Safety to the Public

Formal Sanctioning of Reflexology Practice

Demands from society

The lack of licensing and formal sanctioning by city, state, and provincial officials has become an issue for reflexologists in Canada and the U. S. Some reflexologists are concerned about massage licensing requirements. Others are concerned about being granted the same business license as a house of prostitution.

Additional concern has been raised over economic issues. Reflexologists have gained the community's informal sanctioning of their profession as a unique service. As American HMO's and other businesses are poised to pay for reflexology services, will reflexologists find themselves cut out of the marketplace by the lack of licensing? Reebok, for example, is currently providing reflexology/foot massage services at shoe stores with licensed massage therapists. If HMO's seek the formally sanctioned services of state-licensed professionals, massage therapists stand to profit as reflexology providers in the twenty-one states with licensing.

The Situation

• Reflexologists in Toronto and Kitchener, Ontario recently avoided the classification of reflexology as a "body rub" establishment in city business licensing. The body rub category includes houses of prostitution in both cities. In a next step to some sort of designation within the city's business licensing code, reflexologists in Toronto have been asked to explain how reflexology is different from massage practice and why it should not be considered a form of massage.

• Reflexologists in Alabama find themselves categorized as massage practitioners following a finding by an assistant attorney general last summer. Frances R. Clement found that since reflexology is neither regulated not exempted in the Alabama Massage Therapy statutes then it is included under the definition of Therapeutic Massage and Related Touch Therapy Modalities. She states that the next step for the professional reflexologist is to obtain massage licensing or change the law through legislation.

• Reflexologists in New Mexico face the prospect of a changed state massage law. A change in definition will be proposed when the state legislature meets in January. Some in the New Mexico massage community are calling for the inclusion of reflexology practice in massage practice with reflexologists required to obtain massage licensing. At the time legislation was created to license massage in 1994, reflexologists were assured that it was a "title" only law&emdash;effecting only those who provide "massage" labeled services.

• A New Jersey state massage law continues to work its way through the state assembly. At a recent assembly committee meeting, physical therapists failed to stop the legislation. (In Massachusetts, physical therapists successfully lobbied against efforts to legislate bodywork through an umbrella law that would have included reflexology.)

Reflexologists and officials in other cities are waiting to see what happens to business licensing in Toronto, Canada's largest city. Nine states and six large cities now require massage licensing of reflexology practitioners. Some one-third of the American population lives in an area where reflexology practice is licensed to massage practitioners.

As demands increase that reflexology practice be shaped into a formally sanctioned professional practice, reflexologists are not without direction.

The Process of Official Sanctioning

During the process of professionalization, society comes to recognize members of a profession as specialists who provide a unique, valued service. Those who provide services and especially health-related services are granted recognition by licensing. Such official sanctioning is created to protect the interests of the consumer in obtaining services.

The Reality of Current Regulation

Massage law regulation of reflexology has been created by two trends. First, massage laws have been in place for many years to contend with city and state officials' concerns about nude services. Because of this clear and present public danger, massage laws have become established procedures in at least twenty states and six major cities. It has become legislatively convenient to include regulation reflexology practice with the established massage regulation.

Secondly, reflexology is a weak profession. The profession has a standard of practice, but does not insist that its practitioners follow accepted standards. So, when members of other professions provide reflexology services that substandard, members of the reflexology profession are in a weak position to insist that they are the more qualified professionals.

The reality is that the continuing practice of unqualified but sanctioned practitioners could hurt the ability of members of the reflexology profession to become the officially recognized providers of the service. In any other industry, questions about antitrust issues and price fixing would be raised.

Public safety issues

Massage laws have encouraged a mixing of modalities. Courts have gone the other direction, finding the practice of reflexology presents a public safety issue when other products and services are combined with reflexology services. Massage laws encourage rather than discourage this clear and present danger to reflexology practice.

Regulation by finding

Currently, few decisions effecting reflexology practice occur in state legislatures. Most occur in states attorney generals' offices and city attorney's offices where a "finding" is made that encompasses reflexology practice into massage regulation.

Reflexology practice is frequently a victim of officials' rush to protect the public from the prostitution problems inherent to massage practice. It is bureaucratically convenient to regulate all "touching" professions and require that "touch" professionals prove they are not prostitutes by obtaining massage licensing. (The Alabama state massage law of 1996 includes provisions about sexual acts.)

As reflexology practice continues to evolve, the focus of a defense of reflexology practice continues to be the defining of reflexology practice as separate from massage and the reflexologist as the best possible provider of services.

ŠKunz and Kunz 2003
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