Inquiring Minds Want to Know

I’ve spent the past couple of weekends teaching at AMTA meetings; first in SC and this past week in Alaska. One of the classes I taught at both meetings was “Using Research to Market Your Massage Therapy Practice.” I’ve been on my research soapbox for a while now. The big question is, “Who gives a flip about research?” My answer to that is, inquiring minds want to know.

Except when they don’t want to know. Consider this: IF research validates an idea, a theory, or a belief you’ve had, doesn’t that make you happy? Don’t you want to give a thumbs-up and shout “Yes! I knew it all the time!” That would make anyone feel good, wouldn’t it?

So when research shows something that’s contrary to what we believe, we don’t like that. We don’t want to accept it. We don’t want to listen to it. We want to act as if it doesn’t exist, or that it applies to everyone except us.

I’ve been surfing PubMed this afternoon and reading interesting studies. I don’t have any research to back it up, but my educated guess is that maybe, just maybe, 20% of massage therapists actually read research studies…or even know what the difference is in a peer-reviewed study performed within the parameters of scientifically accepted procedures, as opposed to website hype making all kinds of unfounded claims.

I’ve also been on a roll lately looking at some of the more dubious products that are out there that massage therapists buy into, and foist upon the uninformed public. Some of my favorite (NOT!) claims are: Causes detoxification. Regulates the endocrine system. Flushes your lymphatic system. Gets rid of cellulite once and for all. Causes you to lose weight without making any effort. Contains negative ions. Balances your chakras while simultaneously regenerating your brain cells and your liver and revitalizing your sex drive. Makes your body totally alkaline. Connects more strands of your DNA…I could go on all day, but you get the picture.

Most people, if they’re going to buy a new car, do a little research…they want to know the gas mileage, the safety rating, the bells and whistles they get for the money they’re paying. And they wouldn’t buy a house without checking out the foundation and whether or not there’s mold in the basement. But the same people will buy some whacky, over-priced gizmo that doesn’t have any basis in reality and couldn’t possibly do all, if any, of what it claims to do, without doing any research at all, other than reading the hype that appears on the website or listening to the sales pitch at a multi-level marketing meeting.

The sad thing is, I don’t think most of these people are just seeing the dollar signs and thinking about how much money they can bilk clients out of. They just fall into believing these things actually work.

The Code of Ethics states that we are to avoid giving treatment when there is no benefit to the client and the only benefit is our own financial gain. It would serve everyone to think about that the next time they’re tempted to spend money on frivolous products with no proven benefits. If YOU want to lay out the big bucks for something and use it on YOURSELF, that’s one thing, but when you make claims to clients that this (machine, product, supplement, etc) is going to change their life, cure their disease, get rid of their pain, or whatever, that’s a clear-cut violation and one that you ought to be aware of. Do the research. Don’t just fall for every word on the company’s website and repeat that to the client like it’s fact. It isn’t.


Most of the time when the media, or Hollywood, casts a light on massage, it seems to be a paraphrase of Rodney Dangerfield’s classic line, “We don’t get no respect.”

The latest hue and cry is over the upcoming new lifetime series, The Client List, in which Jennifer Love Hewitt is a massage therapist/prostitute who is of course just doing it because she needs the money to feed her kids. Last year it was that picture of a race car driver getting a massage from a skimpily dressed massage therapist, and the year before that it was The View. Last Halloween, I got ticked off about a costume that was labeled “Massage Therapist” and included a skimpy lingerie outfit and fishnet stockings. And always, always, the “massage parlor” busts make the news, while the therapists who work their fingers to the bone actually helping people rarely get on tv. While I hate these things as much as the next legitimate massage therapist, I do try to keep it in perspective. The same shelf in the costume store had a skimpy nurse outfit. There are tv shows portraying crooked cops…it doesn’t mean every cop is crooked, but it’s a stereotype that we’ve bought into, and it’s the same with  us. We’ve been trying to separate ourselves from the sex stereotype for many years, and my guess is we’ll have to continue to do so.

Worse to me than the way the media portrays us is the way our lawmakers stereotype us. Legislation is afoot in several places that just serves to hold us back as a profession. HB 2387/SB2249 in Tennessee, which I first reported on several weeks ago, will remove massage therapy from under the division of health-related boards and move it to the jurisdiction of the commerce and insurance division–the division that regulates “trades.” Bottom line, massage therapy would be a “trade,” not a “profession,” and insurance companies don’t pay tradespeople. They pay professional health care workers. That bill was referred to the Government Operations Committee on Jan. 13 and no further action has yet been taken.

A similar situation is happening in Florida with SB 1860. I just finished reading the latest analysis of this bill, which was updated 02/03/2012. Among other things, SB 1860 removes the right of massage therapists to bill for PIP insurance. The analysis states the following:

The Consumer Advocate’s report found rapid growth in the number of procedures billed from 2005 to 2010. The largest increases were found for “Massage, 15 minutes” and “Therapeutic Exercise, 15 minutes” which each increased by approximately 2.6 million units from 2005 to 2010.  Specifically, “Massage, 15 minutes” increased from approximately 1.42 million units in 2005 to approximately 4.05 million units in 2010, while therapeutic exercise increased from approximately 713,000 units in 2005 to 3.36 million units in 2010. These two procedures are now the two most commonly billed procedures in the PIP system.

The Consumer Advocate’s report also presented data on increases in the average charge per claimant by provider. Average charges by massage therapists saw the greatest increase, increasing from $2,887 in 2005 to $4,350 in 2010. The second largest increase was by acupuncturists, whose average charge increased from $2,754 in 2005 to $3,674 in 2010. In contrast, the average charge by an orthopedic surgeon only increased $126 from 2005-2010, billing on average the comparatively smaller figure of $2,810 in 2010. As of 2010, massage therapists and acupuncturists issue the largest average charges of any medical provider that bill within the PIP system.

