This Standards of Practice document was developed to ensure that Standards are set that lead to high quality care being provided by Members of the Massage Therapist Association of Saskatchewan (MTAS). It will assist members of the public and other health care professionals to understand the duties and responsibilities of massage therapists.

The Practice of Massage Therapy

Duty

The duty of the Registered Massage Therapist is to deliver assessment and therapeutic treatment that assist the Client in reaching a desired health outcome.

Purpose

The purpose of treatment is to develop, maintain, rehabilitate, or augment physical functioning, relieve or prevent physical dysfunction and pain, and to enhance the well being of the Client.

Scope

The practice of Massage Therapy is: the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissues and joints in order to develop and maintain, rehabilitate or augment physical function or relieve pain.

Professional Misconduct

The following are acts of professional misconduct:

Records

• allowing any person to examine a Client health record or giving any information, copy or thing from a Client health record to any person except as required or allowed by law
• failing to provide information from a health client record for which the Member has primary responsibility, as required by law
• failing to make arrangements with the Client for the transfer of the client's records in the care of the Member, when the Member changes office location and the Client requests that the records be transferred

The practice of the profession and the care of, and relationship with client

• contravening a term, condition or limitation imposed on the Member's certificate of registration
• contravening a standard of practice of the profession
• abusing the Client, verbally or physically
• practicing the profession while the Member's ability to do so is impaired by any substance
• discontinuing professional services that are needed unless
  1. the Client requests the discontinuation
  2. alternative services are arranged
  3. the Client is given a reasonable opportunity to alternative services
  4. the Client is abusive, and the Member has made all reasonable attempts or arranged alternative services
• practicing the profession while the Member is in a conflict of interest
• breaching an agreement with the Client relating to professional services for the Client of fees for such services
• failing to reveal the exact nature of a secret remedy or treatment used by the Member following a request to do so by the Client, a Client's representative, or the MTAS.
• inappropriately using a term, title or designation in respect of the Member's practice
• using a name other than the Member's name as set out in the register in the course of providing or offering to provide services within the scope of practice of Massage Therapy
• failing to identify himself/herself by name or certificate number, on the request of the Client, a Client's representative or another health professional

Record Keeping

• failing to keep records as required
• falsifying a record relating to the Member's practice
• failing, without reasonable cause, to provide a report or certificate relating to an examination or treatment performed by the Member, within a reasonable time, to the Client, or his/he authorized representative after he/she has requested such a report or certificate.
• signing, or issuing in the Member's professional capacity, a document that the Member knows contains a false or misleading statement

Business Practices

• submitting an account or charge for services that the Member knows is false or misleading
• charging or accepting a fee or amount that is excessive or unreasonable in relation to the services performed
• charging or accepting a fee or amount under any agreement, wherein fee or amount is excessive or unreasonable having regard to the services to be performed or that may be performed pursuant to the agreement
• failing to advise, in advance of services being rendered, of the fees proposed to be charged for the services to be rendered
• failing to abide by a written undertaking given to the member by the MTAS or to carry out an agreement entered into with the MTAS
• offering or giving a reduction for prompt payment of the account
• failing to itemize an account for the professional services, if requested to do so by the Client or the person or the agency who is to pay, in whole or in part, for the services
• selling or assigning any debt owed to the Member for professional services. This does not include the use of credit cards to pay for professional services.

Needs assessment and treatment planning

Policy

A needs assessment must be conducts and a treatment plan proposed prior to treatment of the Client.

Where an assessment determines the Client's condition is beyond the Massage Therapist's scope of practice, the Therapist is expected to refer the Client to the appropriate health care practitioner. When referring to a health care practitioner, the Therapist is expected to ensure that the reason(s) for the referral and relevant clinical information are conveyed to that Practitioner.

