Massage: The Big Picture

I was just cruising through my social media sites, and it has reinforced for me something that I’ve known for quite some time about massage therapists: they’re a caring bunch. That’s not exactly a big surprise; after all, our job is helping people feel better. I’d say a certain amount of caring and compassion is a prerequisite for becoming a massage therapist. We all care about our clients…even when I see posts from people who may not be working in their ideal situation, that’s pretty consistent.

I’ve written over the years about why I think it’s important for massage therapists to care about The Big Picture–to be aware of and involved in what’s going on around them, and I want to expand on that on several fronts. It’s the 4th anniversary of my blog. Humor me, and I’ll tell you why I think it’s important.

I get a lot of “I’m busy running my business. I don’t have time to think about it,” in reply to something I’ve reported about massage regulation and legislation. If you’re in Alabama, why should you care about something happening in Michigan? Here’s the reality check: When something detrimental happens in the regulation of massage, it sets a precedent and makes it easier for it to happen somewhere else. That could be anything from the consistent referencing of our businesses as “massage parlors” in legislative language, something we’ve all wanted to get as far as possible away from, to crazy zoning laws requiring massage businesses to be located in seedy areas zoned for heavy industry, prohibitions on having a massage therapy business located in a shopping mall, or prohibiting massage being performed after 8 pm. Yes, indeed, those are all realities, but if they’re not affecting you personally, people don’t want to think about it. Based on my questioning therapists in the classes I teach, not even 10% have read the entire practice act in their own state. They don’t know the letter of the law even where they’re practicing. That’s a pretty sad state of affairs. I get questions all the time from therapists wanting to know “is it legal for me to do so-and-so?” and while I pride myself on being a fountain of information, it’s all right there on your board’s website. Read it.

Massage is suffering growing pains right now…I think of it as the evolution and revolution of massage. We’re stuck in that place in between being an industry and being a profession. Some don’t care which way it goes. I do. If something affects my right to practice massage, my license, my certification, my teaching of massage therapy, I want to be informed about it, and I want to be in a position to take action on it. I’m a provider of continuing education, approved by the NCBTMB, so I want to keep up with what they’re doing–and any other developments in the realm of teaching CE. At the current time, the Federation of State Massage Therapy Boards is working towards giving their own approval of continuing ed. I’m watching that like a hawk, because a) it could mean I have to fill out an application to get another approval from another entity–or even individual approval from each state I teach in b) it could end  up costing me more money for another approval, although that hasn’t been decided yet and c) if my class isn’t involved directly in public protection, it might not be approved at all. This initiative is still in the planning stages, and it serves me as a provider to stay informed and know what’s going on.

In the same vein of education, I am a member of the Alliance for Massage Therapy Education, and I encourage everyone else who has any involvement in education to join immediately. The Alliance is working on a project to define teaching standards on a national level…to spell out the knowledge, skills, and attributes that one needs to have in order to teach both entry level massage and CE. What if I don’t live up to those standards; will I be cast into the abyss? I don’t want to be clueless about what’s going on. I want to have some input into that project–and if you’re teaching, or aspiring to, you should want the same thing. This is going to happen; not overnight, but it is going to happen. I don’t intend to be the last to know. I’d rather make the effort to be involved in the process. I will never forget the statement made by Jan Schwartz at the last Alliance meeting: “If you’re not at the table, you’re on the menu.” I don’t intend to be chopped liver.

Then we’ve got the massage therapy associations. A lot of people just sign up for membership because they want the insurance, and they don’t care about the leadership, or the government relations, the networking opportunities, or anything else. I personally do care who is running them–and what they’re actually doing. I personally do care what they’re doing on the front of government relations. State boards cannot lobby–that is the domain of AMTA and ABMP–and any special interest group who has the wherewithal to hire a lobbyist–like the chiropractic associations, for example, or PT associations who think we’re encroaching on their territory. And if I think one of my membership associations is doing something that doesn’t protect the rights of massage therapists, or serve the highest good on that front, I am perfectly capable of calling them up and giving them an earful–or taking my membership dollars right out of the coffers. Let me add that my legislators also hear from me, and if I don’t like what they’re doing, I let them know that, and I don’t vote for them the next time.

