Category Archives: Building Your Practice

Treat Your Own Kinks…

While we massage therapists are busy rubbing away knots, an industry has been developing of how-to guides to assist clients between office visits.

The publications start with “Treat Your Own…” and I have always been a fan of the guru self-treatment book, Robin McKenzie’s “Treat Your Own Neck.”

When I worked in a busy office, I finally put McKenzie’s book on a chain by my desk because it would somehow disappear, especially when we all got busy and crabby.

I am also a fan of Jim Johnson’s “Treat Your Own Spinal Stenosis” a great guide to the basics of home therapy.

Clients recently diagnosed with stenosis understandably have a massive freak-out, especially if they read on-line medical websites about paralysis and loss of continence. Johnson takes the fear out and breaks it down to simple, regular stretching and strengthening.

Before I recommend any of these books to a client, I buy them, read them, and do them. I might just learn something new, and as long as the book advice appears sound, I’ll recommend it to clients. These publications are written by very experienced doctors, physical therapists or massage therapists, but I’ve seen a couple of pubs, and especially videos, I would call off-beat.

A check of the web turned up troves of “Treat Your Own….’’ books for shoulders, knees, carpal, shoulders, backs, etc.

It gives people with these conditions a step-up to consistent therapy. Human nature being what it is, few of us will do “knees to chest” six times, six times a day in Johnson’s stenosis book.

But a massage therapist or client who does draw knees to chest at least once a day will feel better than those who never do it. My personal favorites are those who stretch only during nine supervised physical therapy visits. A go-to book comes in handy!

Leave a reply

Best Intentions? Massage and Permission

Is it OK to stretch a client’s adductors? What if the client is female, the therapist male, and the wind is whistling through openings in the drape?

Oh my, the topics that come up for question in a massage clinic. One of my friends had a complaint from the husband of a couple whom had simultaneous massages. The female client had a massage from a male therapist, and during the massage he stretched her adductors.

The client complained to her husband that there was something wrong about it. The therapist stretched her, said nothing before, during and after the stretch. She could feel an air gap between her draping and her crotch. First, it is unusual for people to complain about such tactics in a massage. Often the response is simply to never use that clinic or spa again.

My friend noted that she received the complaint because the husband was a long-time client and they had a good professional relationship. When my therapist friend talked to the male therapist about the massage, he just said that he felt her adductors needed stretching and did not consider it a big deal. The client said nothing, and the massage continued as usual. It can happen that we may have the best of intentions in a massage, but our efforts are interpreted differently. It is also quite possible that someone doing a massage is not being honest about intentions.

The therapist may be using the massage as an opportunity to play games, such as intimidation games, sexual games, etc. Those games – and the appearance of games – have no place on a massage table under any circumstances. A good way to make sure your intentions are clear is to ask permission of the client first. Explain what you want to do, why, and emphasize the person’s draping will not be revealing. Then wait for an audible answer and accept the answer. No means no.

My friend decided not to call in the male therapist, a contractor, again to her clinic. His answers about the massage were not satisfying, and she told him that. Hopefully he was not playing games and learned something from the experience. It cost him an opportunity to work.

Leave a reply

Massage and the Past Perfect

The Adventures of Ana Log, Massage Therapist

My alter ego in my massage therapist career has been “Ana Log.” She is a heroine of old school practices that simplify life instead of clouding it.

Contrary to trends out there in e-land, Ana Log has her own schedule book, written in pencil, to give her the flexibility a good therapist needs. She doesn’t want to do 10 hours of massage in one day, then two the next. Her antique paper day planner keeps all of her appointments, client names and phone numbers and daily/weekly/monthly trends in check. To look something up, she turns a page. She even takes lunch a few times a week.

Ana Log also keeps her muse, a clock with a second hand, in her therapy room. Ana can count stretches, trigger point treatments and coordinate breath-work without being too obvious about it. The clock makes just enough noise to be able to tune into the seconds count when turned away from it.

