Patients reaching out for healing touch

Mae DeLuca understands the skeptics. Before she attended a presurgery counseling session at North Shore Medical Center in Salem two years ago, the Lynn secretary was not the sort to try any kind of unconventional health treatment.

''I didn't buy it," said DeLuca, 59, about the reiki (pronounced RAY-kee) demonstration she watched during that session.

The ancient Japanese technique, which involves the gentle laying-on of hands, is offered to help patients relax in the weeks prior to surgery and to aid healing afterward.

DeLuca, who struggled with pain after hip replacement and other surgeries, ultimately decided to give reiki a try before her gastric bypass surgery. She even underwent a session shortly before she was wheeled into the operating room. Since the operation, she has been meditating regularly, something she also learned during presurgery counseling. DeLuca said the combination of reiki and meditation have proven so effective that she has not had to take pain medication since leaving the hospital two years ago -- despite suffering from severe arthritis in her hands, ankles, and hips.

''I am a much more relaxed person," DeLuca said, ''and I can deal with pain in a different way than I ever could before."

From reiki and meditation to massage therapy, reflexology, and polarity, the number of nontraditional health care options is soaring in communities north of Boston. Patients are inhaling flower and berry oil essences, having their energy fields realigned, and pressure points stimulated.

In the past 18 months, requests for nontraditional healing sessions have jumped 38 percent at North Shore Medical Center's sites in Salem, Lynn, Peabody, and Danvers with such visits up to about 22,000 a year, said Sandy Skinner, the hospital's administrative director for integrative and wellness services.

''It's really consumer driven, a grass-roots kind of thing," Skinner said. ''A lot of these wellness, alternative medicine kinds of things give people control and empowerment and that's key to their success in managing and coping with illness."

North Shore Medical Center offers 30 options, including inpatient sessions and outpatient classes, in tai chi, yoga, and Chinese herbal medicinal food courses. Neither the classes, nor the inpatient sessions, are covered by insurance.

Yet consumer demand for alternative therapies is so strong that the state's largest health insurance provider, Blue Cross and Blue Shield of Massachusetts, now offers members up to a 30 percent discount on visits to Blue Cross-approved acupuncturists, massage therapists, and eight other types of alternative health practitioners. The visits are not covered by insurance, so patients must pay out of pocket and then receive the discount from the practitioner.

More than a third of Americans use some sort of unconventional health treatments, with the total number of visits each year exceeding those to primary care physicians, according to a January report commissioned by the National Institutes of Health. The influence of nontraditional healing is substantial, the report concluded, ''yet much remains unknown about these therapies, particularly with regard to scientific studies that might convincingly demonstrate the value of individual therapies."

In Massachusetts and the suburbs north of Boston, it is hard to assess precisely how many people are seeking such nontraditional care. While acupuncture and chiropractic are regulated and monitored on the state level, the vast array of unconventional treatments, such as aromatherapy and shiatsu, have no state oversight. Many communities, however, require massage therapists to obtain a license, issued by local health departments.

Beacon Hill lawmakers are considering a proposal to regulate massage therapists statewide, in much the same way the state monitors doctors, due to the rapidly growing ranks of massage practitioners.

In Newburyport, for instance, the number of massage therapists seeking a local license has jumped more than 50 percent in the past two years, from 33 in 2003 to 53 licenses so far this year, said John Morris, the city's director of public health.

''Every other week, I seem to be getting a new application," he said. ''I am not exactly sure what's driving this."

At the Palmer Institute of Massage & Bodywork in Salem, enrollment has jumped from about 30 students a semester when the school opened seven years ago, to more than 300 a semester, said director David Palmer.

To be certified, students at the Palmer must complete 650 hours of training, with 450 of those hours including required courses in anatomy and physiology. For the other 200 hours, students can choose from a wide variety of electives, including aromatherapy, herbalism, hot stone massage, polarity energy balancing, reiki, and Zen shiatsu.

Often massage therapists -- including some of those in the Blue Cross-approved list -- offer clients other therapies in addition to massage, such as shiatsu, polarity, reflexology, and zero balancing.

Anne L. Collins, director of the state's Division of Professional Licensure, said she would like to see Massachusetts pay closer attention to the massage therapy field. Her division sets minimum training standards and regulates the activities of more than 40 trades and professions, including chiropractors, dentists, nurses, podiatrists, veterinarians, hairdressers, and even manicurists. A separate state agency, the Board of Registration in Medicine, oversees acupuncturists and physicians.

''The realm of professionals who actually touch peoples' bodies, most of those people are licensed," Collins said. ''The more that massage becomes a popular treatment, not just a recreational spa trip, there is a sense that you want to know these people have been trained and they are accountable for their actions."

Thirty-six states, including New Hampshire, Connecticut, and Rhode Island, regulate massage therapists, according to the American Massage Therapy Association.

The proposed legislation in Massachusetts would require massage therapists to undergo at least 500 hours of training and carry liability insurance to receive a license. It also would require continuing education courses to renew a license every two years and would create a board to investigate complaints against therapists.

However, the legislation would allow a wide variety of alternative health practitioners to continue operating without a state license, as long as they do not perform massage. In these therapies, patients are usually fully clothed and the practitioners often do not need as much in-depth study. The exemptions include practitioners of reiki, shiatsu, reflexology, polarity, and acupressure.

Collins said the breadth of the exemptions concerns her.

''Are we properly covering the scope of experiences consumers are having, or are these exemptions too broad?" she said. ''We're looking at the bill to make sure it's something that we have good criteria for who is fit to license, so the board can provide meaningful consumer protection."

Currently, each community sets its own criteria for licensing massage therapists, creating a hodgepodge of rules that change at town lines. Some communities, such as Swampscott, Winthrop, and Lynn, do not require practitioners to have liability insurance. But Lynn, unlike Winthrop and Swampscott, requires applicants to have a minimum of 500 hours training in a school that meets the standards of a national professional association. Danvers, on the other hand, dropped all licensing requirements for massage therapists two years ago.

''We were licensing an awful lot of massage therapists and started feeling uneasy about managing that many people performing health services," said Peter Mirandi, Danvers director of public health. ''The state did not want to recognize these folks as allied health professionals and we were uncertain of the liability for us licensing people who do quasi-medical treatments."

But Danvers health officers still inspect massage therapy establishments for cleanliness and issue licenses for the businesses to operate. Today, there are 19 such establishments, up from 14 two years ago. Health officials aren't sure how many massage therapists are working in Danvers now, but they believe the number has increased from the 43 that were licensed when the town stopped its regulation two years ago.

''I get one or two calls at least a week from people coming out of massage school, saying 'What are your licensing requirements?' " said Danvers public health inspector Mark Carleo.

His answer?

''You can do massage therapy in Danvers without a license. We only permit the establishment."

Kay Lazar can be reached at klazar @globe.com.