This bill is really about fraud. Another part of the analysis states that the number of “staged” car accidents in FL doubled in a year’s time. People are milking the system. And while it’s nice to know that their favorite thing to milk it for is massage therapy, that’s really working against us here.

How do we get the respect we deserve? And do we really deserve it? Some of us think we do. Some of us want to advance massage therapy and integrate it into the full realm of mainstream health care. The way to accomplish that is by acting like health care providers, by becoming research literate and supporting the evidence-based practice of massage. It’s just my opinion that is the key to massage therapists earning respect. Others say if we want to be thought of as health care providers we should just become PTs instead. I don’t buy that. I think what we do is good enough to be considered in and of itself.

We can complain to Lifetime TV and The View when the situation arises, but it’s much more important to complain to our legislators. I’ve been preaching this sermon for years, and I’ll continue to preach it until I’m gone. If all the people who holler about stereotypes on television and write letters to Lifetime would write one to their lawmakers and insurance commissions, it would be a great thing.

And now for a shameless solicitation: The Massage Therapy Foundation is working to fund research in the massage therapy profession, to teach research literacy, and to advance the evidence supporting massage therapy as a vital part of health care. For Valentine’s Day, I am asking everyone to show some love and to donate $14 to the Massage Therapy Foundation. You can do that by clicking here.

E-mail Etiquette 101

I’ve had a few meltdowns over e-mail in the past couple of weeks. In spite of my attendance at one of Michael Reynolds‘ brilliant presentations on how to be an e-mail ninja and have a “zero inbox,” I confess I just haven’t gotten there. And I’m wading through a field of spam.

I have a good spam filter on all my email accounts, so basically most of those trashy emails advising you on how to enlarge your anatomy, how to collect the $40 million that the dead person in Nigeria has left you in his will, and offering to sell you cheap prescription drugs get trapped there.

What usually doesn’t get trapped there are all the unsolicited mailing lists and newsletters from massage therapists and other health practitioners who have taken the liberty of adding my name to their list. Most of them are people from Facebook or LinkedIn…they apparently just harvest the e-mail address from everyone they see on their networks, and add them on. That’s not a good thing. In fact, it’s just plain spam.

You have to ASK me in order to be added to any of my mailing lists. My websites have the little click-on feature for that, if you want to be added, but just visiting my websites is not going to cause you to receive any e-mail from me.

I use Constant Contact for my newsletters and group e-mail. I have it set to automatically give people the link to unsubscribe if they wish, and to allow people to share it on their networks, if they desire. It’s $30 per month, but I don’t have to be concerned  about removing people who ask to be removed; it’s done for me. If you are sending group e-mails to anyone, whether it’s from a company like Constant Contact or just through your own e-mail, you should have a simple link for people to unsubscribe. Some companies make it such a hassle, by sending you to a new website to create a new account and answer a couple of captchas, before they will allow you to unsubscribe to something that you never subscribed to to begin with. I think they count on it being such a hassle to unsubscribe that you’ll just choose to stay on the list.

The other thing you don’t have to worry about, when you use such an e-mail service, is failing to use BCC (blind carbon-copy)  for group e-mails. It will be automatically done for you. Some people do not realize–and others do realize it but just don’t care–that when you send more than one person an e-mail and you don’t use the BCC function, everyone it is sent to can see everyone else it is sent to, including their e-mail address. The cc may list the people by name, and not e-mail address, but by right-clicking beside the name, or in some cases hovering over it, you can see the address. That opens a can of worms–spam, not to mention exposure to viruses and worms. The most serious thing about it, for a massage therapist or any other health care provider, is your failure to maintain confidentiality. Some people cling to the idea that massage therapists don’t have to abide by HIPAA rules, but that’s beside the point. You are obligated to abide by the Code of Ethics, and safeguarding client confidentiality is a big deal, in case you haven’t ever noticed that.

According to the dictionary of computer-speak, SPAM stands for “Stupid Person’s Advertisement.”  When people turn on the television or open the newspaper, they expect to see advertising. It’s part of the deal. Does it have to be part of the deal on e-mail, too? Apparently so, judging by the amount of it that’s out there. I dumped my spam filter a moment ago, and in the two weeks since I dumped it last time, I have received 694 pieces of spam…in just one of my several e-mail accounts.

People sometimes use e-mail to inquire about a job opening at my facility. While it’s one thing to use emoticons, techno jargon and computer-speak on your FB page, don’t do that in a professional business e-mail. How does this look: “Dear Mrs. Allen, OMG, I saw your job listing and IMHO, I am the best person for the job 🙂 FWIW, I am a graduate of MMMS….” you get the picture. They’re not getting an interview with me.

I found an interesting website that lists the 32 biggest mistakes in e-mails. There are quite a few on the list that jump out at me. Spell-check, for one. Sending out your newsletter full of typos doesn’t do anything for your professional image. Using all bold and all caps isn’t good, either. Forwarding chain letters is another. People have good intentions, but really, just like some of the stuff people continually repost on FB, I’ve received requests to pray for someone who died a year ago. Why in the world would you send those to a business acquaintance?

In a nutshell, if you’re going to use e-mail to market your practice–and you’re missing the boat if you don’t–go about it in the right way. You want your e-mail marketing to be effective–and ethical.