Related to education, to me anyway, is the state of evidence-based practice of massage and the need for research literacy. I support the Massage Therapy Foundation, and if you have a single dollar to spare, I suggest that you support it, too. Research literacy should be taught in every massage school. I’ll go further and say the teaching of that should be mandated by state boards who license schools. Frankly, any school who is not teaching their students how to be research literate is not worth their salt. That doesn’t mean you have to be a researcher. It means you have to know what constitutes valid research and how to find it…which in turn will lead to throwing out some of the long-standing “myths of massage” that are perpetuated. If you’re still teaching that massage is detoxifying the body and that drinking a lot of water after the massage will flush those toxins out, you’re in dire need of research literacy. I just completed my first peer review and site visit for COMTA, and I am happy to say that the teaching of research literacy is one of their required standards. I have a new appreciation for them after really delving into their standards and it would be a great thing for every school to seek that accreditation. Basically, for a school or massage program, it means “I’m doing more than the state requires me to do in the interest of higher standards.” Amen to that.

I think a major stride was made a couple of months ago when the leaders of the profession all came together for the Massage Therapy Leadership Summit. Ego and personal agendas had to be left at the door. The ABMP, AFMTE, AMTA, COMTA, FSMTB, MTF, and the NCBTMB came together for the first time to discuss common problems. They’ll be doing it again in 2012. This wasn’t a “my organization is better than your organization” meeting. This was about The Big Picture.

So that’s where I’m at right now. I can’t roll along just surviving and only caring about my own clients and my own business. It’s not just about me. It’s not just about you. It’s about The Big Picture and massage therapy on the whole.

The Financial Health of Our Organizations: COMTA

This is my third year of doing an annual report on the financial status of the major non-profit organizations of the massage therapy profession. I am not an accountant or a financial expert. This information was taken directly from FORM 990, the Return of Organization Exempt from Income Tax, which is published on Guidestar.

COMTA is the Commission on Massage Therapy Accreditation. Obtaining accreditation from COMTA is a voluntary and rigorous process that few schools choose to go through; of the hundreds of massage schools and programs in the US, less than 100 have the credential. It is a banner of excellence, requiring that the school do an in-depth self-study and meet high standards meant to insure that they are offering a program and learning environment of the highest caliber.

Non-profits are on a different filing schedule than the rest of us; this form covers the fiscal year of COMTA from 03/01/09 to 02/28/10.

COMTA’s revenue increased by $167,345 over the previous filing. While they still showed a deficit overall of $98,102, it is a vast improvement over last year’s deficit, which was in excess of $277,000.  I guess this does go to show my ignorance on the financial matters of non-profits…COMTA isn’t the only one operating in the red, and you just have to wonder how our non-profits keep on going whenever they’re showing such losses. Presumably, some of that money comes from savings and other assets. COMTA’s assets have dropped by almost $100,000 in the past year, leaving them with net assets of a little over $93,000.

COMTA is a smaller organization than most of the other non-profits, because of the nature of their work. They are not a membership organization and they don’t have a big staff. Their Executive Director doesn’t receive anywhere near the amount of compensation of those in comparable positions in the membership organizations; Kate Ivane Henri Zulaski’s salary, including benefits, is slightly over $57,000. Only one other executive salary was paid, and that amount was a little over $14,000 to former interim director John Goss. COMTA also employs only one staff member. Site visits are carried out by volunteers who get their travel expenses paid and a $100 per diem. It’s great that volunteers will take time away from their offices to do the visits, as most would probably make a good deal more money if they stayed at home and did massage.

This is the second year in a row that COMTA did not receive any grant money from AMTA, and presumably will not be receiving it in the future. The future of COMTA, and their financial stability, is dependent on their ability to bring in income from their accrediting services and their ability to cut expenses to the bone. Their office expenses more than doubled this year; the costs of conference and workshop attendance also increased by almost $14,000. However, I won’t criticize the conference attendance; I think that’s a necessary part of networking and it gives them the opportunity to recruit new schools.

I’d like to see COMTA enjoy a substantial increase in the number of schools and programs they accredit. And of course anytime you’re working to increase business, you’re going to see a subsequent increase in costs. It costs money to recruit through marketing efforts, it costs money to train volunteers, and it costs money to do site visits. It’s a worthy credential that 93 schools and programs currently have. COMTA is the only accrediting body focused on the massage profession. There are others accrediting agencies, but some of them accredit everything from airline pilot schools to lawn mower repair programs. I appreciate the organization being focused on massage education.