Ana’s brother, whose alter ego is “Mr. IT Excel,” loves to point out that all of these things can be programmed in to a good scheduling software and “make life easier.” All of Ana’s preferences can be handled by her automated device of choice, “making her life easier.”

“P-shaw” says Ana, with the vigor of a 19^th century ink-stained author. That would involve learning how those programs work and then applying it. And what happens if the cloud is clouded? Or the device is dropped? Or the charger is at home? And what about sunspots?

Mr. IT Excel, whose life involves countless hours of making things easier by adding things to programs, and then even more hours of making those changes actually work as promised, then extracting viruses that try to wreck those programs and then changing the “shaky” platforms those devices dislike (etc., etc., etc.) insists that devices do “make life easier.”

Says Ana Log: “Remember when Dad said if he wanted to talk to someone he didn’t need a computer to do it? He would just pick up a phone or go see the guy?”

Leave a reply

Massage Therapists Do the Math

Perhaps you have seen the ads in the massage therapist trade publications: What would happen if you could see four clients in an hour?

Folks in the massage biz are not often associated with great math skills. Four clients in a single hour? As a private practice therapist, heck, I figure could make a lot more money. The bottom line is a tough talk for most massage therapists. We work hard, yet few of us make the mythical “six figures.” It’s the same elusive goal of others in hard-working, hands-on, self-businesses such as hair stylists, estheticians and realtors.

Most of us make our bills OK, but few achieve the income that we feel we deserve based on our combination of effort, hours worked, and costs of training and licensing. The three times the money carrot sure made me look further into the pitch. Aha, this ad is for acupuncture school.

That’s enticing. Learn a very similar technique that requires a lot less sweat. More clients, more income, and yes, in most states you get to call yourself a doctor. Hmmmm. Then there is the tuition, the time spent and the apprentice time and licensing tests and costs. Could it work? How many acupuncturists have to take three months off for carpal?

That’s way too much math for me. I cut to the chase. I asked the acupuncturist I share space with. He has been in practice for more than 30 years.

My officemate looked at me in horror. After graduation, he had no idea how to book a client, let alone manage a practice. For years he worked as a contractor for other acupuncturists – at about half of the $50 session fee. It didn’t seem very fair then, of course now that he knows about office rent, insurance, ads, etc. he has a different perspective.

So he saw about 30 patients a week for others, and tried to see at least 20 people a week in his own practice. That’s 50 plus treatments a week, about double what I can do. “I hit the wall,” he said. “I burned myself out. It took a long time to be able to come back and feel good about doing treatments again.”

Well, fudgesticks.

We talked a bit about burnout and why. I have to admit I really didn’t see it at first. He explained that it takes a lot out of an acupuncturist to perform treatments that address specific complaints. “It’s the energy,” he said. “It’s all about the energy.”

You know, I totally get that math.

Leave a reply

Practice Punts

Massage therapists are not all alike when it comes to their understanding of how to build a practice. I have heard lots of explanations as to why bookings stay low, very few explanations of why they are full.

How to develop a practice is an art just as much as massage. It requires some close self-observation and sometimes an outside hand to help therapists along. Often when I catch an episode of some show like Salon Take-over or Bar Rescue or Hotel Impossible, I am reminded very quickly of what it takes to have a consistent practice.

If you catch one of these shows the clichés are numerous. The owner wants help to make their business pay, but they don’t want to hear anything critical of their skills. The help is interested in making money, but stymied and discouraged by unsolved problems. Often there is a sacred cow: a lazy staffer or manager whom the owner wants to avoid confronting – or an unworkable idea that the manager/owner won’t drop. The bottom line is that the bank wants its money, not excuses.

I enjoy these shows as a kind of self-therapy even though the environments are very different. Most massage therapists work alone. They are the owner, staff, manager and investor. The outlay to start a massage practice tends to be small, and there are very few therapists who make anywhere near “six-figures” when it comes to gross income.

In common, though, are some basic universal truths. The formula for success is not a secret requiring an expensive marketing class or a practice coach. It is, just like the roaches in the kitchen of a failing restaurant, right in front of a person with eyes to see.

