Unlicensed Practice of Massage
I am writing to you in response to your letter to dated , concerning the practice of massage without benefit of licensure by the State Medical Board of Ohio. You have requested that the Board inform you of what massage practices are allowable under State law without licensure by the State Medical Board.
Section 4731.41, Ohio Revised Code, states in part that “no person shall practice medicine and surgery, or any of its branches, without a certificate from the State Medical Board; no person shall advertise or announce himself as a practitioner of medicine or surgery, or any of its branches, without a certificate from the Board.” Massage is a limited branch of medicine and its scope of practice is defined in part by Rule 4731-1-05, Ohio Administrative Code, as “limited to the treatment of disorders of the human body by the systematic external application of touch, stroking, friction, vibration, percussion, kneading, stretching, compression and passive joint movements within the normal physiologic range of motion; and adjunctive thereto, the external application of water, heat, cold, topical preparations and mechanical devices.” Furthermore, Section 4731.34, Ohio Revised Code, defines the practice of medicine in a broad manner (please see copy enclosed) that includes “the use of words, letters or titles in such connection or under such circumstances as to induce the belief that the person who uses them is engaged in the practice of medicine” or in this case one of its limited “branches.” The states and rules mentioned above should give you an idea of the parameters of the Board’s jurisdiction in governing the practice of the limited branch of medicine known as massage.
In 1972, the Attorney General rendered Opinion No. 72-101, which stated that “the practice of massage is a limited practice of medicine, as defined in Section 4731.15, Revised Code, and those who give massages in sauna baths or for physical therapists are subject to examination and registration under that Section.” That Opinion also states that “the General Assembly considered the practice of giving massages a limited branch of medicine which should be the subject of regulation.” Moreover, the Attorney General saw “no reason why the regulation of a limited branch of medicine should depend on where, or under whose direction it is practiced.”
The Board has traditionally read the syllabus of Opinion No. 72-101 in conjunction with the Statutes and Rules mentioned previously in this letter. The Board has regulated the practice of massage falling with the jurisdiction of Sections 4731.15, 4731.17 and 4731.34 of the Revised Code and the scope of practice of the limited branch of massage currently defined in Rule 4731-1-05 of the Administrative Code.
However, the Board in the past has not recognized jurisdiction over individuals practicing a “non-therapeutic” form of massage in which the specific practice does not fall within the jurisdiction of the State Medical Board of Ohio as defined in its governing Statutes and Rules. The General Assembly of the State of Ohio apparently validated this interpretation of the law when they passed Amended Substitute House Bill Number 247 (effective June 3, 1992) which allows a Board of Township Trustees to regulate and require the registration of massage establishments and their employees. Ohio Revised Code Section 503.40(A) defines massage within the limits of Sections 503.40 to 503.50 of the Revised Code. However, nothing in that Bill “shall be construed to allow a Board of Township Trustees to regulate the practice of any limited branch of medicine and surgery.
Therefore, it would seem apparent that there is some practice of massage, be it “non-therapeutic” massage for lack of a better term, allowed in this State which will be subject in part to regulation by Boards of Township Trustees within the limits of Sections 503.40 to 503.50 of the Revised Code. However, please remember that the State Medical Board of Ohio will retain jurisdiction over the limited branch of medicine known as massage defined within Chapter 4731. of the Revised Code and Chapter 4731-1 of the Administrative Code. If would be prudent for you to check the laws of the city or township in which you are practicing for pertinent local regulations.
If you do intend to work as a “masseuse” and perform massages within the authority of Sections 503.40 to 503.50 of the Revised Code, these massages must be “non-therapeutic” in nature. Please understand that if you are practicing “non-therapeutic” or “relaxation” massage on a person who has or recently has had a “disorder of the human body” such as a strained muscle or high blood pressure, you may in fact be conducting a massage within the meaning of Rule 4731-1-05, Ohio Administrative Code, although you claim or intend that the massage not be “therapeutic” in any way. Therefore, it would be appropriate to take measures to thoroughly screen individuals to determine that you are performing your massage on a healthy body free from any disorders. It may also be advisable to specifically state to your clients that State law prohibits you from treating “disorders of the human body.” By providing therapy or treating disorders, you would be practicing massage as a limited branch of medicine in violation of Section 4731.41, Ohio Revised Code, which is a criminal offense. Furthermore, such a violation or the violating or attempting to violate, directly or indirectly, any provision of Chapter 4731. of the Revised Code or any rule promulgated by the Board are grounds for possible denial of Medical Board licensure.
As you may be aware, the State Board of Cosmetology has specific laws governing which practitioners may work in salons under their jurisdiction (please see enclosed copy of Section 4713.14, Ohio Revised Code). Ultimately, the Cosmetology Board must decide which practitioners may perform massage in these salons. You may wish to address the Cosmetology Board directly concerning those practice questions.
I hope this letter is of benefit to you in determining the parameters of your practice. This letter is not a written legal opinion, but is meant to give you guidance. You may wish to consult with a private attorney. I have enclosed copies of the Statutes and Rules specifically mentioned in this letter for your further information. Please feel free to contact the Board should you have further questions.
Very truly yours,
Thomas A. Dilling
Government Affairs Officer