Here’s the Plan

On any given day on my FB page, there will be massage therapists who are excitedly reporting an increase in their practice, talking about the big day or big week they just had, or some other joyful news related to their business. On any given day, there will also be someone posting that they’re closing up shop because they can’t make it, and taking a job they don’t really want because they have to have money to survive. And let’s be real, folks…none of us want to just survive. We want to thrive, don’t we? Be able to take a vacation, give money to charity, buy a new car when we need one without having a financial meltdown. All those things are hard to do when you’re worried about making the rent.

Nine times out of ten, it isn’t that they’re not a talented massage therapist that leads to their failure. Most of the time, it is a lack of careful planning that leads to the demise. Here’s a reality check:

Almost no business is profitable during the first year. Those folks who work from their home or who only do outcalls may be exceptions, but if you’re operating a massage business out of your own storefront, planning to do so, or  or even as a renter or independent contractor in someone else’s space, there are a lot of things to consider.

I’m going to get the independent contractors out of the way first. You are a self-employed person who performs your services in someone else’s space. You don’t have all the same overhead that a person in their own space does, but you still have certain expenses, and you’re working in someone else’s environment. They may–or may not–be throwing you a lot of business.  If you don’t have all you need or want, and it’s because you’re just sitting there waiting for the owner to do it all for you, you’re missing the boat. You still need to market yourself. That doesn’t mean taking out a big ad in the paper. It means you are actively engaged in trying to increase your client base on a daily basis, by networking, giving out business cards, getting yourself out there by performing community service, introducing yourself to people and telling them about the benefits of massage. Instead of blaming the owner for your lack of business, look at what you could be doing to increase it.

For those who are opening their own business, starting out without a business plan and a budget is a serious mistake. My advice is don’t take the plunge into opening your own business until you know you can survive for a year without a profit. When you initially open your business, you’re going to have a lot of one-time expenses–equipment, office furnishings, security deposits for rent and utilities. If you’re signing a lease, you’re committing yourself to paying rent (or a mortgage payment, if you’re buying.) You need to know what your monthly expenses are before you open the door.You need to include laundry, phone, Internet access, office and cleaning supplies, liability insurance, bank service charges and credit card processing charges, self-employment taxes–and that’s before you’ve spent any money on advertising.

I know that in my office, 52 massages have to take place before I’ve covered the monthly overhead. That’s my break-even point, and you need to figure out what yours is. But you can’t stop there–especially if you’re a single person or if your family is dependent upon a two-income lifestyle.  You also need to figure your break-even point for supporting your household.

Let’s say for argument’s sake your office expenses are 1500. a month. Imagine that at home, you need $500 for rent, $100 for  utilities, $100 for the phone, $200 for a student loan payment, $300 for credit card payments, $300 for groceries…then you’ve got clothing, medical care, insurance if you’re paying for that.  If you’ve got children, I don’t have to tell you how much that costs. So if you need $1500 to run the office, and $2000 to run your household, you need $3500 a month to cover your expenses. If you’re charging $60  for a massage, that means you have to perform 58 massages in a month just to make ends meet. That means you aren’t making a dime of extra money that you could spend on the previously mentioned vacation, charity, and any other extras you might like to have, until you’ve done 58 massages.  And if you’re self-employed and also having to take care of the cleaning, the laundry, the bookkeeping, and all the other things that go with that, be realistic about how much you can do.

You must also have a contingency plan…what if you don’t get those 58 massages during the first month, or the first few months? What if it snows and you miss a week at work, or you get sick and miss a week at work? What if your car needs an expensive repair, like mine did last week? Can you still meet your obligations?

In any business, and in service businesses in particular, the biggest mistake people make is sitting around waiting for business to come to them. Unless you own a funeral home, that’s a bad idea. Word of mouth is of course the cheapest and best form of advertising, but you have to get those people in the door first. And the chances are you don’t have a big advertising budget, so what are you going to do? These are just a few of the things I’ve done to increase my own business, and it has worked well for me.

I spend 30 minutes every morning on marketing activities intended to increase my business. That could mean working up a new ad, writing the client newsletter, calling clients I haven’t seen in here lately, sending out a welcome postcard to a new one, or any number of things, as long as it is something that will help spread the word about my business.

I am very active in our Chamber of Commerce (in fact, at this point in time, I am on their Board of Directors, but that’s a very recent development.) I’ve been active in it since the first week I opened my business. I attend as many networking functions, grand openings of other people’s businesses, open houses, etc. Why pay to belong to the Chamber if you’re not going to take advantage of all they have to offer? If you’re joining just to get a certificate on the wall that says you belong, then save your money.

I give a business card to two new people every day. You’re out somewhere every day where you have the opportunity to meet new people, or where you see someone you may already know–at school, church, the grocery store, the doctor’s office. Strike up a conversation with someone and give them a card. It takes three minutes.

Track your clients. Create a simple form on your computer listing the places you are advertising, plus referrals from doctors and clients, and ask each client, “Where did you hear about us?”  Write that down. If  a month or two has gone by and not one person says they’ve come in because of the ads you’ve been running in the Woman’s Weekly, it’s time to spend that money elsewhere.

Before you spend money on an ad, think about the potential return on investment. If you spend 100. to advertise in a regional magazine that goes to 5000 people, when you could spend that same 100. to place an ad in the local newspaper that reaches 50,000 people, it doesn’t take a rocket scientist to figure out which one you ought to do.

These days, people expect every business to have a website. If you’re using some obscure url for a free site, they’re not going to find you. Spend the money to have a real website, one that is search-engine optimized and user-friendly.

You don’t have to be a financial whiz, or even a marketing whiz, to succeed in a massage practice, but you do need to take a realistic look at what you need to do in order to have a profitable bottom line. So before you start out, take a good hard luck at your budget and your personal financial situation…and don’t depend on opening a business to get you out of some financial mess you might already be in. And once you hang out your shingle, don’t sit on your hands waiting for business. Go out and get it. You can see more of my business tips, along with tips from Irene Diamond, Allissa Haines, Michael Reynolds, Felicia Brown, the Massage Nerd, and many more great educators on the Massage Learning Network.