Practice

Needs Assessment

The needs assessment includes:

• the Client's stated needs
• biographical information
• health history relating to the present condition
• physical evaluation
• review of referral or authorized reports from the Client's additional health care service providers, when available

Treatment Plan

On completion of the Client needs assessment, the Therapist will determine a treatment plan, which includes:

• desired health outcome
• frequency of treatment
• type of treatment
• Client self care programs

There will be a periodic review of the needs assessment and treatment plan, when applicable.

Certification and Title

Policy

A Certificate of Registration will be issued to the Therapist by the MTAS upon successful completion of the Entrance to Practice Examination.

Practice

Identification

The certificate must be displayed in a prominent place in the Therapist's principal place of work for inspection and recognition by any citizen. The certificate is not to be duplicated and is non-transferable, nor may it be "leased out" to unregistered facilities or persons and any time for any purpose by the Therapist.
A current Massage Therapist is entitled to use the title "Massage Therapist", "Registered Massage Therapist", and the designation of "M.T.", or "R.M.T.".

Personnel

A Therapist or establishment will not hire any person to administer any form of massage treatment unless the individual is a current Massage Therapist holding a valid Certificate of Registration issued by the MTAS.

Records Management

Policy

The practice of Massage Therapy includes the keeping of current client records. These will be stored securely.  The Canadian Medical Protective Association recommends that their practitioners keep medical records for at least 10 years from the date of last entry or, in the case of minors, 10 years from when the age of majority is reached or 10 years from the last entry, whichever is greater. Destruction will be by methods that protect Client confidentiality.

Practice

Client Records

Client Records include:

• Needs assessment information
• Treatment plan
• Record of written or verbal consent to treatment by the Client
• Record of treatment dates, types, results and authorized communications with other health care providers where applicable

Confidentiality

Client information, both verbal and written, is confidential and will be safeguarded by the Therapist. Written authorization is required and will be obtained prior to all communications concerning the client's records.

Storage

Client Records will be stored securely. The location for storage is the responsibility of the Therapist.
A failure to maintain records in accordance with accepted professional standards constitutes professional misconduct.

Fees

Policy

The fee structure and Client's method of payment will be agreed upon prior to treatment. Fees for services should be appropriate and reasonable.

Practices

Receipts

The Client is entitled to an official receipt for all payments made to the Therapist. Each receipt will include the date, treatment given, fee received, Therapist's name, designation, registration number and signature, and may include the location and nature of practice. A Massage Therapist my not issue receipts in blank to anyone for any purpose. All receipts issued must be signed and delivered to the Client receiving the massage therapy service. A failure to follow this policy may facilitate an improper payment by underwriting health care insurers and expose the Member to potential civil and/or criminal proceedings in addition to charges of professional misconduct.

Quality Assurance

Policy

The Massage Therapist must follow practices to ensure delivery of high quality treatment.

Practices

Hygiene

The Massage Therapist will maintain their premises (including supplies) in a sanitary manner. This includes adherence to technique of communicable disease control.

Reporting

The Massage Therapist will respect all pertinent reporting requirements outlined in legislation regarding child abuse. The Therapist is required under Section 12.1 of the Child and Family Services Act of the Province of Saskatchewan to report all suspected child abuse.

Draping

It is incumbent upon the Therapist to assure the privacy and respect of the Client and to ascertain that the Client feels comfortable, safe and secure with the draping provided.
The Client may choose to be fully draped and/or clothed throughout the treatment.
The Client must give verbal consent before the therapist undrapes the breasts.
The genitals, perineum or anus are never undraped.
Consent of the Client is required to work on any part of the body, regardless of whether the Client is fully draped or partially draped.

Competency

The Therapist will maintain competency in care delivery.
 

Professional Development

The Massage Therapist will maintain and enhance their practical and theoretical knowledge through professional development of the individual's practice.
The Massage Therapist will display or make available any certificates obtained for attendance, training and successful completion of professional development courses when the subject matter is included in their practice.
The Massage Therapist will maintain current certification in Standard First aid and Cardiopulmonary Resuscitation (CPR), Level C. (revised May 2, 1999)

 

Client Consultation and Consent

Policy

All decisions regarding the initiation of a treatment program will be made jointly with the Client, or when necessary, with the Client's consent advocate. Client consent will be based on informed consent.

