An Open Letter to the Board of Massage Therapy
I feel I should provide some context for anyone interested. At the beginning of the COVID-19 pandemic, around March 16, 2020, non-essential medical practices were told to close, with a tentative reopen date of May 8, per DOH and Governor DeSantis. As the governor released his phased approach to reopening Florida, I contacted FDOH, our governing agency, to help determine if the orders included LMTs. Their response was vague, and non-committal. One of their “canned” responses included this verbiage; the part that ultimately pushed me to send them an angry-gram is in bold:
Thank you for your inquiry concerning the practice of massage therapy in light of COVID-19. On April 29, 2020, Governor DeSantis issued EO-20-112, which can be read here. We would encourage you to read the executive order in full.
The Department cannot advise health care practitioners about the meaning of the Executive Order or how to interpret it. If after reading the Executive Order, there are still questions on how it may apply to your specific set of circumstances, we recommend consulting with a private attorney or risk manager at your facility (if applicable) to seek clarification.
Responsibility without accountability. So the following interaction occurred.
To Members of the Board of Massage Therapy,
As a massage therapist, I feel left out of the conversation regarding COVID-19 among our local and state government officials. I feel this because I see industries similar to ours - chiropractors, hair salons, nail salons, PTs, and others - who are specifically addressed in public talks and official orders, guiding them on when and how to operate during this time.
Public opinion does not always regard our profession highly. But many people know massage therapy is much more than a "personal service", as evidenced by the numerous medical studies done to show its effects on the human body and mind. I'm not here to argue these facts; I'm simply stating that, based on the public acknowledgement by Governor DeSantis, professions like cosmetology appear to have more impact on our government than massage therapy, a health care practice. This is disheartening, especially when many LMTs make so many efforts to represent our field in a professional manner. We complete our education and board exams, pay our dues, get our fingerprints taken, and jump through any other hoops the FDOH throws at us to make us prove our validity.
We do all of this because it is our chosen profession, our livelihood. We also do this in exchange for the guidance, government, and representation of our profession by you, the Board of Massage Therapy. We have not seen the rewards of this exchange when we need it most - during a pandemic, the worst in recent history. In lieu of real guidance, we have received vague emails telling us to "read the governor's order" and "seek legal advice" to determine when and how we should operate. This is not a legal issue. This is a communication issue. An absence of any real direction leaves us to fumble around, looking to our peers who are also uninformed for interpretation of government regulation.
All of this is really to say simply, please show up. Represent us. Connect with us. Give us a voice. We need better connection and guidance during this and any other health crisis moving forward. Please provide. Thank you.
Respectfully,
Pamela Moyer
LMT and owner of Haven Spa
*******UPDATE*******
I did receive a response and replied to him, clarifying my concern about the mixed information LMTs were receiving.
Good evening, Ms. Moyer -
I do hope you’ll pardon my late evening response, as most of my day was spent on phone calls with therapists addressing concerns like yours, which are currently affecting the massage profession in light of COVID-19.
As you are aware, our standard response to inquiries includes language about reading the order specifically - this has to do with section 5 of the EO and consideration of what is and is not permissible under the EO with regards to practice. I can assure you that it is not intended to mislead or confuse therapists, but to provide the EO and additional information in a concise way. Yes, massage therapists are health care practitioners, and yes, establishments are health care facilities. They are included in phase one of the EO.
As one of board staff who has watched as this profession has become integral to the health care community, I can understand the frustration felt when that legitimacy does not seem to be at the forefront in the broader conversation of a pandemic.
In the weeks following the first EO, much as with this one, myself and other staff have heard from so many therapists just like you, who seek to be not just health care practitioners, but to care for their community, and who speak to the best the profession has to offer - whether that is working with clients of twenty years to ease chronic pain, or working in the area of palliative care and providing those most vulnerable with what they need to make it through difficult times further complicated by Coronavirus.
While the Board is not formed to advocate specifically by statutory mandate, I earnestly believe that the work that has been done and which is ongoing in the regulation of this profession speaks to an understanding of the importance of therapists in the context of allied health care provided to the people of Florida. I don’t believe a day has gone by where staff has not been in contact with Board members, professions associations, etc. who are, much like you, trying to figure out how to make sense of the present situation, and to solve out the concerns of a safe return to practice both for clients and for therapists working in the field. We will continue to address issues that arise from misunderstanding of the profession, insofar as our authority as regulators allows.
