Features Op-Ed
The RMTAO and CMTO relationship

Recently the College of Massage Therapists of Ontario (CMTO) polled registered massage therapists in the province in anticipation of the implications of Bill 87: Protecting Patients Act, 2017. The CMTO solicited feedback on draft Standard changes particular to maintaining boundaries, the use of video recording devices in session space, “sensitive areas”, receiving gifts from clients/patients, and mandatory reporting. By surveying, the CMTO gathered feedback from RMTs on draft Standards, providing them opportunity to reflect upon – and counter if necessary – these proposed Standards. Further, RMTs would benefit from discussion amongst the professional community on social media how these proposed Standards would affect them.

Not surprising, the proposed Standards generated lively discussion and debate in social media. Many believed the Standards were oppressive, regressive and imposing on the very nature of the way RMTs deliver care. Some RMTs posed the concern that such Standards would sexualize areas like the buttocks or chest wall, stating written consent was both ineffective in addressing sexual abuse and generating unhelpful public scrutiny in demanding written consent for the assessment and treatment of such areas. These RMTs referred to the actual Bill 87, and pointed out requirements for consent were not increased over previous rigorous requirements RMTs already adhere to.

In the context of this dialogue arose a more insidious perspective perhaps many RMTs share : that the regulatory body appears authoritarian and imposing. RMTs may fear drastic changes they can’t react to effectively, unreasonable demands on the way we practice, and the application of punitive measures if we don’t comply. Our relationship to the regulatory body may feel impersonal and provocative, analogous to a strained parent/child relationship.

Yet, by surveying, the CMTO demonstrated they care about what RMTs think. I sympathize with the CMTO, as it is in a tough position. Its mandate is to protect the public, respond to regulatory changes imposed by government, and then interpret the regulations and design Standards and Polices to assist RMTs in adopting the changes. The CMTO helps us remain compliant and stay out of trouble, what’s likely a thankless job.

I don’t believe the CMTO’s mandate to “protect the public” makes them unempathetic to the real challenges RMTs face in adopting new Standards, policies and guidelines. I have observed the CMTO take great measure to help RMTs adopt and work with new regulations, of which there have been many.

Since the Regulated Health Professions Act (1991), the CMTO has had to interpret and help RMTs incorporate the Massage Therapy Act, the Health Care Consent Act, Personal Information Protection and Electronics Document Act (PIPEDA) and the subsequent Personal Health Information Protection Act (PHIPA). The proposed Protecting Patients Act, 2017 is just one in a long series of regulations the CMTO must process, in consideration of RMTs in Ontario.

I appreciate the role of our regulatory body, and try to imagine my life as a practitioner if there wasn’t a regulatory body mediating between myself and government. I would personally have to do the reading of regulations, interpreting and adopting as much as possible, likely requiring legal counsel for the process. No, thank you.

The RMTAO responded to the CMTO formally with tangible and assertive feedback representing the concerns of its members. The RMTAO is our professional association, and represents the interests of its members to government (Ministry of Health, funding, services tax), to insurers (working relations, preventing fraud, access to care via employee benefit plans), gatekeeper health disciplines (who authorize our treatment plans) and the public and media (perception, efficacy, utilization of services). That’s a big advocacy portfolio to balance, and the RMTAO has done it increasingly well over the years.

The RMTAO consistently represents the profession well and delivers valuable services to its members. It has captured almost half of all active RMTs in Ontario as members, with an impressive membership of students in the various RMT programs. As RMTAO membership grows, it will cultivate increasing resources to leverage and represent the common interests of RMTs across Ontario.

The relationship between the RMTAO and CMTO is based on shared interests – the cultivation and advancement of the massage therapy profession in Ontario – although their mandates differ somewhat. While the relationship is naturally formal, it is occasionally tenuous – perhaps even adversarial – and this tension is necessary and important to addressing the salient issues of the profession.

Like the body that uses tensional forces to generate fluid, graceful and functional movement, a tenuous relationship produces a robust, responsive body that weathers threat to balance and coordination.

As RMTs we all benefit from the dynamic between the RMTAO and CMTO. It’s in our collective interest that this relationship remains congenial, truthful and ever evolving. I feel grateful and fortunate for this tension between key decision-makers of our profession.