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Regulation, pros and cons

Oddly, this feels like a controversial post. It feels like a taboo subject that isn't to be spoken about unless you are in support of regulation in the holistic health field. You may be asking are doulas regulated in Canada? What about reflexology, is reflexology regulated in Canada?

Despite the debate about whether or not these modalities should be regulated, I want to do my best to write an unbiased post but I think it's important to state from the start, I don't personally desire for any of the modalities that I work or teach in to be regulated and that bias is going to come through in this post. I have had this conversation about regulation with people who work in regulated natural health modalities like massage therapy (regulated in Ontario, but not all provinces), people who work in unregulated modalities like reflexology or Reiki both who desire regulation and who don't.

In Canada and most of the USA, reflexology, Reiki and doulas are not regulated/licensed. There are a few exceptions. Here is a link to states that have licensing or regulation requirements of reflexologists. Reflexology is not regulated in any part of Canada. Some municipalities require a reflexologist to pay for a license (this isn't the same as regulation). Here is an example of license requirements in some parts of Ontario. Doulas are not regulated in Canada. To see doula laws by state, check this out.

I always recommend that you search for your specific state or province, county or municipality and license or regulation requirements for each modality that you currently or want to offer. You can also contact your local city hall for most up to date local information about businesses like yours.

Here are some of the perspectives both for and against regulation in these fields:

Regulation can help these modalities be covered by benefits

Regulation isn't necessarily a prerequisite to being covered by benefits though. In the two decades that I have been offering reflexology and doula servi

ces, I have had some clients request receipts for the purpose of submitting to their employee benefits program for reimbursement. Some plans specifically cover reflexology, although they are few and far between, but increasing over the years. Other plans have health spending accounts that can be used for anything health related and I have had clients have success getting reimbursed this way as well. I have been told that increasingly, insurance companies are requiring reflexologists to be members of an organization such as the Reflexology Association of Canada for their clients to get reimbursed.

The reality in my experience has been that my clients have always been willing to invest in their health by paying for my services themselves without insurance coverage. What about people who cannot afford our services you might ask? Generally the people who have the kinds of benefits that cover these kinds of services aren't the least fortunate among us. I always remind my students, there is a difference between "I can't afford it" and "I don't value it enough". I have supported clients all over the income spectrum including low income clients. I have always had a busy enough practice that I can offer some charity support as well. I've definitely had some experiences from people who say they can't afford reflexology who indulge in other areas (like fancy coffees

or even big boats) and I've had single low income mom's on a tight budget who pinch their pennies because they very much value what I offer.

Clients who only use benefits for healthcare don't tend to be ideal clients. Benefits dollars only go so far and these clients can tend to wait until the end of the year to then use up their $300-$500 before it expires and then not come back. Ideal clients really value what we offer and investing in their health is a priority so they make it work.

Regulation makes our modalities safe for our clients

Reflexology, Reiki and doula services are safe, non-invasive, complimentary modalities. Regulation doesn't inherently make our modalities safe, they already are inherently safe. What it offers is a place for clients or other practitioners to report bad behaviour such as practitioners practicing way outside of their scope of practice. Once a practitioner has been reported there would be an inve

stigation and they may lose their regulated title. It doesn't mean a person has to stop practicing. Massage is still offered in Ontario by practitioners who do not pay their regulating body or even who have had their Registered Massage Therapist title removed after investigation. The reality is, anyone can offer massage for a fee. Estheticians offer Relaxation Massage in Ontario as an example, but they aren't Registered Massage Therapists. It's up to the client to do their research about the practitioners they use. You can get a beneficial and enjoyable massage from a registered therapist or from someone not registered. You can also get a harmful or bad massage from a registered therapist or an unregistered practitioner. Ultimately, the market will determine someone's value or not. If they're good, they'll get plenty of referrals. If they're not good, they'll have a hard time being successful regardless of their status.

Regulation sets a high standard for the industry. It's more professional

Every regulating body or organization is made up of industry experts who determine what regulation requires, codes of ethics, stan

dards or scope of practice, etc. Practitioners pay an annual fee and may have to meet certain requirements each year to maintain their registration. It can include continuing education, documentation requirements etc. In exchange, what a regulating body offers in return will vary wildly depending on the organization. They may or may not provide workshops, seminars and conferences (for a fee), regular communications, advocacy at state/province or federal levels, education to the public, referral listings, and more. Where modalities are not regulated there are often membership organizations such as the Reflexology Association of Canada, the Registered Reflexology Council of Ontario, the Canadian Reiki Association etc. These are not (at the time of this post) regulating bodies. Practitioners can pay an annual fee to be a member and in exchange receive benefits or support, but it is not a requirement to work in the industry.

I think some practitioners feel that being regulated can be seen as more professional by colleagues in other healthcare fields, such as doctors, nurse practitioners, etc. I'm not sure if anyone's ever surveyed our colleagues in regulated healthcare to see if regulation changes perceptions, or if they would suddenly start referring more often. I personally am not looking for recognition by the medical field. We view health very differently (in general, of course there are exceptions). What matters to me is that my clients believe in what I offer, experience benefits, and want to continue using it as long as they continue experiencing benefits. Open minded, holistic thinking medical professionals who we establish relationships with will refer to practitioners they trust, regardless of regulation. Medical minded, conventional medical professionals probably won't be a source of referrals, no matter what.

In conclusion, here is my personal feelings about regulation based on my own experience and my conversations with colleagues. In general people desire regulation because they would feel differently about the modality they offer, a feeling of being legitimized. Or, people desire regulation because there are bad practitioners out there (although in twenty years I haven't encountered many). Other colleagues have felt really burdened by the financial expense each year. One RMT I know found she could not justify ending her maternity leave before the beginning of the next calendar year because her part-time (new mom) schedule couldn't justify the cost of renewing her registration.

I believe in self regulation. I teach our students the importance of continuing to invest in ourselves through education and real self care. We talk thoroughly about safe and professional practices and business ethics. If someone is going to go way outside of what they were taught causing some kind of risk or harm, they're going to do it, regulated or not. But, I honestly believe that is extremely rare. And additionally,

I think modern times are showing us that governments of any kind are made up of other imperfect humans, who we don't always agree with, but once we are regulated, how do we become unregulated again? What if it isn't all it was cracked up to be? Those are my 2 cents.. or 99 cents maybe more like it. What do you think? I welcome healthy dialogue. I think a commitment to being curious and expansive in our thinking is always helpful. Is there something that I missed? Share your point of view.


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