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Scope of Practice Standard of Practice

CMTBC Standards of Practice

Purpose

Practice standards define the minimum level of expected performance for registered massage therapists, and therefore define what constitutes safe, ethical, and competent delivery of care by RMTs.

RMTs are responsible for exercising their professional judgment to apply the standards to the situations that they face in practice.

Scope of Practice

Definition

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

The Regulation states that registrants of CMTBC may practice massage therapy. Massage therapy is defined in the Regulation 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.”

The Regulation also sets out a specific list of services that RMTs are not allowed to perform. RMTs cannot:

  1. prescribe or administer drugs or anaesthetics,
  2. treat a recent fracture of a bone,
  3. apply any form of medical electricity, or
  4. move a joint of the spine beyond the limits the body can voluntarily achieve using a high velocity, low amplitude thrust.

Further to the Regulation, CMTBC’s Notices to the Profession set out scope of practice limits and conditions for RMTs (see Application to Practice section of this standard for more information).

The scope of practice of an RMT includes many different massage therapy services that RMTs are educated in and able to provide to patients, when indicated, as part of the provision of safe, ethical, and competent massage therapy care.

Requirements

  1. An RMT maintains awareness of the scope of practice for RMTs in BC, including by reviewing and staying current with the Regulation and with all Notices to the Profession issued by CMTBC in relation to scope of practice (see Application to Practice section of this standard).
  2. An RMT practices within the scope of practice for RMTs in BC, as defined by the Regulation (including the limits and conditions set out in the Regulation) and as interpreted by CMTBC in Notices to the Profession (see Application to Practice section of this standard).
  3. When considering whether to incorporate a massage therapy service within their massage therapy practice, an RMT must:
    1. take all reasonable steps to determine that the massage therapy service is within the scope of practice for RMTs in BC; and
    2. ensure they have sufficient training and knowledge to perform the massage therapy service safely and effectively.
  4. An RMT may provide non-manual therapy services only when done so as an adjunct to care.
  5. An RMT does not, in performing massage therapy services, put a finger, hand, or instrument beyond a patient’s anal verge or labia majora.
  6. An RMT who is also a licensed health care professional with another college which regulates a profession other than massage therapy (a “dual-registered RMT”) ensures that there is a clear separation between the health professions the dual-registered RMT practices, including by:
    1. clearly communicating to the patient when the dual-registered RMT is or is not providing massage therapy services;
    2. practicing within the scope of practice for an RMT in BC when providing massage therapy services, including with respect to intake, assessment, treatment and recommendation of home care; and.
    3. keeping separate health care records for each of the health professions.
  7. An RMT who is also trained to provide a service that falls outside the scope of practice for an RMT in BC ensures that there is a clear separation between the RMT’s massage therapy services and the non-massage therapy service, including by:
    1. ensuring that the non-massage therapy service is not linked to or associated with the RMT’s massage therapy practice or status as a registrant of CMTBC;
    2. practicing within the scope of practice for an RMT in BC when providing massage therapy services, including with respect to intake, assessment, treatment and recommendation of home care;
    3. refraining from discussing the non-massage therapy service when providing massage therapy services;
    4. refraining from discussing massage therapy services when providing the non-massage therapy service; and
    5. keeping separate health care records for the massage therapy services provided from the non-massage therapy service provided.
  8. An RMT issues invoices and receipts for massage therapy which:
    1. include the RMT’s CMTBC registration number;
    2. identify the RMT by only those professional titles reserved to registrants of CMTBC under the Act and Regulation, and no other occupational titles or designations (see Application to Practice section of this standard); and
    3. describe the service provided only as “massage therapy”.

Appendix – Defined Terms

Medical electricity: any device that introduces electricity into the human body, whether directly or indirectly through the dermis or other external surface, and includes ultrasound, forms of light therapy, including low level laser therapy or low intensity laser therapy, and TENS devices.

Licensed health care professional: a health care practitioner who is registered or licensed to practice in BC pursuant to the Act or another health care profession statute, and includes but is not limited to another Registrant, a medical practitioner, a naturopathic doctor, a chiropractor, a physical therapist or an acupuncturist.

Massage therapy services: includes but is not limited to assessment, patient education, manual therapy techniques including manipulation, mobilization and other manual methods, and non-manual therapy services when done as an adjunct to care.

Non-Manual Therapy Services: includes but is not limited to providing one-on-one therapeutic exercise instruction for the purpose of homecare and the use of hydrotherapy.

Adjunct to care: non-manual therapy services that are provided in combination with massage therapy services to support the agreed upon treatment plan and increase the efficacy or safety of the massage therapy services.    

Non-Massage Therapy service: a service that falls outside an RMTs scope of practice, including but not limited to psychological counselling or talk therapy, life coaching, energy-based modalities, Reiki, treatment of animals and nutritional advice (including supplements).

Additional Resources

Additional resources to help RMTs understand and apply the scope of practice standard of practice to their practice can be found on the Resources for Registrants – Scope of Practice page.

RMTs who have questions about the Scope of Practice Standard of Practice can contact [email protected].

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