Spring/Summer 2014/Volume 21 Issue 1

TouchPoint

Spring/Summer 2014/Volume 21 Issue 1

Table of Contents

From the President

Get to Know Your College

Champions of the College – Interview with Gina Iamario, RMT & Inspector

MTRF Research Review #1

Risk of Harm

Health Claims for Auto Insurance

Massage Therapy Competency Standards

“Illegal Practitioners”

2013 Certification Examination Statistics

SPECIAL ANNOUNCEMENT

2013/2014 MTRF Grant Recipients

Renewals Are Going Paperless!

Council Highlights

Council Members

New Council Members

Notice of Acclamation of Registrants to Council

College Committees

Council Meeting Schedule

In Memoriam

2013 Retired Members

2013 Revocations

2013 Suspensions

Summary of cases completed in 2013

From the President

We are now late into spring with a new Council actively engaged in the governance of the College. The statutory committees have been struck for 2014 and their work is well underway.

The seven statutory committees of the College are: Executive, Registration, Quality Assurance, Client Relations, Discipline, Fitness to Practice, and the Inquiries, Complaints and Reports Committee.

Council & Committee Training & Orientation

Before the committees engage in their work, the College provides extensive orientation to all committee members. It is very important that committee members understand the significance of the important role they play in protecting the interest of the public, and ensuring safe and ethical Massage Therapy care.

The Council has guiding principles that oversee the work of its members. Key principles include service orientation and focus; respect and valuing diversity; and collaboration. Open communication is paramount: a safe place to have difficult conversations. There is a focus on the big picture for the health and safety of the public and the vitality of the profession.

Council members are also accountable for the decisions that they make; we must have the courage of our convictions and work with trust, competency and integrity. We must also have the ability to forgive. In many respects, these guiding principles are a tall order for any organization. As Registered Massage Therapists, we collectively work to regulate our own profession through the work of the Council. This is a privilege which we enjoy as a regulated health care profession in Ontario.

Great News from New Brunswick

There is good news with respect to regulating Massage Therapy on the national front. An Act to Incorporate the College of Massage Therapists of New Brunswick, received royal assent on Dec. 13, 2013, effectively paving the way for regulation of the Massage Therapy profession in the province.

With the passage of the legislation, New Brunswick becomes the fourth province in Canada to have Massage Therapy as a regulated profession — the first three are Ontario, British Columbia and Newfoundland & Labrador.

Under the legislation, a new College of Massage Therapists of New Brunswick will be established. The College will consist of persons who are:

• Active members in good standing of the Association of New Brunswick Massage Therapists;
• Active members of the New Brunswick Massotherapy Association; or
• Active Massage Therapy members, in good standing, of the Regroupement Professionel Francophone en Naturo-Masso Kinésiologie du Nouveau-Brunswick.

The new College will also develop, maintain, and enforce standards of qualification for the practice of Massage Therapy, as well as establish and enforce a code of professional ethics.

The New Brunswick Massotherapy Association (NBMA) welcomed the new legislation, saying that the regulation of the profession "…enhances our credibility as health-care professionals – with the distant goal of working in hospitals."

On behalf of the College, I would like to congratulate all the Massage Therapists and other individuals who worked diligently to get this legislation passed. At CMTO, we look forward to working with our colleagues in New Brunswick, and assisting them as they become established.

Dave Janveau, RMT

President

Get to Know Your College

For New Registrants of the Profession

The regulation of the profession is an import aspect of your journey as a Registered Massage Therapist. This section will offer you insights into how the College exists to protect the public interest; services that you can take advantage of to further your knowledge base; as well as helpful resources to better understand your responsibilities as a self-regulated professional.

TouchPoint Newsletter

The TouchPoint Newsletter is published twice per year, in the spring and fall. Each issue covers a range of topics that are all important to you as a Massage Therapist: insurance fraud, CEU articles, Massage Therapy research updates, and information on courses and workshops. Be sure to read each issue, as well as familiarizing yourself with the College’s website, in order to stay informed about your profession.

Quality Assurance Program

As mandated by government legislation, the College runs a Quality Assurance (QA) program to promote continuing competence and the highest possible professional practice standards among Registered Massage Therapists.Elements of the QA program include: self-assessment, continuing education units (CEUs), and peer assessment. In the case of peer assessment, registrants are randomly selected to participate in the peer assessment program.

Peer assessment involves a peer assessor conducting an on-site review of the registrant’s practice to ensure that they are maintaining the Standards of Practice and Regulations of the Profession. More specific information about each of the elements of the Quality Assurance program can be found on the College’s website, along with detailed guidelines and forms to help you meet the QA requirements.

“Pause Before You Post” - Social Media Awareness for Regulated Healthcare Professionals

This learning module was produced in collaboration with six other health regulatory Colleges in Ontario. Numerous examples and case-based scenarios are included to illustrate social media use in health care and to help you reflect on your own use of social media in your Massage Therapy practice.

