The following is a feature story published in the 2022 CMTBC Annual Report.
At a CMTBC annual general meeting, an RMT suggested that the College formally offer registrants an ongoing service providing practice advice about meeting regulatory requirements. When CMTBC Registrar and CEO Eric Wredenhagen heard that suggestion, he thought it was an excellent idea.
CMTBC was already providing the service on an ad hoc basis. “Senior staff at CMTBC were fielding calls and questions fairly regularly about practice requirements, and how to apply the Bylaws, Standards of Practice, and Code of Ethics,” says Mr. Wredenhagen. “It was clear that there was enough of an interest and need that it made sense to create a dedicated role.”
So the College proceeded with planning to add a Practice Advisor to the CMTBC staff. After consulting with other health regulatory colleges that provided practice advice — including the College of Massage Therapists of Ontario and regulators of other health professions in BC — CMTBC budgeted and recruited for the position. RMT Alison Esser started working as Practice Advisor for the College in June 2020.
Communicating the new position in the CMTBC newsletter and website, informing the Registered Massage Therapists Association of BC about the Practice Advisor role, and word-of-mouth ensured RMTs knew about the service, and uptake steadily increased. The COVID-19 pandemic prompted numerous questions to the Practice Advisor. In 2021, there were approximately 1,000 interactions with registrants who asked for practice advice.
While COVID-related questions gradually decreased in 2022, requests for practice advice about various regulatory requirements continued. In October 2022, RMT Jane Abbott began as a part-time Practice Advisor for CMTBC, working together with Ms. Esser, now Manager of Practice Development & Support, who continues to provide practice advice in addition to working on the College’s Quality Assurance program.
Practice advice is provided by email, on the phone, and through video conferencing, to individual RMTs and sometimes groups of RMTs. Topics that RMTs ask about are diverse: charting, obtaining consent, scope of practice, and CMTBC Standards of Practice are among the many aspects of College requirements that are discussed as part of practice advice.
“Practice advice is a way to help bridge what is written in the Standards of Practice, Bylaws, and Code of Ethics, and make it applicable to an RMT’s practice,” says Ms. Esser. “We help direct RMTs to what Standard of Practice, Bylaw, or part of the Code of Ethics they need to be mindful of given the question that they’re posing to the College.”
There’s a key point about practice advice: “We can’t provide them with legal advice or specific advice on what to do in a situation, but we can talk to them about where their professional obligations lie,” says Ms. Esser. An RMT, for example, could ask about what to do with clinical records if the person is leaving a clinic and joining another one. “We could say, ‘The Bylaws in this section say that you have to maintain your records for 16 years or transfer them. Let’s look at those Bylaws together so you understand what your professional obligation is and what your choices are.’ Then the RMT has to take that information away and ultimately make their decision about what path they will take.”
Therefore, practice advice provides parameters for RMTs to consider instead of specific instructions. “Our approach is not to tell people to do A, B, or C,” says Mr. Wredenhagen. “Through the practice advice program, the College helps RMTs think about: What do I need to be considering? What are the appropriate factors to bear in mind? What am I aiming at with this decision?”
While it would be difficult to verify whether practice advice contributes to prevention of complaints, as Mr. Wredenhagen notes: “If the right advice at the right time prevents a complaint from happening, that’s good for everybody, and most importantly, it’s good for the patient.
“I see practice advice as really important to fulfilling CMTBC’s role as a regulator to be able to provide practical and concrete guidance about what the Standards of Practice, Bylaws, and Code of Ethics mean in the context of practice, because that’s ultimately the environment we’re most concerned about: the point of contact between the RMT and the patient.”
Feedback from RMTs about the College’s practice advice service has been very positive. Practitioners in rural and remote areas, for example, have expressed appreciation for the support. “Some of the most rewarding conversations I’ve had as a Practice Advisor have involved talking to RMTs in remote locations who don’t have a lot of colleagues to ask questions,” says Ms. Esser.
“Our goal as Practice Advisors when speaking with RMTs is to let them know that we’re here to answer their questions and make them feel comfortable that they can reach out for assistance if they need to,” she adds. “They’re really happy to have someone to talk to who is an RMT.”
Ms. Abbott has heard similar feedback. “They’re pleased that they can connect with another RMT who’s not just regurgitating rules,” she says. “Because we’ve been in the same role that they are in, we can help put requirements in context.” She adds: “I’ve had really pleasant, wonderful conversations with people. They seem to really appreciate being able to connect with a Practice Advisor.”
To request practice advice, RMTs can email [email protected] or call 604.736.3404 or 1.877.321.3404 (toll-free) and select extension 301.