Yes, darn it, arrive on time. Be clean. Do not wear jeans. Listen to the client. If it is a return client, go over your notes before they arrive. No notes? Where are they? Why be paid professionally if you don’t practice like a professional? Do you report your cash? And yes, a warm room and a clean heart.

No shortcuts.

Leave a reply

Massaging Without a Net

One of my favorite massage therapists to trade with recently let me in on a secret.

She has been doing massage for more than 20 years without health or disability coverage.

That pressed some buttons with me. Since getting into massage, I have always had coverage, health through my own individual plan, then my spouse’s work policy, and disability through my professional massage association. I wouldn’t think of going “bare.”

My friend explained to me that she wasn’t aware that she could get coverage through her association, and had she been, she might sign up. She carries practice insurance because she is a contractor for a spa that requires it.

Why not look into her options?

Well, she said, she didn’t look into it because no one told her it was available. And even then, it is probably too expensive to pay out of pocket for insurance every month and still pay rent.

So what happens if she breaks her wrist while mountain biking?

Well, she can always move back with her parents for a while.

I know my friend very well, so I held back a bit and counted to 10.

She has a very nice mountain bike, I noted. And a nice, though used, car. Every other year, sometimes every year, she takes continuing education classes Hawaii or Costa Rica. How can she fit those in but not insurance?

My friend and colleague thought about that one for a while. Her time to count to 10.

She told me she works really hard and has to have some reward for her efforts. The physical and mental health benefits of those activities outweigh paying for insurance, something she may never use. Thinking about it stresses her out.

I asked my friend not to resent the questions I was asking. It was just my way of identifying priorities. I do that sometimes with clients who need massage but are too busy for massage. Or with clients who need to stretch but are too busy to stretch.

I ask if they manage to get their hair done, get the car washed, or take a shower every day. Do those “get in the way” of doing other things or are they necessary?

We all have priorities, even I, who would rather go get a massage than organize the taxes box and put it in storage that day. Or fold sheets. Or make out a will. Or a few thousand other things I designate optional, like a mountain bike trail ride.

We made a deal. She is going to look into her insurance options with her association or Obamacare. I’m going with her (wrists and elbows wrapped, or course) on a trail ride.

by Sue Peterson

Leave a reply

What We Massage Therapists Know…

Recently in looking for an associate to assist in my practice, I interviewed a bunch of massage therapists with ample experience. I thought I would offer a good step-up to private practice to people who wanted to move in that direction. I looked for experience because I wanted people who understood the economics and challenges of massage practice. The resumes were pretty interesting.

One resume listed athletes the person had massaged. That’s it.

I did ask for credentials. People told me they were licensed in my state. We don’t have a state license.

Or they could get it if required, along with insurance. Tell me, how had they worked in the field thus far without the basics?

As I weeded through the applicants, I tried interviewing a few by phone. One hung up when I explained that I would pay minimum wage//click//plus piece-work for massages performed.

I was getting a little bummed out. Then I found someone who I thought was great in person, on the phone and in resume. There was only one problem. She did not want to work on any of the days/shifts I could make available. Turns out she was burned out on her spa job and did not want to take on any more massage time.

Why was she answering my ad, I thought.

Sigh.

Back to the drawing board.

8 Replies

Tidy Time

With each year end, I like to do two things: tidy up the loose ends of my massage therapy practice and set my sights on the coming year.

Tidy time is important in the visceral sense: make sure my tax stuff and books are at least all in one box, if not organized, all set for the tax man. I also like to get some statistics: How many massages have I done, daily and weekly averages, etc.

An important part of this look-back is to check and see when I have been feeling good or overworked. I can often see some times when I should have done a little less or spread my duties out more.

Gone are the days when I could work straight through an 8-hour spa shift and then see two private clients after hours. I don’t miss that a bit. But when I was foolish enough to have done those things, I learned, as I laid prostrate on my bed the next day, not to do so much in one day. Days off are no fun if they are spent flat out zombie-fied.