The module does not replace your professional obligation to read relevant standards and legislation; rather it reviews the professional standards of practice, the legislation and the principles you need to know to establish risk management strategies to help maintain a professional reputation and appropriate professional relationships in your practice. It also answers everyday practice questions and offers best practice suggestions for using social media.

Other Courses & Workshops

The College currently offers several educational programs for registrants – two web-based distance education courses and a one-day in-person Professionalism Workshop. One important e-course is on the subject of Standards and Regulations. This online course provides an overview of the Standards of Practice and the Regulations. It is designed to help you gain an understanding of the legislation, regulations, policies and procedures that govern Massage Therapy practice in Ontario. It is important for public safety and for the development of the profession that every Massage Therapist in Ontario has sufficient knowledge of the legal aspects of the profession.

Champions of the College – Interview with Gina Iamario, RMT & Inspector

Upholding the Standards of Practice

By Steven Hobé, CEO at HOBÉ+HOSOKAWA INC.

“I’ve been a Registered Massage Therapist since 1990. I owned my own business for twenty years, mainly focusing on sports massage. Now I work part-time filling in for Massage Therapists at different practices. But a focus of mine for the past three years has been my role as Inspector with the College,” comments Gina Iamario, RMT.

Inspectors are Registered Massage Therapists in good standing with the College with at least five consecutive years of practice experience in a variety of settings. They are contracted and trained by the College to carry out their role as an Inspector.They have signed confidentiality agreements in relation to the information they obtain throughout the Inspection process.

The inspection process is not guided by specific legislation; however, the process is governed by legal principles of natural justice. In accordance with these principles, the inspection process has been devised to include a commitment to objectivity, fairness, transparency, and timeliness.

The registrant will be provided with details of the complete inspection process to be undertaken prior to the Inspection. The Inspectors are trained and committed to a high ethical standard when carrying out their duties as an Inspector. The Inspectors evaluate a registrant’s practices based on objective performance standards. The results of the inspection will be shared with the registrant and the registrant will have an opportunity to respond to any findings of an Inspector prior to any further action being taken in relation to those results by a panel of the Inquiries, Complaints and Reports Committee.

“Inspections provide the College with the opportunity to determine registrants' compliance with professional standards, to ensure that they are continuing to provide safe and appropriate care to their clients. It relates back to the College’s primary mandate of protecting the public’s interest, which I very much believe in,” says Gina.

Inspections also provide registrants with the opportunity to gain further knowledge and expertise of the profession to help improve their practice, and demonstrate that remediation has occurred following concerns raised through the College's Complaints, Investigations, Discipline, or Fitness to Practice processes.

Gina points out, that many of her cases have involved, “circumstances relating to fraudulent receipts”. Her job is to evaluate their practice and at times make recommendations for improvement where the results of an inspection are somewhat concerning but less serious deficiencies within areas of practice. Some of her recommendations may include the completion of different courses or workshops, such as record-keeping, so that they may brush up on their skills.

The inspection process is different and separate from the peer assessment process of the Quality Assurance Program.Beyond ensuring compliance with the College's professional standards, the goal of the inspection process is to also ensure that true remediation by the registrant has occurred where remedial work has been directed through an Undertaking/Agreement offered by the Inquiries, Complaints and Reports Committee or Penalty Order imposed by the Discipline Committee or on occasion Terms, Conditions, and, Limitation placed by the Registration Committee.

“We look at all facets of an RMT’s practice, and there is an extensive checklist that they must meet.” A registrant’s practice includes any location where the member practices the profession, as well as, any information, objects or persons involved in the provision of Massage Therapy at that location.

The following is a summary of the primary duties of an Inspector:

(1)Attend the primary and/or any alternate practice location;

(2)Conduct a review of the practice environment;

(3)Conduct an in-depth review of client health records;

(4)Conduct an interview with the RMT and any possible coworkers;

(5)Discuss with the therapist their experience throughout the completion of the Undertaking, SCERP or Penalty Order;

(6)Prepare a report summarizing the results, including their evaluation of the registrant’s practice.

“On the whole, I find that, especially with record-keeping, people aren’t aware of how important those records are, and that they need to be accurate and up-to-date. Treatment is very much based on the client’s record, and the more accurate, the better the patient outcome. It actually makes life easier for the therapist when they keep accurate records. In that instance, once they take the record-keeping course, I find they understand – that it gives them the foundation for why to keep complete records.”

The Inspector will consider all of the following factors when determining the appropriate rating for a practice:

(1)The number of deficiencies found during the inspection;

(2)The nature of deficiencies found during the inspection and how they relate to the initial allegations reviewed during the investigation process;

(3)The seriousness of the deficiencies found during the inspection;

(4)The recommended actions that would be needed to address each of the deficiencies found during the inspection; and

(5)The risk of harm such deficiencies would present to the public if left unaddressed.

