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Notices to the Profession

Group Exercise is Not Within the Scope of Practice of Registered Massage Therapists

CMTBC advises registrants that group exercise is not within the scope of practice for massage therapy.  

Effective immediately, registrants who currently provide and bill for group exercise services (shared exercise for a group of people coordinated and directed by a registrant) as massage therapy services are advised to stop doing so.

Registrants may provide group exercise so long as this is not associated or linked in any way with their status as RMTs, and they do not bill for such services as massage therapy (see more detailed discussion below).

Scope of Practice

“Scope of practice” refers to the activities that registered massage therapists are educated and authorized to perform, which is established through the legislated definition of “massage therapy” in section 1 of the Massage Therapists Regulation (the “Regulation”).

The Regulation states that registrants of the College may practise massage therapy. Massage therapy is defined as meaning the health profession in which a person provides, for the purpose of developing, maintaining, rehabilitating or augmenting physical function, or relieving pain or promoting health, the services of

  1. assessment of soft tissue and joints of the body, and
  2. treatment and prevention of physical dysfunction, injury, pain and disorders of soft tissue and joints of the body by manipulation, mobilization and other manual methods.

While this definition does not expressly include, for example, formulating a treatment plan and designing a home care program, neither does it exclude those activities, which are important parts of massage therapy practice (and are expressly referenced in the College’s Standards of Practice).

A health profession is defined, under section 1 of the Health Professions Act, as meaning a profession in which a person exercises skill or judgement or provides a service related to

  1. the preservation or improvement of the health of individuals, or
  2. the treatment or care of individuals who are injured, sick, disabled or infirm. (emphasis added)

When the legislated definition of massage therapy is read in conjunction with the definition of a health profession, it is clear to the College that directing a group exercise class or coordinating another form of shared exercise for multiple people does not constitute the practice of massage therapy.

The College views the practice of massage therapy as involving the provision of individualized, one-on-one services to an individual patient.

Registrants may still provide services that fall outside the scope of practice of a registered massage therapist if they comply with section 78.91 of the College’s Bylaws, which provides as follows:

Advertising of services that fall outside the scope of practice

78.91 If a Registrant is also trained to provide a service or technique that falls outside the scope of practice of a massage therapist as prescribed by the Regulation

  1. that Registrant may advertise that service or technique so long as
    1. that non-massage therapy service is not linked to or associated with her status as a Registrant, and
    2. there is a clear separation of professional services that fall within and outside the scope of practice of Registrants,
  2. that Registrant must use separate letterhead, business cards, statements of account and similar documents for her non-massage therapy service, and
  3. that Registrant must not bill for massage therapy services while using an occupational title of the non-massage therapy profession.

In simple terms, this means that RMTs may provide a “service or technique” that is not massage therapy, but must not do so in a way that identifies them as RMTs or suggests that they are relying on their RMT status. Also, they are not permitted to bill for such services (for example, group exercise) as massage therapy.

Standards of Practice

The provision of (and billing for) group exercise as a massage therapy service violates section 9(d) of the College’s Standards of Practice (Schedule “D” to the College’s Bylaws), which requires that registrants maintain awareness of, and practice within, the current scope of practice of massage therapy in British Columbia.

A violation of the College’s Standards of Practice may be subject to investigation and professional discipline under the Health Professions Act.

Other Ethical Considerations

The College also cautions registrants that providing group exercise services as part of massage therapy services may result in violation of other standards of practice or professional ethics.

For example, the College’s Code of Ethics requires registrants to be aware of and comply with all applicable laws regarding the collection, use, disclosure and access to patient’s personal information as well as to avoid public discussions about a patient that could reasonably be seen as revealing confidential information, except with the patient’s consent (see sections 17 and 18 of the Code of Ethics). When providing group exercise services, registrants may not be able to protect the confidentiality of individual patients’ personal information.

The provision of group exercise services also raises concerns about patient safety, in that a registrant may not be able to monitor each individual’s safe adaptation of exercises in a group setting.

If you have any questions, please contact Kate Parisotto, Director, Inquiry and Discipline, at 604.736.3404 ext. 106.

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