The economy has been tough for all non-profits, and COMTA is no exception. Schools and programs that may want the accreditation have probably held off due to the recession. May next year be better for them and for us all.

Disclosure: I have taken the COMTA Peer Review training and will conducting my first site visit at the end of this month.

The Financial Health of Our Organizations: NCBTMB

Author’s note: This is the third year that I have reported on the financial state of the non-profit organizations of the massage therapy profession. The information I use to write these is obtained from www.guidestar.org, which is a clearinghouse of information on non-profits. If a non-profit does not provide their own Form 990 filing to Guidestar, it will be provided by the IRS, providing the organization meets the obligation of public disclosure. I am not an accountant or a financial expert. I merely offer this series as a source of information.

Just like last year, there’s good news, and there’s bad news for the organization. The National Certification Board for Therapeutic Massage & Bodywork could be the poster child for cutting expenses when revenue drops. They have done a bang-up job of tightening the belt without making services suffer….I say that because people complain to me about any of our organizations all the time, and I haven’t gotten many complaints about the service from the NCBTMB in the past year.

The bad news is that revenue has taken another million-dollar hit, almost the same as the decline last year. $800,000 of that can be mainly chalked up to the MBLEx taking away exam revenue. The good news is that in spite of that, the organization managed to get back in the black, nothing short of miraculous since they were $1.9 million in the hole just a year ago. They reported a net revenue of a little over $469,000. The Approved Provider revenue was actually up by almost $100K over last year. Their assets increased by almost $500K, and liabilities decreased by over $200K as well. I’m very happy to see them back in the positive column.

The belt-tightening that went on at the NCBTMB, to me, is also telling of their getting back on track and letting go of the battle with the FSMTB over the MBLEx. Legal expenses dived by $185,000, since they realized the futility of interfering with the states in choice of examinations.

Marketing was scaled back to the tune of over $260K, another sign of improvement to me…instead of wasting money on an agressive anti-MBLEx campaign, their advertising efforts in the past year have focused on their own positives, and that’s a good thing.

Salaries and compensation went down over $300,000.  CEO Paul Lindamood’s compensation was $228K, down slightly from last year. I’d have to say he deserves it for his pivotal role in cutting expenses and focusing on the good points of the NCBTMB instead of continuing down the path of destruction that led to legal and financial woes for the organization. The Board and volunteers are also to be commended. There were 8 less employees reported in 2010 than there were in 2009, and 10 less volunteers.

Bottom line: I applaud the NCBTMB for turning it around. Even though revenue on the whole was down, I will almost take bets that as I get through this series, I’ll find that the same has happened at some of our other organizations. The recession has affected organizations just like it has affected massage schools and individual practitioners. Kudos to the NCBTMB for adapting to the situation.

Milestones

Anytime I reach a milestone, whether it’s one of those birthdays that ends in zero or some other momentous occasion, it causes me to stop and reflect on the things I’ve done. I see what worked and what didn’t….what I coulda, shoulda, woulda done given another chance. And I pat myself on the back for those things that turned out well.

Next Monday is the 8th anniversary of my clinic. In 2003, I had been working for five years in the massage school I attended. I loved my job. I loved the students. The only thing I didn’t love was the pay. I wanted and needed to make more money. An opportunity presented itself when a couple of friends who were MTs asked my husband and I to go into business with them. We moved into a brand-new professional building and set up shop. Two months later, they decided being in business wasn’t for them…their parting words were that they could see our office was never going to support four people making a living. For the past five years or so, it has actually supported at least a dozen.

I’ve had a lot of therapists ask me how I built my business, so here’s my philosophy in a nutshell: The road to success is usually long and winding. There are curves and potholes, and sometimes roadblocks. But as is the case with a real road, whenever you hit a roadblock, you find a suitable detour that still leads to where you want to go. You don’t just quit.

I got another massage therapist to join us. When she got saturated, I got another one, and so on. Today we have six full-time and a part-time Rolfer.

A couple of years into the business, I got an email out of the blue from an acupuncture student in Colorado who had seen my website, was intending to move to this area, and expressed an interest in working with us. She’s been on our staff now since 2005. Around that same time, a friend of mine who is an RN and was nearing retirement expressed to me that she just couldn’t sit around retired and that she’d like a part-time job. She had taken many classes in naturopathy over the years…as her retirement loomed, she upped her class schedule, became trained first in aesthetics and later went to Upledger’s training in manual lymph drainage, and she joined us too.

