Dear Mr. Lewarne, ED, RMTAO Andrew@RMTAO.com
Congratulations on your appointment to the position of Executive Director, Registered Massage Therapists Association of Ontario. I’m writing today as a long-time RMTAO member to express my hopes and aspirations for you in your tenure, and to affirm an urgency which I hope you will take to the task at hand.
We all acknowledge the association has been hamstrung in selecting and retaining an executive director to see the association through the long term, and as a result it’s been hard on the board to maintain even basic operations. Accolades to staffers Jill Haig, Rachel Chuffart and Valbona Kapastra!
As you have served on the board for a number of years before this ED assignment, you’re aware in the past 5 years the RMTAO has employed two Executive Directors – each lasting less than 2 years each. You, Mr. Lewarne are the third, and I suspect RMTAO members have great expectations of you. RMTAO members rely on their association to advocate their interests to outside influences – some potentially harmful to massage therapist practice – and to bring us together in dialogue and debate to work through our profession’s issues and engage us in the solutions. We are hopeful that you will apply a direct hand so the RMTAO can now move forward on achieving outcomes long-overdue outlined in the RMTAO board’s End Policy.
Five Years with Little Progress
The Ends Policy – the desirable outcomes for the profession as identified and set by the board – was ratified in 2007 and revised in 2013. The Ends Policy is the RMTAO’s benchmark, defining where the association is going and what it looks like when it has arrived. These are the every-day targets you, in your command of the association’s resources, are shooting for. It’s how RMTAO members determine if you’re on track and are reaching your targets.
End Policy objectives: the profession 1) has a clear and visible identity 2) has the highest professional standards 3) engages a culture of inquiry 4) is recognized by the public, health care professionals and other stakeholders as a valued health care option 5) engages in inter-professional collaboration to achieve best possible patient outcomes and 6) is prosperous and financially viable.
The RMTAO record for meeting RMT interests in the last five years isn’t good. It doesn’t appear the RMTAO since 2007 has moved in any way towards these desired ends, and in fact, status for RMTs on a variety of important fronts has declined. Despite RMTAO Chair Krystin Bokalo’s assertions at the last RMTAO AGM that the revised Ends Policy is “dramatically different”, I suspect if you review the two together you’ll find they are quite similar. In effect, we can and should measure whether and how much the RMTAO has moved, since 2007, toward achieving its objectives. Let’s compare what is with the above stated objectives:
1) The RMT profession is maligned frequently in the media with an identity of prostitution, insurance fraud or as a fringe, unsupported-by-evidence wellness modality. In recent media coverage into sex-trade workers using massage services as a front, journalists have interspersed the title “massage therapist” when referring to sex trade workers, leading to public confusion and harmful association. To RMTAO members’ knowledge, these representations are not being responded to/corrected by the RMTAO.
2) The association, regulatory body and 49 training schools in Ontario do not appear to be working collaboratively, as was premised in the Strategic Plan of 2009 http://www.cmto.com/cmto-wordpress/assets/strat_plan.pdf. These stakeholders and their members/students should be regularly engaging in discussion on education and training, lobbying government policy, improving relations with gatekeeper health disciplines and the public/media and negotiating with insurers on fair compensation for services.
3) The “culture of inquiry” objective has been facilitated largely by the regulatory body’s mandate to include some instruction in research literacy in training college programs. As far as we can tell, the RMTAO hasn’t moved this forward. It’s been the regulatory body that has contributed to supporting research grants in organizations such as the Interdisciplinary Network of Complementary and Alternative Medicine (IN-CAM), not the RMTAO.
4) Massage therapy is not recognized as a valued health care option – services are not covered by the provincial health plan and are subject to the onerous HST consumption tax where chiropractors, physiotherapists and recently naturopaths and acupuncturists are not. Naturopathic and acupuncture services were announced in the 2014 federal budget to be HST exempt. This is embarrassing for massage therapists because our profession is larger, had a head-start in positioning mainstream and now has been out-paced by services once considered fringe. Along with greater regulation and HST exemption come higher credibility and consideration in health care and insurance funding…we’ve been left behind.
Adding insult to injury, the newly regulated kinesiologists were invited to participate in the Ministry of Health and Long Term Care Low Back Pain Strategy. Massage therapists are glaringly absent from the recommended provider list.
5) The RMTAO appears to only sparsely interact with other stakeholders, and there’s little evidence in inter-professional collaboration on any of the key issues. The RMTAO finally attended a meeting of the Canadian Massage Therapist Alliance this Autumn – after several years refusal and only upon intense pressure by RMTAO members demanding they participate. There appears to be still a long way to go before the RMTAO participates in necessary national strategies like repairing relations with insurers.
6) For the profession to be prosperous and financially viable, it must encourage an environment of innovation and opportunity while addressing its core problems – unviable, time-and-labour intensive work models, unsustainable inter-professional business agreements, poor credibility with government, insurers/funders, gatekeeper health care practitioners and the public/media, and an inability to deal with exploiters that profit from the lucrative popularity of massage therapy services. The RMTAO has negated forming strategic partnerships with other provincial associations or established Complementary and Alternative Medicine (CAM) professions like chiropractic, naturopathic and traditional Chinese medicine/acupuncture that have similar objectives and could jointly work towards these objectives.
RMTAO: In the Business of Serving Members?
Part of the RMTAO’s difficulty maybe with the organizational model it operates under. The board consists of up to 15 volunteers but only three paid staff to carry out the work of the association. A ratio of 5 deliberators to 1 worker…too many chiefs, and not enough warriors! Compare this to the Massage Therapist Association of British Columbia (MTABC). The RMTAO has a larger board, only a third of the staff (MTABC – 9 staff), and according to 2012 records only half the operating income. Despite association dues 3 times the RMTAO’s, the MTABC maintains 80% of the RMTs in their province as members, compared with under 50% retention for the RMTAO.
