO can effectively meet the needs of RMTAO members.  For example, the RMT associations of British Columbia (MTABC) and Saskatchewan (MTAS) have significantly higher membership fees than the RMTAO, despite having far less of a pool of members to draw from.

The RMTAO does not have sufficient resources to provide essential services to its members.  Essential services include: public and media relations and protection against exploiters; gathering, collating and sharing industry information; advocating RMT interests to government, the insurance industry and gatekeeper health disciplines; and collaborating with other RMT associations and like-minded professions to advance research, regulation/policy and reasonable, unfettered compensation in invoicing insurance programs.   The RMTAO does offer opportunities for securing preferential rates on products and services, and professional development courses, but these could be expanded considerably with a larger staff and more resources.

The RMTAO surplus in 2012 of $143,000 was surprising – given the aggregate deficit of $76,000 reported in 2010/2011 and the consequent hiring an executive director and additional staff member.  It is curious how the RMTAO created a surplus with just a marginal increase in membership while adding two staff members.

In your celebration of the financial report and membership rising, I encourage you to look carefully at your numbers.  The RMTAO did enjoy a boost of 1000 additional members from 2009 to 2010 – after the Strategic Plan was announced.  It appears member optimism faded however when the plan did not materialize, and RMTAO growth in 2011 was 500.  It was even less in 2012 at about 370.

In 2011 when the RMTAO membership increased by 500, CMTO active members grew 1600…in effect the RMTAO is not capturing the hearts and minds of the majority of new graduates.   If RMTAO active membership (as of Sept 30, 2012) is 4371 and CMTO membership is 10,800 at the end of 2011, RMTAO representation is about 40% of all RMTs in Ontario. Compare this to BC or SK RMT associations who boost 80% representation of RMTs in their province.

Again, without sufficient resources the RMTAO cannot effectively advocate for the interests of its members.

Further, you suggest that the number of Directors of the Board is cumbersome and ineffective. We would like to point out that serving as a Director of the RMTAO is a volunteer position. There are numerous committees required for continued operation of the Board. Reducing the number of Board members would in fact increase the amount of time individual Directors donate, thereby becoming an onerous task and slowing the progress of all the various aspects of the work. We would like to note that currently the Board is operating below the authorized number of Directors allowed according to our by-laws. The Board believes that as representatives of the entire membership it is important to include the many varied voices to provide for a balanced and well thought out viewpoint on all the issues being considered.

I understand the governance model the RMTAO is employing, and I suggest this is the main problem. The RMTAO should not place the important job of representing RMT interests across the province on the shoulders of a large volunteer board.  A small, action-oriented board and a large paid-staff contingency can do a much better job.  MTABC for example has 9 board members (one is past-chair) and 9 paid staff to carry out the direction by the board.  Compare the RMTAO volunteer board at 14 with only 3 paid staff.  And despite MTABC membership fees 4+times higher than RMTAO fees, the MTABC retains 80% of RMTs in their province – compared to 40% in Ontario.  BC RMTs purchase membership because the value of membership is clear.  Your operations model is the problem, not the cost of your membership.

A large board deliberates excessively and is slow to move initiatives forward.  A streamlined board takes its cues from its membership – not itself.  It makes well-counseled but expedient decisions and directs staff – via the Executive Director – to carry decisions out. I argue the organization structure of the board and its governance structure is not serving its members interests.  As an example, I challenge you to show proof in the last 7 years (since Andrew Parr, Executive Director resigned) where the association has effectively provided the essential services I’ve listed above.

I suggest the board not be attached to its governance model, but instead actively serve both the immediate and long-term interests of its members.

The individual mandates of the RMTAO are ever evolving as with any organization. Overall, it acts as an advocate for the profession. The Board believes this can be achieved in a number of ways. The decision to not belong to the CMTA, as an example, is something that has been a focus of discussion on several occasions. Shortly, a position statement will be published detailing our current decision. Among the reasons for declining to be a member is the view that the financial obligation of membership is not warranted until the CMTA can provide clear goals with a comprehensive and accountable organizational structure.

The Board believes that it can continue to act to support the profession on a national stage through other avenues. This can be done through letters of support to other provinces, taking an active role in the development of national competency standards and accreditation, and the support of other Regulated Health Care Professionals to name a few. The decision to turn down membership with the CMTA was not taken lightly, nor is membership in it viewed as the only way in which we can maintain a national presence.

I have spoken to representatives of other RMT provincial associations, and they cannot understand the RMTAO’s position to deny collaboration with the Canadian Massage Therapist Alliance (CMTA).  The CMTA serves 7 member provinces – British Columbia, Alberta, Saskatchewan, Nova Scotia, New Brunswick, Newfoundland/Labrador and Prince Edward Island – and the North West Territories.  The CMTA’s primary objectives are: i) preserving and improving insurer relations ii) supporting regulation in all provinces and iii) organizing research initiatives.

The CMTA has represented the member provinces for the last five years at the conferences of the Canadian Life and Health Insurance Association (CLHIA), and the Canadian Health Care Anti-fraud Association (CHCAA).  CMTA representatives Brenda Locke, ED MTABC and Lori Green, ED MTAS have gathered information from insurers regarding their concerns with massage therapy claims.  In response, the CMTA has actively invited non-participating provinces to get involved in improving insurer relations, and designed a standard RMT receipt at the request of insurers.