“Once complete, I prepare a report of the results of the RMT inspection, which is provided to the therapist and the Registrar for review. The Inspector’s report outlines any comments, concerns and/or deficiencies and provides an overall rating of the practice. The process is very transparent and clear. When I write my report everything is factual and open, the aim being that the therapist benefits from it.”

The RMT is then assigned one of three ratings by the Inspector, these are as follows:

Compliant:

The registrant is compliant with the standards and the governing authorities and has addressed the areas for remediation as required.

If the RMT has been given a rating of “Compliant”, after receiving a copy of the Inspector’s report, no further follow-up will be required.

Compliant with Areas for Improvement:

The registrant is generally compliant with the standards and the governing authorities, however, the Inspector has identified specific areas for improvement and recommendations that will assist the RMT in addressing the areas for remediation as required.

If the therapist has been given a rating of “Compliant with Areas for Improvement”, after receiving a copy of the Inspector’s report, the RMT will be required to provide written assurances to the College that they have read and understood the concerns raised by the Inspector.

As well as, having read the governing authorities (i.e. any applicable regulations, standards, policies, position statements, etc.) relating to those concerns, and that the RMT is committed to addressing the issues within their practice to avoid any ongoing concerns. A written acknowledgment will be provided outlining the points noted above which is to be signed and returned to the College.

Non-Compliant:

The registrant is not compliant with the standards and governing authorities and has not addressed the areas of remediation as required.

If an RMT has been given a rating of “Non-Compliant”, they will have an opportunity to make written submissions in response to the Inspector’s findings which will be reviewed by the Registrar.

If the Registrar is of the opinion that the results of the inspection form a reasonable and probable belief that the member engaged in act(s) of professional misconduct, they may request a panel of the Inquiries, Reports and Complaints Committee to commence a new investigation inquiring into and examining your practice in relation to the results of the inspection pursuant to Section 75 (1)(a) of the Regulated Health Professions Procedural Code (“The Code”).

The panel of the Inquiries, Reports and Complaints Committee may also request an additional inspection of the RMTs practice, if they feel that this will address the concerns outlined in the Inspector’s Report.

“As a final point, I should preface that when I go into the clinic for the follow-up I am not looking for wrong, I’m looking for improvement; and for the most part, I do see vast positive differences in the running of the therapist’s practice. I really focus on giving constructive feedback.

As an Inspector, I gain satisfaction, not only from fulfilling the College’s mandate, but helping RMTs to better their practice – to understand the importance and relevance of practice guidelines and how these can, if implemented properly, aid the RMT in their practice of Massage Therapy.”

MTRF Research Review #1

By: Ania Kania-Richmond, PhD

Introduction

The College recognizes that for Massage Therapy to continue developing as a recognized health care profession, it is important that the practice of registrants is research informed and driven by critical inquiry. Development of such a practice and culture within the profession requires the involvement and commitment of all stakeholders – Massage Therapists, educators, professional associations, and regulators. Under legislation, CMTO has the specific responsibilities to:

• Develop, establish and maintain programs and standards of practice to assure the quality of the practice of the profession;
• Develop, establish and maintain standards of knowledge and skill, and programs to promote continuing evaluation, competence and improvement among its registrants.

In addition, the Inter-jurisdictional Practice Competencies require all Registered Massage Therapists (RMTs) to be able to access and, where relevant, utilize research and professional literature to enhance patient care. This means that RMTs must be able to:

• Access reliable sources of published research and professional literature;
• Analyze the information presented; and
• Integrate new information into practice where appropriate.

To these ends, the College has supported Massage Therapy research through the Massage Therapy Research Fund (MTRF).

In addition, the College is in the process of initiating additional activities to strategically support and enhance RMTs to satisfy current practice competency requirements. One such activity is the introduction of a new section in the TouchPoint Newsletter with a research focus – MTRF Research Review.

The Goal of the MTRF Research Review

The MTRF Research Review will be dedicated to providing access to the findings of research studies funded through the MTRF.

Since its inception, over $200,000 has been awarded to support studies carried out by 17 research teams from across Canada. Results from these studies have been shared through various methods by the researchers including: publications in academic journals, special reports and/or conference presentations.

The aim of the MTRF Research Review is to provide registrants with practitioner friendly access to the findings of these studies. The reviews will:

• Introduce the topic
• Identify the purpose of the research study
• Provide an overview of the study design
• Summarize the results
• Highlight other studies on the subject and compare results

In addition, a commentary will be included to highlight what the findings may mean for practice, education and future research. These reviews will also be available on the CMTO website, so that they can be easily accessible to registrants.