Massage therapy self-regulation doesn't go far enough to protect Quebecers, federation says

If you see a chiropractor, an acupuncturist or even a hearing-aid audiologist in Quebec, they must be licensed and are regulated by the province's professional code.

Massage therapists, however, are under no such obligations.

Despite decades of calls for provincial regulation from within the industry, massage therapy in Quebec remains largely a patchwork of minimum requirements and codes of conduct and the profession is entirely self-regulating.

Technically, anyone, regardless of their training or experience, can call themselves a massage therapist in Quebec, said Sylvie Bedard, head of the federation of Quebec massage therapists (FQM).

But she says that creates a risk for the public.

"If they don't have the necessary training, they don't have the necessary skills to be able to offer a quality massage and quality care in a safe environment," said Bedard.

There are 34 professional associations that govern more than 20,000 massage therapists in Quebec, each with their own standards and disciplinary procedures.

In Ontario, British Columbia, Newfoundland and Labrador and New Brunswick, the provinces which have established colleges for the profession, presenting yourself as a massage therapist is illegal if you haven't passed a series of benchmarks, including uniform accredited training and exams, and hold a licence.

The FQM, one of the largest massage therapists associations in Quebec, is pushing the province to create a professional order like the ones in those provinces — a call that has grown more urgent, Bedard says, in the wake of a spate of sexual assault charges laid against men offering massage services.

In one of the most recent cases, a 37-year-old man from Saint-Jérôme was arrested after more than 30 victims came forward with allegations of what provincial police described as a "series of acts of a sexual nature committed in the performance of his duties."

After his initial arrest in April, 20 more victims came forward with allegations.

In Montreal, former massage therapist David Kost, who pleaded guilty to two charges of sexual assault late last year, will return to court later this month on new charges linked to sexual misconduct in the performance of his job.

Kost, who was a member of the FQM, left the federation before his case was heard by its disciplinary committee, but he has been permanently barred.

Lack of central registry

While the federation keeps track of therapists who have been sanctioned by its own disciplinary board, there is no central registry of decisions.

There is no requirement to disclose the results of those disciplinary decisions to the public or report it to other associations.

Bedard pointed to a recently publicized case in Victoriaville where a social worker, also trained in massage therapy, was suspended from that provincial order for sexual misconduct involving a vulnerable client for giving intimate massages the order found crossed ethical boundaries.

He was banned by the social work order from treating female clients, but continued practicing massage therapy.

"There are no controls over anything," Bedard said. "There is no order. So there are so many associations that [they] could go anywhere and start again with the same thing."

It is up to each individual association to vet their members.

In Ontario, British Columbia, New Brunswick and Newfoundland and Labrador, massage therapists must pass a criminal record check to be eligible to join the colleges.

"In our general regulations, it's written that if a person has a criminal record, they have to disclose it," Bedard said.

"But not everyone is going to necessarily tell us and not all of the associations have that [requirement] in their general regulations. It's not obvious."

The FQM requires a minimum of 400 hours of training from a recognized school and a signed declaration that includes adherence to its ethics code and regulations to become a member. 

No risk for serious injury, government says

Quebec's Office des Professions, which is responsible for professional orders, has reviewed massage therapy previously and did not recommend an order be established.

A statement from provincial Justice Minister Stéphanie Vallée's office said she recently mandated the Office des Professions to conduct another review of the situation and the profession did not meet the criteria for an order because "current massage therapy practices do not present a risk of serious physical injury and are practiced by several other professions."

More invasive practices are already governed by other professional orders, the statement reads.

"While we deplore cases of sexual misconduct in the context of massage therapy treatment, we must not forget that criminal and civil remedies are always possible and that the creation of a professional order is not intended simply to add protection where it already exists."

Eric Wredenhagen, chair of the Federation of Massage Therapy Regulatory Authorities of Canada, said that the aim of an order is to protect the public and the bar for criminal prosecution is often much higher than the one required for disciplinary measures.

"Having a single regulator provides a level of protection that the criminal justice system alone simply can't," he said.

"If there's a complaint about misconduct by a massage therapist, we have the statutory power to act very quickly and either suspend the person's practice or impose limits and conditions on a practice even while the matter is being investigated so that we immediately remove the potential for public danger."

Lack of consensus in Quebec

Wredenhagen said there has been movement toward central regulation of massage therapy in other provinces, but often it is hindered by a lack of consensus among the various associations. 

In Quebec, that lack of consensus was highlighted by the minister's office as one of the reasons there have been no further steps taken. 

The president of the largest professional association for massage therapists in Quebec, Martin Vallée, said they would like to see a universal registry created that would standardize the ethics code and training required, but stopped short of calling for a formal college to be established.

"We would really like a proactive solution," he said. "We're very conscious of the need for regulations to better guide the public."