It Was a Very Good Year

As I look back over 2011, it was a very good year. For the 8th year in a row, since I first opened my business, I am going to finish the year with a growth in sales and in my bottom line. That’s rather miraculous, considering the unemployment rate in my county has been between 14-16% for most of the year. Many businesses have closed. The foreclosure notices in the paper have far outweighed the job listings for the past couple of years. And still, we have thrived, and we had zero staff turnover. I’m very grateful to be blessed with such wonderful staff members and clients.

This year started out with a bang when we made a trip to Miami to participate in the Massage School Makeover organized by Angie Patrick of Massage Warehouse. What started as a little project of Angie’s snowballed into one of the most magnanimous displays of generosity throughout the massage world. The Educating Hands school ended up with over $80,000 worth of equipment and supplies donated by industry partners. As they were moving into a brand-new building at the time, it was just a fresh start for their well-respected school. It was a joy to participate in it and to see so many of my friends from the profession at the festivities. I also got to visit my youngest brother on that trip, and got to see a dear friend who used to live here in NC that I  hadn’t seen for several years. That one was bittersweet since her husband, who was also a friend and former business partner with Champ, had passed away suddenly a few months before, but it was a wonderful visit.

I was honored at the American Massage Conference this year as the Massage Therapist of the Year…and that wasn’t even the highlight of the conference. Getting up to play a few tunes with Errol N Schroeder at the dinner dance was the high point for me. I had a blast! Scott Dartnall and the rest of those Canadians came out of the gate running and made their first American event a resounding success.

Then the World Massage Festival came along and I was inducted into the Massage Therapy Hall of Fame, which I appreciated, but I was also awarded there for Government Relations, which I’d have to say meant even more to me. I’m no Sally Hacking–whom I greatly admire and who has been working in GR for several decades–I’m not able to go all over the country attending legislative sessions and even if I could, I certainly lack her expertise and experience; the award was for my efforts to keep the masses informed of what’s going on through my blog and social media. My politics aren’t popular with everyone, and that’s okay. I feel good about it if I am able to jolt even one person out of complacency to take up the fight against detrimental legislation. I got to play some music at that one, too. The Hinkles are just some of the nicest people in massage and I always enjoy the World Massage Festival, which I refer to as the Woodstock of massage. Leave your coat and tie at home, and just come and have a great time! The 2012 event will be in Las Vegas.

My annual trip to Ireland was one of the high points of the year. It always is. I enjoy teaching the students at the Obus School of Healing Therapies, hanging out with my Irish friends, visiting a few pubs 🙂 and in general, just breathing the Irish air.

I traveled a lot this year. I was invited by the NCBTMB to come to Chicago for a meeting with a lot of industry leaders to offer input on how they can improve the Approved Provider program. I in particular appreciated that meeting, because that’s where the seed was planted for the Massage Therapy Profession Leadership Summit that took place a few months ago, where for the first time, all of our national leaders came together for the common good. It was attended by the executive management and board chairs from the AFMTE, FSMTB, AMTA, ABMP, COMTA, NCBTMB, and the MTF. Speaking of the Massage Therapy Foundation, it was another red-letter day for me to be included on Rise and Shine, a CD of wonderful music donated by massage therapists to raise money for the Foundation. If you don’t have your copy yet, get on the ball! I am very honored to be in the company of such great musicians. It is truly a great compilation.

The Alliance for Massage Therapy Education meeting in Charleston was one of the best events I’ve ever attended. The annual national convention of AMTA in Portland was probably the best one I’ve ever attended, and I’ve been going to those for quite a few years. Kudos to the Oregon Chapter and to President Glenath Moyle for putting on a heck of a good time in such a lovely city. I also got to make my first trip to New Orleans on behalf of the North Carolina Board of Massage & Bodywork Therapy, and it was a blast. I completed five years of service to that board this year, and while I miss the wonderful staff and friends I made at the board, I don’t miss that five-hour haul to Raleigh or having to participate in disciplinary hearings. I got to make my first trip to Los Angeles to attend the Federation of State Massage Therapy Boards meeting, which was as usual, informative and a good time visiting with so many other board members from across the country.

Without dragging out my calendar, I can’t recall every place I got to teach in this year, but they were all fun and filled with beautiful people. One of the high points–literally–was the Take it to the Top Summit put on by Vivian Madison-Mahoney over in Gatlinburg, TN. The hotel was at the top of a mountain, we were on the 14th floor, and the view was just beautiful. That was one of the best education conferences ever, and Vivian and her husband John certainly know how to throw a great event. A lot of my buds were there–Lynda Solien-Wolfe, Michael McGillicuddy, Irene Diamond,  Mike Hinkle and his wife Cindy and a lot more, and a good time was just had by all. I got to play some music at that one, too. Vivian loaned me her limited edition Martin for the occasion since I came without a guitar. It was great.

I made my first site visit as a peer reviewer for COMTA a couple of months ago. I went to New Bedford, MA to review a community college massage program. It was a good learning experience for me, and the other reviewers were great companions. We had a good time. Our hotel was across from the harbor and a good seafood restaurant, so it was a good time.

I had some great classes at the office this year. Marjorie Brook came down from NY to teach a Scar Tissue Release seminar, and she was accompanied by my friend Allissa Haines. We had a good time visiting with them. Christine Courtney and her husband Colum came over from Ireland for Christine’s classes in Indian Head Massage and Traditional Chinese Medicine, and we always look forward to their visit as well.

