By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer
Recently, I had a reader post a questions about an earlier post I had written regarding massage and chiropractic issues in Illinois. While trying to answer her questions, I found out much more about the legislation that governs the use of unlicensed personnel to perform massage in chiropractic offices. I thought it might be useful to others if I wrote it out in a post versus burying it in a comment, so read on…
In my mind, having a non massage therapist receptionist perform a massage, whether or not the chiropractor is in the same office, is unethical, even if it were legal in Illinois. However, there other stipulations that restrict the use of a receptionist and office manager from performing massage in a chiropractic office. And specifically, in Illinois, unlicensed people may not practice massage on new patients outside the office setting even if the chiropractor is present.
Let me give another example of how this law can be broken and how unlicensed, untrained people can be giving massages out in public. Last fall, I volunteered at a charity event performing massage with the understanding that my company would be the only massage providers at this event. I bought signs for our booth (which set me back quite a bit), contracted with a massage therapist to work the event with me (because I don’t expect other massage therapists to work for free to promote my business) and made it to the event to locate our booth. And what did I find? A chiropractor was setting up massage chairs in our booth and had a young lady in tow to help him give massages. I was uncomfortable with having people I don’t know giving massages under my company’s banner, but at that point the event had already started. So we welcomed the chiropractor and his staff person and got to know them better.
We had spoken to the chiropractor about our frustrations with the law regarding chiropractors hiring unlicensed people to perform massage. I asked the young lady if she was a licensed massage therapist and she said “No.” My fellow massage therapist and I were shocked and concerned that she would be giving massages in our booth. The young lady said “Well, I’ve been in enough locker rooms and have seen people get massage to know what I am doing.” With that as her rationale for being able to provide massage, and the chiropractor mumbling something about his other massage therapist not being available that day, she started massaging people. Soon she was massaging children under 18 years old. Granted, the chiropractor was standing right next to her the entire time. But would you want your kids or loved ones to be given a massage by someone who’s main claim to her abilities was seeing other people get massages in a rehab room? I wouldn’t. Was the chiropractor violating the law? Yes. Was she? Yes, as well. And if she hurt someone or even gave them a bad massage, it was my name on the banner people would associate her with. I did not know then that they were not obeying the law. Now that I know I would have handled the situation differently.
So if you are hosting a charity event or getting a massage at such an event, make sure you ask if the massage therapist is licensed, especially if they are part of a chiropractor’s booth. I have to wonder too if a chiropractor is using unlicensed people illegally to give massages, could I trust him or her in other areas of my care?
I pasted the relevant text of the relevant law below. Note that although the text says physicians, chiropractors are included as physicians in this act. My clarifications are given in brackets.
(225 ILCS 60/54.2)
(Section scheduled to be repealed on November 30, 2011)
Sec. 54.2. Physician delegation of authority. [Which also includes chiropractors]
(a) Nothing in this Act shall be construed to limit the delegation of patient care tasks or duties by a physician, to a licensed practical nurse, a registered professional nurse, or other licensed person practicing within the scope of his or her individual licensing Act. Delegation by a physician licensed to practice medicine in all its branches to physician assistants or advanced practice nurses is also addressed in Section 54.5 of this Act. No physician may delegate any patient care task or duty that is statutorily or by rule mandated to be performed by a physician.
(b) In an office or practice setting[so only in the office, not at health fairs or at charity events to market the practice] and within a physician‑patient relationship, [which means, within the context of an existing patient/physician relationship, not to market new clients] a physician may delegate patient care tasks or duties to an unlicensed person who possesses appropriate training and experience provided a health care professional [which in this case would either be training by the chiropractor OR licensed massage therapist], who is practicing within the scope of such licensed professional’s individual licensing Act, is on site to provide assistance [so the licensed massage therapist must be on site to provide assistance unless the chiropractor is trained to give massages].
(c) Any such patient care task or duty delegated to a licensed or unlicensed person must be within the scope of practice, education, training, or experience of the delegating physician and within the context of a physician‑patient relationship. [Again, the massage given must be within the scope of practice of the chiropractor/and or licensed massage therapist on site AND must be within an existing physician-patient relationships, not for marketing purposes or for new patients]
(d) Nothing in this Section shall be construed to affect referrals for professional services required by law.
(e) The Department shall have the authority to promulgate rules concerning a physician’s delegation, including but not limited to, the use of light emitting devices for patient care or treatment.
(Source: P.A. 96‑618, eff. 1‑1‑10.)
The link to the final law is here.