Days off for a massage therapist are for stretching, tai-chi, family, errands, the beach, all the things that days off are for. I learned not to work so much that I felt drained.

Another lesson is to not drown in paperwork. If, like my therapist friend, you use a bookkeeping program, you still have to plunk the numbers in. Amazing how many other things you can find to do before doing the books. To save myself some angst, I found a good bookkeeper.

Outsourcing is great for the things you do not want to do. For me, it is the bookkeeping. For others, it might be the laundry. The key is figuring out what you do not want to do, or what you are truly bad at doing, and if you are willing to pay for it.

In hindsight, “outsourcing” is what many of us do when we work for employers. We take a pay cut because we don’t want to book clients, make re-appointments, keep track of permits, negotiate leases. There is nothing wrong in that, by the way. Some therapists enjoy being able to leave work at their appointed time and not keep a to-do list. A lot of us have to pick up kids, make dinner and a host of other things for family.

When I’ve looked back at my year, I then look forward. More about that next blog.

1 Reply

Care and Greeting of Clients

What are you doing?

My therapist friend said that phrase in a tone of voice that implied I was sculpting a stone wheel from a boulder.

I’m writing holiday cards to my clients, I replied.

Ohh, no, no, no you will get carpal! she said. Let me show you my toys.

Out whipped the tablet. With its apps. This one sends appointment reminders automatically, along with holiday greetings and birthday offers. Au-to-ma-tic, she said, as if it were a word I have never heard before.

Yup, that’s me sitting there with my stones knives and bear clubs, sending out cards to people whom I have been seeing for massages for so long they are like family. But no, I am modern. My stamps are self-sticking.

I swear it is not age. We are about the same age, my massage therapist friend and I, and we have come up through the ranks into developing our own independent practices.

And I still have an appointment book and pencil. And I send holiday cards. Handwritten.

As my software engineer client told me one day, those apps. are great. Until all your data gets stuck somewhere in the cloud.

Bah Humbug!

Leave a reply

Adding New Skills

One of my massage therapist friends had a good bit of extra time on her hands when she first started her practice, so she picked up a Spanish book and taught herself to speak it.

My therapist friend has not used her knowledge of Spanish much in her day spa, but it has come in handy many times when out and about in Southern California, where the number of people more comfortable speaking Spanish than English is fairly significant. Learning another language was a good brain stretch for her.

Spanish is also good to know in a therapeutic setting, especially in medical massage, with many staff therapy aide jobs preferring bilingual.

Thus I had been thinking a bit about trying to learn at least survival Spanish, the kind that can help you find a fire exit or a bathroom. At the hotels where my day spas were located, most of the staff was more comfortable speaking Spanish.

I often sat at the large round table in the cafeteria where the house-workers had lunch, trying to follow as much as I could of the conversation, which went on at about 450 miles per hour. I picked up a few verbs and phrases with a little coaching, and felt a little more confidence in my language abilities.

My motivation was something else as well. During the height of the recession, I decided to limit the amount of time I spent banging my head against the wall trying to book clients. I needed something to stretch my brain, too.

If you have ever watched TV there are about 500 commercials on about 500 channels for a language immersion course on computer. I didn’t do that. I picked instead some cd’s that I could play to and from work in the car. Old-fashioned, yup, that’s me.

Months into my cd experience, I decided to try my Spanish out at the local Mexican restaurant. My mother-in-law orders in perfect New-Mexico Spanish all the time. I thought I would try my luck. The staff at Bahia’s is famously bilingual, slipping from English to Spanish and back to English with ease.

I carefully ordered what I thought would get me a combo with a little cerveza.

Our server looked at me in complete surprise.

Aha! She can tell I am speaking excellent Spanish, I thought.

After a pause, she leaned over the table and looked me right in the eye.

“WHAT?”

My mother-in-law explained, in Spanish, that I was trying to speak Spanish. We all had a good laugh. Me, my folks, the people in the next booth, the entire wait staff and the lady seating customers.

Despite much urging, I declined to repeat my order and pointed at the menu.

Leave a reply