On a personal level, lest I just sound like an effervescent fool who never has a bad moment, we’ve had some. My husband’s best friend Brent Stephens passed away this year…he was suffering, so it was a blessing for him to go, but it was still a great loss to both of us. Another dear friend died suddenly this year. Donna Metcalf was the picture of health when I saw her last, and three weeks later, she was gone…an unfortunate case of going to the hospital for a simple procedure that went very wrong. Donna was a force of nature, one of those women who dressed in sparkly clothes and a feather boa, and just lit up every room she ever entered. Her death was a shock. It was also a reinforcement that you ought to live every day like it’s your last. It just might be.

I’ve had some family trauma and drama this year…hasn’t everybody? But I’m pleased to say it seems to be on the upswing. My constant prayer is that those family members who need to forgive each other will just get on with it. One year at Christmas when there were some family divisions, my husband said “Well, we could have two dinners.” He was referring to the people who weren’t speaking to each other and the “I won’t be there if they’ll be there” situation, and my reply was “Hell no, we will not have two dinners. They can sit down and break bread with each other or they can go to McDonald’s.” My fond hope is that they’ll all come to the table. The people we resent feel good. Carrying around resentment is, as someone said, like drinking poison and waiting for the other person to die. It isn’t hurting anyone except the person carrying it around.

One of the last great things to happen this year was my husband Champ passing the MBLEx. He is currently waiting for his North Carolina massage license to arrive. Champ is a builder by trade, and the economy here has been a sudden death to his business. There are so many foreclosed properties here, no one needs to build anything. You can buy a house that was on the market three years ago for a million bucks for less than $200,000. You can buy a perfectly livable house for less than $30,000. In fact, if you only need a small one with one or two bedrooms,  you can find some for less than $20,000. Still, I feel optimistic that things are looking up. Facebook has recently built a new data center in our town, and a couple of other manufacturing businesses have come in on their coattails. Hopefully, the economy is going to turn around and the residents in my county will see their circumstances improve. I certainly hope so.

Another great thing this year was what I have been referring to as The Grand Purge. I have been on a mission the past couple of months to clean out my house and my office. I keep watching the old video clip on youtube of George Carlin and his rant about “Stuff.” I have too much Stuff. Or rather, I had too much Stuff. A lot of it is gone…I’ve donated things, sold things, thrown out some things, burned some things…I’m getting rid of my Stuff. Stuff is like an albatross around your neck. My attitude is if I haven’t used it in a year, I’m not going to use it in another year.  I figured if I was going to move, and wouldn’t want to take it with me, then I don’t really need it. So goodbye, Stuff. It’s been very liberating.

I’ll remember this year. A lot of good things happened. A few bad things happened. That’s the way life goes. But all in all, it was a very good year.

Problem Solving in Your Practice

Every day, I get emails and calls from therapists who want some advice on problems in their practice. I usually can’t give an answer off the top of my head without questioning the therapist for further details, and visiting their website if they have one (and by the way, not having one is a problem in itself.) Even though two therapists may be  having the same problem, there are a lot of factors that are different from one practice to another, that potentially have a bearing on my answer.

The most common things people contact me about are clients who don’t rebook, and not having enough business in general. They will give me a list, of “I’m doing this, this, this, and this, and I’m still not making it.”

Let’s look at the first problem: Clients aren’t rebooking. There are a lot of reasons why clients don’t rebook. The biggest one is probably that the therapist doesn’t ask! Besides “Thank you,” the most important phrase for your business is “When would you like to schedule another appointment?” When I was a brand-new therapist, I was worried about appearing too pushy if I asked a client to rebook. Get over that immediately, and ask every one at every appointment.

If you are asking every client to rebook, and either they aren’t doing it at all, or it’s a very low percentage, I’d look closer into that problem by taking a searching and fearless inventory. Perhaps your technique–or your level of expertise–is just not what they were looking for. Not every person who gets a license to do massage is a great massage therapist. In my traveling around and getting massage in different places, I’ve had massage that’s mediocre, and unfortunately had some that was downright bad….then again, massage is a subjective experience. The massage that I thought was unskilled and sloppy might suit another person just fine. So how do you know?

There are some indicators. If the majority of people come out from the massage praising you to the high heavens, that’s an indicator. And if they don’t, that’s an indicator. If many of the people you’ve seen have referred someone else to you, that’s an indicator. And if they haven’t, that’s also an indicator.  Judging by comments I hear from successful therapists, most have a rebooking rate of anywhere from 50-100% (yes, some folks do have a practice that has evolved only to regular clients and standing appointments.) If your own rate is extremely low–say 20% or even less, that could be an indicator–maybe not of your skill in performing massage, but of something else.

The biggest complaint I hear from consumers is about therapists who talk all the time. Many people just want to get on the table and relax, not have a conversation with the therapist or just listen to the therapist rattle on. I’ve also heard complaints about people who had offices that were less than clean and cluttered with junk. And therapists who impose energy work or other non-massage practices on people who don’t want it…I had a client tell me that a therapist she saw walked around the table chanting before commencing the massage. And I  hear about therapists who are dressed so sloppily they could be mistaken for a homeless person. If any of that applies to you, you might want to take some corrective measures.

One mistake I often see with practitioners in general is so simple it jumps out at me–but it isn’t occurring to them, and that’s the name of their business. What does the name of your business convey about what you do? Does it convey what you do at all, or is it something that the public would see and say “Mmm, wonder what kind of business that is?”  I don’t want to pick on anyone here or insult any of the hundreds of MTs who are in my social networks by inadvertently choosing their name as an example, so I’ll just say I’ve seen some business names that had absolutely nothing to do with massage; the potential client who hears the name isn’t going to automatically associate it with massage, unless that is spelled out as part of the name.