Further, the RMTAO board has been plagued with member-relation issues. Board members are consistently absent from discussions in the RMTAO social media forum. This forum is a direct opportunity for members to engage their representatives on the RMTAO board. While it is understandable board members need to be discerning in their responses – ensuring they are reflecting the mandate of the association – by the tone of much of the social media conversation I think RMTAO members see the board as aloof and disinterested in the issues that affect practitioners daily.
RMTAO members have chronic concerns, and they need facility to voice those concerns, have them acknowledged and be guided how to act on them, or have the collective concerns advocated for them by their association. Perhaps the RMTAO, instead of positioning the board as the profession experts, could instead trust their front-line members as the experts. Go to the profession to determine your direction, have the board examine the input and craft policy, and you, as executive director can carry it out operationally. The current operations appear slow, unresponsive, and don’t allow members opportunity to engage or feel empowered in influencing decisions that affect them in everyday practice.
There is really only one opportunity – the annual ½ day RMTAO AGM – to discuss issues directly with board members. At the recent AGM only 33 members (out of 4700 RMTAO active members, or over 10,000 RMTs in the province) were in attendance, indicating to me RMTAO members do not feel their voices matter, and they cannot influence board policy.
Compare this to my visits to the Association of New Brunswick Massage Therapists (ANBMT) AGM in late 2013 where of 440 total members about 100 were in attendance. At the Massage Therapist Association of British Columbia (MTABC) AGM in 2012, over 200 RMTs were in attendance in a province with less than 5000 RMTs. It appears in other provincial associations, members have more confidence and a sense of agency in influencing policy decisions by their respective boards.
Let’s Make This Personal
Mr. Lewarne you are aware that I’ve been increasingly critical of RMTAO operations over the last 5 years. You may also be aware that before that time, I was a strong advocate of the RMTAO and used my writing and speaking opportunities to engender support for the association. Perhaps you’re wondering what drives my criticism. When the College of Massage Therapists of Ontario released its survey of the profession in 2003, as a practitioner with a young family I was struck by how influences outside my control – government policy, relations with insurers, gatekeeper HCPs and public/media, economic conditions/recession and exploiters of massage therapy— could negatively and irreparably affect my practice.
I wrote about these threats in a series of articles in the OMTA (RMTAO) publication The Body Politic in 2004/2005, and updated in Massage Therapy Canada over the last few years. In my capacity as a speaker or in chats on social media, I’ve had many RMTAO contact me with concerns about these threats, with the frustration and fear that they are not being countered by their professional association. This is why my call for RMTAO reform becomes increasingly louder every year, and I will continue to diligently push the RMTAO to critically examine its operations and perception of its role in improving the lot of massage therapists in Ontario. I expect you will find other RMTs eager to do the same.
What RMTAO Members Need…Clear and Simple
The RMTAO is in the business of providing membership services…bottom line. Registered Massage Therapists rely on their professional association to represent and advocate their interests:
- to government – to influence health care and taxation policy, and advocate to the regulatory body;
- to insurers – ensuring positive relations with insurers and employers offering worker benefit plans, identifying and rectifying barriers to claims and practitioner reimbursement for services;
- to gatekeeper health disciplines – to strengthen confidence and credibility in the profession, hence referrals for and authorization of care;
- to public and media – to pervasively and consistently present positive information, position the profession effectively and to mitigate harmful media messages and exploiters who would profiteer from the popularity of massage therapy
In addition to external advocacy, RMTs rely on their association to:
- Poll practitioner information – income levels, work capacity versus workload, sectors worked in, problems getting in the way of practice – and provide statistics to help guide practitioner practice and encourage prospective RMTs;
- Facilitate professional development, not only by organizing speakers and workshops but creating opportunities for practitioners to gather, to dialogue and debate and ultimately define their future through rigorous discussion. It’s the outcome of these discussions that should guide the board of directors in their policy and allocation of resources, not their own opinions;
- Partner with other RMT associations to collaborate on the advocacy measures mentioned above. These objectives are more effectively reached in collaboration than by any sole association. The association can also partner with other professions or industries with common objectives to magnify advocacy initiatives;
- Provide premium pricing on common and desired products and services for RMTs such as insurance, technology, education and training, practice management software, etc.
What Will You Do with This Opportunity?
Mr. Lewarne, I don’t need to tell you that the vocations and very livelihoods of massage therapists rely on an effective association to secure opportunities and mitigate threats. You have served as a long-standing board member before accepting this salaried position as executive director. Five years have passed, with only decline in the political and economic position of massage therapists in Ontario.
I hope you will not deliver more of the same, but will act to deliver the services clearly defined in this letter, and take the difficult but necessary steps to reform operations at the RMTAO so it can do what it is designed to do…represent its members interests and deliver essential services effectively.
Yours sincerely and earnestly,
Donald Q. Dillon, RMT OMTA/RMTAO member since 1990. don@MassageTherapistPractice.com
Krystin Bokalo, RMTAO Board-Chair Board_Chair@rmtao.com
Debbie Wilcox, RMTAO Board Vice-Chair Board_Vice_Chair@rmtao.com
Tracy Lovitt, RMTAO Secretary Board_Secretary@rmtao.com
Copy this letter and add your signature to send to the RMTAO Executive Director, Chair, Vice Chair and Secretary. Or, feel free to reference this letter or cut-and-paste portions in your own writing campaign.