Distance Education -> Prevention of Medical Errors for the Massage Therapist -> Chapter: 05

Medical Errors and Massage Therapy

Introduction

It is important for the massage therapist working as part of a health care team to be well aware of, and participate in, medical error prevention as stated in chapters 1 - 4 of this course.   But what about the massage therapist who is working at a massage establishment, a spa, a gym, a salon, or in private practice?   What are the important items from Part 1 of this course that every massage therapist should have an awareness of? And, is there any additional information the massage therapist should know that would be more specific to their scope of practice?   When a massage therapist applies the information learned in Part 1 of this course, they need to be concerned with the specific medical error that can be defined as an error of execution and/or an error of planning.   For the massage therapist in private practice errors of execution and errors of planning can result from a misunderstanding their scope of practice, improper sanitation and hygiene practices, not practicing universal precautions, and incomplete knowledge of contraindications and endangerment sites.   Part 2 of this course will focus on these five items, with the understanding that medical errors may not be limited to those, and may also encompass some areas of massage therapy that are not covered in this course.

Chapter 5: The Scope of Practice for Massage Therapy

The "scope of practice" of a profession defines its parameters, minimum standards, and knowledge base.   Every health care professional has a unique knowledge base and practice parameters that make their scope of practice unique. 11

Scope of practice is also defined by whatever legal body (state, province, federal government) that has the authority to set the parameters of a profession in terms of what can and can not be performed.    A professional operating outside of their scope of practice would constitute a violation of law. 12

State of Florida

 Massage Therapy in the state of Florida is regulated by the Department of Health, Board of Massage Therapy. Specifically, Florida Statute Chapter 480, known as the "Massage Practice Act." [Section 480.031, F.S.]. And, has received specific recognition by the Florida Legislature as a therapeutic practice [Section 480.032, F.S.].  

The Primary purpose of the regulation of the practice of massage therapy in the state of Florida is to protect the public.   Chapter 480 of the Massage Practice Act states: "Purpose. The Legislature recognizes that the practice of massage is potentially dangerous to the public in that massage therapists must have knowledge of anatomy and physiology and an understanding the relationship between the structure and the function of the tissues being treated and the total function of the body.   Massage is therapeutic, and regulations are necessary to protect the public from unqualified practitioners.   It is therefore deemed necessary in the interest of public health safety, and welfare to regulate the practice of massage in the state; however, restrictions shall be imposed to the extent necessary to protect the public from significant and discernible danger to health and yet not in such a manner which will unreasonably affect the competitive market.   Further, consumer protection for both health and economic matters shall be afforded the public through legal remedies provided for thin this act."[Section 480.032, F.S.].  

The legal definition of   "massage therapy" in Florida is:   "The manipulation of the soft tissues of the human body with hand, foot, arm or elbow, whether or not such manipulation is aided by hydrotherapy, including colonic irrigation, or thermal therapy; any electrical or mechanical device; or the application to the human body of a chemical or herbal preparation." [Section 480.033(3), F.S.].   This specific definition does not include the diagnosis of illness or disorders.

The purpose of the Massage Practice Act is specific in its purpose to protect the public, realizing that massage therapy practice can be potentially dangerous, when practiced by an unqualified practitioner.

While the legal definition of massage therapy, and the regulation thereof, is identified as the scope of practice for the massage therapy profession in the State of Florida; as a scope of practice, this definition in Florida Statute Chapter 480 is not well defined by the Board of Massage Therapy.   And, compared to other Scope's of Practice, this definition may be considered very general in nature.   While the definition of massage therapy in Chapter 480 generally defines what massage is (manipulation of the soft tissues of the human body,etc...), it does not define the types of manipulation that is to be used, only the part of the body that can be used to perform the manipulation. It goes on to state what can be used to assist the soft tissue manipulation, but does not go any farther to define those specific aids. This may lend itself   to a broad interpretation of just what the scope of practice for massage therapy truly is in the State of Florida.   Because of this generalized definition of massage therapy, the massage therapists should familiarize themselves with the scopes of practice of the other health care professions of which massage is a complementary therapy.

PRACTICE QUESTIONS FOR CHAPTERS 5.

Please answer the following questions:

1.  The scope of practice of massage therapy in the state of Florida includes:

    a.  diagnosis

    b.  hydrotherapy

    c.  psychological counseling

2.  Which item is not true?   In the State of Florida, the definition of massage therapy is:

    a.  very broadly defined.

    b.  considered the scope of practice for massage in Florida.

    c.  is very specific in definition.

3.  The State of Florida defines Massage Therapy as:

    a.  Manipulation of superficial tissues of the human body.

    b.  Manipulation of the soft tissues of the human body.

    c.  Manipulation of the circulatory system of the human body.

11     Fritz, Sandra, Mosby's Fundamentals of Therapeutic Massage, 2 nd Ed ., St. Louis, MI, Mosby's Inc.  2000, pg. 37.

12     AMTA, The Business of Massage The Complete Guide to Establishing Your Massage Career , Evanston IL., AMTA, 2002.