I’m not picking on therapists who incorporate energy work–when that is what the client wants–but I will say this: are you trying to be known as a massage therapist or not? The other day I looked over the website of a struggling therapist, and the first thing I noticed was that Reiki was in the top spot on the menu of services. Massage was listed below the energy modalities on the list. If you’re trying to build your reputation as an energy practitioner instead of a massage therapist, that’s going to work for you. If you’re not, it isn’t. There are a certain amount of people who will immediately decide you aren’t the therapist for them and not read any further. This is also a problem with practitioners who do a modality that the general public isn’t really educated about. For example, if your business identity is Mary Jones, Craniosacral Practitioner, you are apt to attract the limited clientele that already knows what craniosacral is. If that’s what’s on your signage and your advertisement, you are not getting a message to people who are seeking a massage therapist. That’s fine–if craniosacral is all you want to do and you don’t care about attracting new clients.

I’ve heard a few other complaints from the public…like therapists who smell like smoke. Therapists who smell like garlic. Therapists wearing perfume. Sheets and face cradle covers that smell of old oil. Cats and dogs in the office. Therapists who ask nosy personal questions that don’t have anything to do with the massage. Therapists who try to pressure sell retail items or sign up clients for MLM companies. Therapists who go outside their scope of practice and give diet and nutritional advice, or psychological advice, when they have no qualifications to do so. The list goes on.

If you take your searching and fearless inventory, and you aren’t guilty of any of these offenses, then consider a few other possibilities. Did you do a market survey before opening your business? Did you ascertain how much competition is in the immediate area? Did you choose to open your business in an environment that’s already saturated? Are you charging a lot more–or a lot less– than your nearest competitors? Is there a parking problem? Are you in an upstairs office with no elevator? Is your entire office handicapped accessible? Do you keep regular hours, and are they plainly posted?

Simple mistakes are sometimes at fault. Like using your cell phone for business and answering with a “Hey, what’s up. Leave a number and I’ll call you back.” That should be “You’ve reached Laura Allen, massage therapist. Please leave your name and number and I’ll call you back within an hour,” or whatever is the shortest time frame you can offer.

The biggest mistake therapists make is sitting around the office waiting for business to come to them. You have to go out and get it. A lot of free business and marketing advice from myself and other experts in the field is available on If you’re struggling, don’t give up on yourself just yet. There’s a solution to every problem–and identifying that there’s a problem is the first step in solving it.

“Ownership” of Clients

If you’re an employer of massage therapists, or you are a massage therapist who’s is employed by someone else, who “owns” the client? The short answer is, no one. People have the right to go where they choose, and to patronize whatever massage therapist they choose to patronize. The long answer is a little more complicated.

A friend of mine who employs other therapists in her practice was upset last week when an employee gave clients a reminder call from her own cell phone on her day off, instead of calling them from the office. The issues there were ownership of the client’s information and a concern about HIPAA violations…and two clients actually called the office to ask why they were being called from the therapist’s cell phone, since previous calls had always come from her office.  She not only fired the employee, she also went to the police about data theft and filed an ethics complaint with the NCBTMB. The business is in an unregulated state, or she would have filed an ethics complaint with the state board, as well. She had plainly stated in her policies and procedures manual that taking the phone numbers and or other information of clients was prohibited, and discusses that fact with each new person she hires. The therapist had done more than just take the phone numbers; she had also downloaded all the treatment notes, etc–including those sessions performed by someone else that she was not involved in. The owner was perfectly within her rights to fire the employee and take the other actions, based on that policy.

I run things differently in my office. Nearly all of the half-dozen therapists who work at my clinic as independent contractors have the phone numbers of their regular clients in their cell phones (remember, my friend’s staff members are employees). It’s our procedure to ask clients if they would like a reminder call or a text message, and it’s my own desire for the therapists to make those calls personally instead of depending on me to do it. I’m the office manager and chief bottle-washer at my place of business, and in addition to the therapists, I also have an acupuncturist, a chiropractor, a clinical herbalist, and an aesthetic nurse there. I make the reminder calls for the chiropractor. I expect everyone else to make their own.

Some people would say that I am making it easy for them to steal clients, in the event they were to leave my practice and go elsewhere. That’s true, but I choose not to look at it that way.  First and foremost, my staff is what has made my business successful. I’m just the ringleader. Everyone there genuinely likes, supports, and refers to each other; it’s a family atmosphere. Staff turnover has happened so rarely that in 8.5 years of owning my business, I can count on one hand the number of people who have ever left. The few times it has happened, I can only think of one of those occasions when a few clients left my business to follow the departed therapist. I don’t begrudge them. They were attached to their therapist, and that’s okay. On the few occasions someone has left, I willingly gave their contact information to clients who called after their departure, if the client didn’t want to see someone else. It wouldn’t endear me any to the public if I was nasty about it. One of my former staff members opened her business less than a mile away from mine. I’ve given her number to quite a few people. It hasn’t hurt my business.

Some employers in our profession require their staff members to sign non-compete agreements, which usually state something along the lines that the person will not practice massage for X period of time within X miles of proximity. Here’s the reality: non-competes aren’t worth the paper they’re written on, according to Dale Atkinson, the Executive Director of the Federation of Associations and Regulatory Boards, who also happens to be the attorney for the Federation of State Massage Therapy Boards. Atkinson says if you are the VP at Massage Envy, privy to proprietary company secrets, in that case a non-compete could stick, but as far as a massage therapist in the average privately-owned business, it is nothing more than an attempt to restrict free enterprise, and will never hold up in court. Of course, an owner with sour grapes can press the issue and cost the therapist time and money in fighting it, but ultimately, the chances of it being enforced are slim to none.