The second year we were open for business, we hit another milestone when I took over an adjoining suite of offices and turned it into my classroom facility. I had been renting hotel space to hold classes in and really wanted my own space, so I got it. I also gained another treatment room and a nice kitchen and break space for the staff.  I spent a lot of money purchasing tables and chairs, anatomical charts and models, a projector and screen, and all the other things I wanted, which pretty much wiped me out of drawing a good salary that year, but I felt good about it and still do. It’s a nice facility and I’m proud of it.

A few years ago, another milestone occurred when a friend of mine who is a chiropractor and fellow musician dropped into see me. He has a practice in another town about 30 miles away and was passing through and just stopped in to say hello. That discussion ended in him joining us part-time and being able to offer that service, as well. Initially, he worked in the classroom behind hospital screens. But the following year, the universe smiled on me again when the adjoining suite of offices was vacated. The recession was in full force by this time, and the company who moved out had three adjoining suites. I called up the landlord and offered him less rent than he was asking for the suite adjoining mine. He gave it ten minutes consideration and told me I could have it. So the chiropractor got a nice new office, we gained two more treatment rooms plus a big room for couple’s massage, a storage area, and two adjoining rooms for the acupuncturist, who often treats two people at once.

I’m very blessed with the staff I have. They all support each other. They all have different talents and specialties. They don’t act jealous or proprietary with their clients…they refer to each other all the time. They also practice what they preach and hardly any of them go longer than a week or two without getting massage. They trade with each other. The chiropractor trades them all adjustments for massage for himself, his wife, and the secretary in his other office, in addition to referring his clients for massage. The acupuncturist gives them discounted fees and does mutual referrals as well.

As the anniversary comes up, I know that resting on our laurels isn’t the thing to do. I just redid our brochures and raised prices. I am having our website redone. I’ve made some changes in advertising venues. I’ve ordered new shirts for the staff. I am constantly tracking what works and what doesn’t. My main concern is always keeping my staff happy and the doors of communication wide open, because that insures the high level of service that I expect and that keeps our customers coming in the door and referring people to us. I pay more than the average employer around here and that has lead to having zero turnover. It’s worth it to me to give up a little more money out of my pocket in exchange for not having to deal with people coming and going. My staff members are appreciated and they know it, not just monetarily, but in my attitude and management style with them. I couldn’t have built my business without them, and I make sure they know that.

Lest you think I haven’t encountered any of those roadblocks I was talking about earlier, let me assure you that isn’t the case. The partners leaving so suddenly was a shock, but it was the best thing for the growth of the business. I don’t think we would have experienced the same growth if they had stayed; ultimately we didn’t have the same vision. When we first opened the business, my husband was employed by another general contractor and I had been urging him to go out on his own. He did that at about the same time we started THERA-SSAGE, so we went from having two guaranteed incomes to having no guaranteed income, but we were both determined not to fail. We tightened our belts and ate more beans and cornbread instead of going out to dinner and gave up a few new cars and vacations.

His construction business thrived until the recession hit. In one year, he lost about $20,000 worth of income. The past two years, he lost more than $40,000 worth of income. Yes, it affected our finances, not to mention my attitude. He’s busy again now, I’m happy to say. But the point is, the word “failure” isn’t in our vocabulary. We both have a positive attitude and when we make up our mind to keep plugging away, we do it. When we hit a roadblock, we look for a detour. We don’t believe in dead ends.

We’ll soon be hitting another milestone.  My husband is scheduled to take his massage licensing exam a couple of months from now and instead of just keeping up the maintenance at the office and covering the desk when I’m gone, he’ll be able to do massage as well, and he gives a great one. It will serve us as a family unit for him to have a second income when the construction business takes a dive.

Throughout the recession, our clinic has kept on rocking and continued to grow every year. I think when people are stressed out over the economy, they still need and value their massage.

We’re having an open house next Monday to celebrate the anniversary. I’m already looking ahead to the next milestone…I’m not sure yet what that’s going to be, but I already know it will be good. I believe if you expect good things to happen, and you work towards that, it will be so. And if I hit another roadblock, I’ll look for a detour. I don’t give up. I’m not the smartest person, or the smartest business person in the world, but to borrow a quote from George Allen, “People of mediocre ability often succeed because they don’t know when to quit.”