Practices

Informed Consent

The needs assessment, treatment plan, likely benefits and risks of treatment, alternatives, and fees will be discussed with the Client, or when necessary, the Client's consent advocate(s) facilitating informed choice. Informed choice is a continuous process involving information sharing between Therapist and Client.

Consent

Consent of the Client is required to work on any part of the body regardless of whether the Client is fully draped or partially draped.

Record of Consent

A record of written informed consent to treatment or authorized communications will be maintained in the Client's records. (revised March 8th, 2003)

Client's Right of Refusal

It is a Client's right to refuse or terminate treatment at any time. When this request is made during the progress of treatment, the Therapist will comply, regardless of prior consent.

Case Load

A Massage Therapist reserves the right to regulate caseload.
A Massage Therapist may refuse to administer massage or otherwise treat any person if there is a just and reasonable cause.

Sexual Ethics

Policy

All decisions regarding the initiation of a treatment program will be made jointly with the Client, or when necessary, with the Client's consent advocate. Client consent will be based on informed consent.

Practices

The Therapist will not commit any form of sexual impropriety with the Client. Sexual impropriety includes:

• Any behavior, gestures or expressions that are seductive or sexually demeaning to the Client
• Inappropriate procedures, including, but not limited to:
  • disrobing or draping practices that reflect a lack of respect for the Client's privacy
  • deliberately watching the Client dress or undress
• Inappropriate comments about or to the Client, including, but not limited to:
  • sexual comments about the Client's body or underclothing
  • making sexualized or sexually demeaning comments to the Client
  • criticism of the Client's sexual orientation
  • discussion of potential sexual performance
  • conversations regarding the sexual preferences or fantasies of the Client or the massage therapist
  • requests to date
  • kissing of a sexual nature
• The Therapist will not commit any form of sexual abuse with the Client. Sexual abuse includes, but is not limited to:
  • Therapist-Client sex, whether initiated by the Client or not
  • Engaging in any conduct with the Client that is sexual or may reasonably be interpreted as sexual, including, but not limited to:
    • genital to genital contact
    • oral to genital contact
    • oral to oral contact (except CPR)
    • oral to breast contact
    • touching or undraping the genitals perineum or anus
    • touching or undraping the breasts for any purpose other than appropriate treatment, or where the Client has refused or withdrawn consent
    • encouraging the Client to masturbate in the presence of the Therapist
    • masturbation by the Therapist while the Client is present
    • masturbation of the Client by the Therapist

Advertising and Promotions

Policy

1. No Therapist shall offer to guarantee a cure, either verbally or in writing or by advertising or otherwise.
2. Advertising, promotion, and other marketing activities must be in good taste, accurate, and not capable of misleading the public. Any conduct, either directly or indirectly or through any medium or agent that:
   1. misrepresents facts
   2. compares whether directly, indirectly or by innuendo, the Member's service or ability with that of any other Practitioner or clinic, or promises or offers more effective service or better results than those available elsewhere
   3. deprecates another Member or clinic as to service, ability or fees
   4. creates an unjustified expectation about the results the Member can achieve
   5. is made under any false or misleading guise, or takes advantage, either physical, emotional, or financial of any Client or uses coercion, duress, or harassment
   6. is undignified, in bad taste, or otherwise offensive so as to be incompatible with the best interests of the public or members of the MTAS or tends to harm the standing of the massage therapy profession generally
   7. discloses the name of Clients
   8. makes statements which are not statements of fact or makes statements that cannot be proven to be accurate by the member of clinics are to be strictly avoided as such conduct is contrary to the interest of the public and the massage therapy profession