Client information is actually the property of the client. If any client walks in the door and asks for their file to take to their new therapist, you’re obligated to hand it over. You may (and should) keep a copy for yourself, since most state boards have a requirement about what length of time you’re obligated to keep records. You can charge them a copying fee, if you’re so inclined.

My friend was being rightly cautious about HIPAA violations. Since the guilty therapist downloaded client information onto her smart phone, if she were to lose her phone and anyone finding it could access client information, that wouldn’t be a good thing. The burden is on the owner of any business to safeguard client information. Unfortunately, HIPAA has not quite caught up to technology, and some of their wording in regards to the protection of and responsibility for electronic data is vaguely worded. The police department was actually having a hard time deciding what article they could charge the therapist under, because it isn’t very clear on the HIPAA website.  They have a statement on their site that they are “still developing rules.”

When you have been employed somewhere, and you take a different job or go out on your own, it is perfectly legal to take out some advertisements in the paper that say “Laura Allen, Massage Therapist, formerly of THERA-SSAGE, has opened her own practice at Wellness Way in Oxford.”  In fact, it’s a press release, if you send one in to the business editor.

The bottom line is, there are different strokes for different folks. If you are an employer, you have the right to set your own rules. One caveat–it is not enough for you to just tell people on the day you hire them what all your policies are. You need to have a manual, and/or an employment/IC contract, that spells out your policies and procedures in clear terms. And if you’re out there seeking a job, or you already have one, you are obligated to abide by the policies your employer has set forth. If you want to do your own thing, then open your own business. When you agree to go to work for someone else, you agree to abide by their rules, and that includes not stealing client information. It can cost you a lawsuit, and might cost you your license as well, if an employer files an ethics complaint against you.

Rick Rosen: A Job Well Done

Rick Rosen, MA, LMBT, Founder and Executive Director of the Alliance for Massage Therapy Education, announced last week that he will be stepping down from that position effective November 30.

In his letter to Alliance members, Rosen stated that he is returning to his full-time duties at the Body Therapy Institute in Siler City, NC. He founded the school in 1983 and has co-owned and co-directed it with his wife, Carey Smith, for the past 20 years. Their beautiful school and 150-acre property is for sale, and they intend to move permanently to their new abode on the Big Island of Hawaii whenever it’s sold.

Rosen has been a massage therapist since 1978. There are very few people in this profession who could claim anywhere near the amount of hours he has spent volunteering his time, and working for the evolution of massage therapy – both on the legislative and educational fronts.

I first met Rosen in 2000 when he was a founding member and the first chair of the North Carolina Board of Massage & Bodywork Therapy, a position he held from 1999-2003. He was very instrumental in getting massage regulated in our state and in assisting the Board’s legal counsel in drafting the administrative rules and statutes. As a former Board member myself (2006-2011), I appreciate fully the countless hours of unpaid work, and imagine that to be so much more for a start-up Board.

Rosen has always had a fondness for getting in on the ground floor and helping to lay the foundation for the future success of organizations. He also served as the first Executive Director of the Federation of State Massage Therapy Boards (2005-2006), and wrote the Request for Proposal that led to the development of the MBLEx as the licensing exam of choice.

In 2009, Rosen hand-picked some seasoned educators to help launch the Alliance for Massage Therapy Education. Under his leadership, the AFMTE has made its mark as the stakeholder for education among the professional organizations. Recently, the ACCAHC Board of Directors invited the Alliance to join its Council of Colleges and Schools as the designated education representative for the massage therapy field, further solidifying the Alliance’s role. Not bad for an organization only two years old.

Rosen’s school was the first to offer professional training for massage therapists in the Carolinas, and the first to offer post-graduate training. BTI was also the first school in the Carolinas to receive accreditation from the Commission on Massage Therapy Accreditation. He has presented massage education all over the country and in West Africa. He has been a professional member of AMTA since 1983, helped form the AMTA-NC Chapter, and was Chapter President from 1985-1987. He has authored a number of white papers, and was a contributing author to TEACHING MASSAGE: Fundamental Principles in Adult Education for Massage Program Instructors, published in 2008 by Lippincott Williams & Wilkins.

Rosen’s pioneering contributions to this field over the past three decades have been many, and often unsung. In fact, I contacted him and requested a copy of his resume before I wrote this – and I could write a book about all the things he’s done in the arenas of bodywork, education and government relations that I had no idea about.

I gave a list of “kudos” and “thumps on the head” in a recent blog, and I had included a kudo to Rosen for starting the AFMTE. I’ll repeat that here, along with an additional word of thanks for all he has contributed to the massage therapy profession. It’s been a job well done.

Rosen shared with me that he is leaving the door open to future teaching, writing and consulting projects that can continue to advance the field. I’m curious to see what he gets into next!

The Forgotten Flier

Do you use fliers to advertise your business? In this age of Internet marketing, you’re probably overlooking the humble flyer as a way to get the word out. Don’t count it out!

Fliers are cheap and easy to produce. You can make them yourself using Word, Publisher, or many other programs. You don’t have to be an artist to make a professional looking-flyer. Follow a few simple rules and you’ll come up with the perfect one for your business.

First, you want the flyer to attract attention. Bright neon paper will get more attention than a piece of white paper. Bold type that’s large enough for people to read easily is a necessity. A picture or graphic is nice, and it needs to convey the message. This is about massage, so don’t put a picture of a flower or a yin/yang sign–put a massage-related picture. Don’t use your own logo as the main picture unless it truly conveys that this is about massage. I’ve seen thousands of logos that without the wording, people wouldn’t have a clue that it was anything massage-related.