The Board has a scheduled teleconference May 20th - while much of this meeting is administrative (addressing rules and applications - the required stuff), we expect a discussion of advisory materials from the Federation of State Massage Therapy Boards in cooperation with the CDC. As you may know, the FSMTB is an agency comprised of Boards from all states. Our Board, and so many other boards have been in discussion with the FSMTB about the need for this kind of information and how difficult it can be to navigate the practice in the face of a pandemic for licensees in every state.
We are hoping that, when this material becomes available, we will be able to share it directly with our licensees, and we are excited to be one of the first two states to be able to bring this material to a public forum. As with any meeting of the Board, members of the public (and especially licensees) are welcome to attend.
All the best in your (safe) practice, my thanks for your service to the people of Florida (and Tallahassee!) and for your patience in the face of this adversity. If you have further questions, feel free to respond to this email.
Best -
Gerry Nielsen
Program Operations Administrator
Florida Department of Health | Bureau of HCPR
Board of Massage Therapy, Council of Licensed Midwifery
(850) 245-4586
*****UPDATE*****
My response outlining my main concerns with communication, and his response following.
Hello Mr. Nielsen,
I hope you are well. First let me say that I appreciate your response during late hours. Thank you. I know your plate must be full, especially if you're dealing with situations like mine across the state. I would like to propose a way that perhaps your workload could be lightened.
I just want to clarify that not only does my issue pertain to the vague information, but also the mixed, and delayed information received from DOH.
This morning I received a response to an email I sent on April 30th inquiring about the governor's order. That email said that it was DOH's understanding that LMTs can work in phase 1.
When the governor released his phase 1 plan, I emailed the board and received a letter telling me to "read the order", and "the department cannot advance practitioners about the meaning of the EO or how to interpret it", and "consult a private attorney". So I directly emailed DOH employees responsible for license compliance who told me that LMTs were not included in that phase, but to consult the board (which I had already done).
The AMTA Florida Chapter and FSMTA were split on the interpretation of the orders.
Groups on social media were divided. Not a surprise of course; I don't typically get my news from social media, it's simply my last resort.
Some LMTs provided documentation from local authorities indicating LMTs could not open their doors. I know that local government and state government will sometimes have different rules, and had we received a clear message from your organization, that would have been more clear to everyone - something like "DOH says yes at the state level, but Pinellas county isn't allowing it" would have been very clear and easy to understand.
Please understand that I believe the information you provided to me in this email would have been helpful if it was 1) emailed to all licensees, and 2) posted on your website and social media boards, when the determination that we were able to practice was decided. I would have felt comfortable opening my doors with stringent sanitation protocols, and allowing the 6 other people I employ to earn a living. I am receiving this clear information today, and today I can plan. Had all licensees received this information, you may not be getting as many calls right now. I will share this info with the LMTs and establishments I have contact with, but I would truly consider delivering an email to licensees to clarify.
I appreciate your work and information provided here. I look forward to the advisory materials to assist us moving forward.
Thank you again for your work and your time,
Pamela Moyer
He replied.
Good morning, Ms. Moyer -
I appreciate your on-the-ground view of this issue; we too have been contending with when we are able to provide information, and closely monitor EOs, press conferences, etc. As you have probably seen, the situation changes near-daily, and with that our ability to answer questions that appear straightforward.
This kind of blanket email is drafted and is currently under consideration, as are updates to the Board website. We are also working with compliance to resolve any answers that are outdated in that area.
We will continue to provide clarification to professions associations as we are able, as well; I think you should see more alignment in that area in the coming days.
Best -
Gerry Nielsen
*****LATER THAT DAY*****
I received another reply to an email sent on 4/30/20. I’m assuming this is an update to their canned response to questions like this:
Thank you for your inquiry concerning the practice of massage therapy in light of COVID-19. On April 29, 2020, Governor DeSantis issued EO-20-112, which can be read here. This executive order authorized healthcare practitioners, including massage therapists and massage establishments, to return to practice during phase one under certain conditions in all counties in Florida. We would encourage you to read the executive order in full.
You may wish to read information about return to practice and other impacts of COVID-19 provided by leading massage therapy profession associations:
More information about the impact of COVID-19 in Florida, and the Department’s ongoing response to this pandemic is also available.
All updates provided to health care practitioners can be found by visiting www.flhealthsource.gov/covid19.
Department recommendations, tracking, testing information, and links to other valuable information can be found at www.floridahealthcovid19.gov.
We hope that you have been able to stay safe and well during this unprecedented time
Ultimately, I hope that this interaction sparked some cohesiveness in their stance on our practice during COVID-19, and any other impediments to our practice. It’s hard for LMTs to appear aligned in their mission when we receive mixed messages from the powers that be. I look forward to more synergy on issues like this from the board…unfortunately, I don’t think I can hold my breath.