However without a unified collaboration by all provinces and territories, the RMT insurance strategy appears fractured and a clear message regarding evidence-based practices or cost-effectiveness of massage therapy care, incoherent.  The province with the largest number of RMTs – Ontario, is not a member.  Embarrassingly, despite very limited resources the RMTAO appears to suggest it can forward these national initiatives alone.

An historical perspective – then Ontario Massage Therapist Association (OMTA, precursor to RMTAO) Executive Director Andrew Parr expressed concerns with the financial structure of the CMTA in 2005 and advised the OMTA (RMTAO) board to halt the OMTA’s involvement.  Under Parr’s direction the OMTA attempted later to form a coalition with Manitoba, which subsequently failed.  RMTAO members should be informed that, since then, CMTA representatives have openly welcomed and encouraged the RMTAO to explore both the CMTA’s mandate and financial structure, and earnestly wishes Ontario – the province with the largest number of RMTs in Canada – to collaborate on initiatives beneficial to RMTs across Canada.

We have an insurance crisis on our hands.  In Ontario in the last decade we’ve witnessed the insidious increase of denial of RMT treatment plans in auto insurance and WSIB (worker’s compensation).  More recently, there’s anecdotal evidence to suggest insurers are denying employee claims for RMT services under their workplace benefit plans.

According to the original CMTO survey, 74% of patients/clients pay for massage therapy services with some type of insurance program.  Progressive and aggressive undertakings by insurance companies to prevent fraud and discourage claims for massage therapy care will have devastating effects on practitioners.

Bottom line…the RMTAO cannot pursue RMT interests provincially or nationally without shared resources and collaboration.  The passive “letters of support” and the proclamation that the RMTAO “can maintain a national presence” is grounded, I suggest, in rhetoric and not reality.  Please consider the vigorous objections you’ve received at every RMTAO AGM in the last 7 years as well as in social media and commit to collaborating with the CMTA on national RMT interests.

We hope that you find our response to your satisfaction. Again, we would like to thank you for your comments and your candor. The RMTAO is continually looking for volunteers and ambassadors and we would welcome you to encourage members to contact our office. We would also like to see more active involvement and development of our Community Based Networks should you wish to consider helping further.

Yours truly,

The RMTAO Board of Directors

As you know I’ve been one of the RMTAO/OMTA’s strongest advocates in my professional tenure.  I have promoted the importance of professional association membership in my speaking and writing campaigns across Canada.  I am adamant now more than ever that the RMTAO must examine its path and processes and align them tenaciously with those of its members.

With the release of Report on the Massage Therapy Census 2003, commissioned by the College of Massage Therapists of Ontario – my sense of urgency to address the pressing issues of our profession has grown desperate.  Since then I’ve written extensively and have been welcomed by RMT associations and schools across Canada to speak about the threats against viable RMT practice – specifically unfavourable government health care policy and taxation, stonewalling by the insurance industry, skepticism by gatekeeper health disciplines and profiteers who would exploit the popularity and value of massage therapy.  I’ve discussed the implications of a down economy on discretionary income and workplace benefit plans, and hence on the direct financing of massage therapy services.

While I’ve received sincere interest in these topics, and despite best evidence that the profession is facing serious challenges to its existence, I’ve been unable to move those that have the authority and resources to improve the lot for RMTs in Ontario and in fact throughout Canada.

If you check your records you will find I am perhaps one of the most decorated volunteers the OMTA/RMTAO has.  I’ve received two Hands of Thanks, the President’s Award of Merit and the Ken Rezsnyak Award of Merit from the OMTA for my volunteer efforts over the years.  I’ve represented the OMTA/RMTAO in discussions with the health professional coalition regarding auto insurance, with representatives from the insurance industry, and the WSIB.  I’m also one of the organizers of our successful Niagara RMT community-based networks.  Despite my apparent contributions to the profession, I have failed to move the board to consider the weight of their actions, or particularly, inactions.

I feel greatly disappointed and frustrated that at this most urgent time, the RMTAO seems increasingly less capable to deal with the aggressive threats to viability of RMT practice.  I will continue to do my part to rally RMTs across Ontario to push for an effective association that will consider the big picture, take into account the real threats facing viability of RMT practice and forge strong relationships and share resources to ensure the longevity and viability of massage therapist practice.

See you at the next RMTAO Annual General Meeting.

Respectfully,

Donald Quinn Dillon, RMT

There you have it my colleagues.  I’ve fought hard to push for RMTAO reform for the betterment of all RMTs in Ontario, and you can judge the RMTAO’s response for yourself.  If you believe the RMTAO can do better, if you think your interests can be better represented, then you need to make your voice heard.  Come to the next RMTAO AGM or sign your proxy to a fellow member that can represent your values.

Nothing is going to change until you change something, and if your practice, your livelihood, your profession is important, then you need to get off the sidelines and make your voice heard.

This is your livelihood, your vocation, your profession.  Only through sheer volume of response can RMTs hope their professional association will take the steps necessary and urgent to support viable massage therapist practices.

I’m counting on you.  dqd

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