You want the message to be short and sweet: who you are, what you do, and where you’re located. Leave plenty of white space; in other words, don’t try to pack so much on it that it ends up looking like an overload of information. You want it to be easy to read. Have the headline be a call to action–not the name of your business. Something catchy like “Don’t Put up With Pain!” or “Get Rid of  Holiday Stress!” Your contact information should go at the bottom of the page. Most people are carrying around cell phones and can easily enter your number, or you can also put your name and number on pre-cut tear-offs on the bottom of the page. Don’t forget to use the spell checker.

Now that you’ve got the flier, arm yourself with a box of pushpins. Keep them in a manila envelope in your car. Anywhere you go you see a bulletin board, put up a flier. They’re free, so why not make use of them? It’s a no-brainer.

Is there a university or community college in your town? There’s usually a bulletin board in every hallway. The Chamber of Commerce, the Small Business Administration, community halls, your church, grocery and convenience stores, the library, the health food store–there’s just no end to the places where bulletin boards exist. Visit local schools and ask the receptionist to put one on the bulletin board in the teacher’s lounge–maybe offering a first-time discount or an extra 15 minutes with their first session. Avoid mentioning any short-term sales or discounts that have an expiration date or you’ll need to go around and change them frequently.Works for me!

Kudos, and a Few Thumps on the Head

The year is winding down; all the award shows have been on television lately, and I’d like to give out a few of my own, along with a thump or two on the head of those who need it. Call me a critic! These are my opinions only and should not be construed as the opinion of anyone else.

Kudos to Rick Rosen for starting the Alliance for Massage Therapy Education, and to the organization for putting on one of the best meetings I’ve ever attended earlier this year, and for taking the initiative to set some standards for teaching massage. If you are involved in massage education and you haven’t joined yet, I suggest you quit procrastinating.

Kudos to the Massage Therapy Foundation for all the work they do in promoting research in the field, and in particular for offering classes in Teaching Research Literacy. And to Ruth Werner for being such a fabulous ambassador for the organization.

Kudos to the executive officers and chairs of the Alliance for Massage Therapy Education, the American Massage Therapy Association, Associated Bodywork & Massage Professionals, the Commission on Massage Therapy Accreditation, the Federation of State Massage Therapy Boards, the Massage Therapy Foundation, and the National Certification Board for Therapeutic Massage & Bodywork for coming together this year at the Leadership Summit, and particular kudos to Bob Benson of ABMP for taking the responsibility for making that happen.

Kudos to Paul Lindamood, former CEO of the NCBTMB, for doing such a great job in putting that organization’s finances back in order. I was very sorry to see him go.

Kudos to AMTA, in particular the Oregon Chapter, and Glenath Moyle, National President, for putting on one of the best conventions in my memory. Kudos also the the thousands of AMTA members who volunteer at their chapters and the national level.

Kudos to ABMP for their generosity in allowing everyone, regardless of what organization they belong to (or none at all) to read Massage & Bodywork Magazine online for free, and for providing the huge forum at, which is also open to everyone.

Kudos to Facebook. Not only are they my favorite place to hang out online, they are also spending millions of dollars building their new data center in my hometown, and providing much-needed employment in a very economically depressed area.

Kudos to Dr. Christopher Moyer, Bodhi Haraldsson, Paul Ingraham, Ravensara Travillian, Alice Sanvito, Rose Chunco, and the other folks out there who keep beating the drum for Evidence-Based Practice of massage.

Kudos to Jan Schwartz, Whitney Lowe, and Judith McDaniel of Education Training and Solutions. They don’t toot their own horn enough about some of the excellent work they have done for the Massage Therapy Foundation, the World Skin Project, and in general advancing excellence in online education.

Kudos to Angie Patrick of Massage Warehouse for her tireless work in the Sanctuary and raising money through massage for the Massage Therapy Foundation, the Liddle Kidz Foundation, and other worthy causes.

Kudos to all the massage therapists in the trenches, who give of their time in performing community service and their income to support deserving populations and those who can’t afford massage. I know hundreds of them so I just can’t list them all here, but every day, someone is out there donating the awesome power of touch in hospices, abused women’s shelters, the VA hospitals, homeless shelters, and hospitals. Bless them all.

Kudos to all those teachers out there who have what I refer to as “a higher calling.” Those who are teaching hospice massage, cancer massage, pediatric massage…There are too many to name, but they are led to work with the sick, the dying, the special-needs. Bless them all, and those they teach.

Kudos to any massage school and/or instructor who is teaching their students to be research literate.

And now, a few thumps on the head. The names have been omitted so as not to put the magazines who publish my blog in danger of a lawsuit, but you know who you are:

A thump on the head to the therapists who say “I’m better than any doctor or chiropractor. I will heal you when they can’t.”

A thump on the head to the therapists who say “I don’t refer out to anybody. No one is as good as I am.”

A thump on the head to the therapists who say to their clients “You really need this  (expensive water filter, nutritional supplements, foot patches, juice by so-and-so) etc that I am selling.”

A thump on the head to the therapists who say “I don’t need continuing education. I already know everything there is to know.”

A thump on the head to the therapists who impose energy work on every client who gets on their table, as if it is some God-given right, when the client hasn’t asked for it, doesn’t want it or believe in it, and it hasn’t been discussed.

A thump on the head to the therapists who are telling their clients that massage is detoxifying them and that they need to drink a lot of water to flush out their toxins.

A thump on the head to the therapists on massage forums who can’t behave and can’t have civil discourse, and instead resort to name-calling and personal attacks.

A thump on the head to the therapists on Facebook who are identifying themselves as MTs and posting pictures of themselves that look like they belong in the centerfold of Hustler.

I could thump all day–and give kudos all day–but I’ll save some for a future blog.