Professional Jealousy: Not Professional at All

Have you ever been a victim of professional jealousy? Even worse, have you been one to perpetuate it? I personally can’t think of any motivation to be so jealous of a fellow massage therapist that I would do something to try and sabotage their business, or repeat rumors or outright untruths about someone in the hope of ruining his/her reputation. And yet, I hear about this every day.

Someone wrote me recently that some current students from the massage school that she had attended had passed along to her that their teacher was holding her out as an example of a terrible massage therapist and business failure–actually calling her name in class. That teacher needs to be fired in my opinion. Even taking into account that there might be any truth in what she was saying, which I didn’t believe, teaching a class full of impressionable students that kind of nasty behavior is just unacceptable.

I experienced something similar at a business meeting recently. Myself and several other people were present at a meeting of local professionals and a new director was presiding over the group for the first time. I had never met the man and he didn’t know a thing about me. I asked him the question if membership had fallen off some due to the recession, and he replied to me, “No, most people left because they hated _____ (the former director).” I was shocked beyond belief and informed him that the former director had never been anything other than nice and helpful to me, and that I had never seen him be less than that to anyone else. Again, bottom line–doesn’t matter if it was true, it was very unprofessional of him to say that in front of the group, especially considering he was brand new and not even acquainted with most of the people there.

A few weeks ago I heard from a massage therapist who had seen a male therapist as a client.  She made it clear that he had absolutely done nothing wrong, but she said she just got a “vibe” off him. I questioned her about the things he had said and any behavior that took place, and nothing at all had happened…but she wanted to know if she could warn other people about him! I repeat, the man hadn’t said or done anything…she was just projecting that he might do something in the future! Why would you try to ruin someone’s career by spreading that kind of tale? After doing a little more investigation, I found that he had a very successful practice that was not far from her office, while she was having trouble getting hers off the ground.

I’ve known of therapists who opened up a business in close proximity to another MT who was already established, and started advertising their prices at half of what the established therapist charges in an attempt to steal clients.

I’ve heard from therapists who say they won’t refer out to anyone else–even someone who has a different skill set or modality than they do, even when the client is seeking something–and they justify that by saying “No one is as good as I am.” I also see a lot of so-called “medical” massage therapists who act as if they are superior to the therapist who does Swedish massage and who talk about those therapists on the discussion boards as if the Swedish practitioners are the peans and they are the Queen of Massage…go ahead and believe that. You’re making me laugh.

And while I’m on a roll, I’ll just go ahead and mention Massage Envy. I hear therapists criticize them all the time for their low prices–and in reality, their therapists get paid as well as many MTs I hear from who work for chiropractors and in spas, judging from the mail I get and social networks I’m on–and I have also heard many derogatory comments about their massage, as if anyone who works there couldn’t possibly be giving a good massage because they work for Massage Envy, and that is just plain wrong.

Slandering fellow therapists isn’t going to get you any success. Charging half-price isn’t, either. Oh, it may suit you for a while, but eventually, you’ll come to realize that people get what they pay for and that you’ll become resentful of doing the same work for half the money.

Folks, there are enough aching bodies and stressed-out people to go around. Professional jealousy is ugly. It is mean-spirited, and it is about as unprofessional as you can get. If you’re confident in your own abilities, then you don’t need to be jealous of anyone else.

Cultivating Excellence

I often hear from massage therapists who have made the jump from lone practitioner to entrepreneur, and the biggest struggle they seem to face is staffing problems. One of my favorite bloggers, Steph Lasch Lmt, wrote about some of her issues earlier this week. She’s hardly the lone ranger. And I know from my interactions with her that she’s like me–a workaholic and a perfectionist–which makes it all the harder to stomach these things when they arise.

I’ve been incredibly blessed in my own business, with great people who put the clients first. I’m approaching my 8th anniversary at my clinic, and I’ve had very little staff turnover in all that time. I have only had to fire one person…which I did for having a negative attitude. He only lasted a couple of weeks. I need to back up and say that I HIRE people based on their attitude, not on their skill as a massage therapist. If I hire a therapist who is lacking in technical skills that are important to me, I can fix that.  I would rather hire a therapist fresh out of school who may not know as much as I do, who is upbeat and positive and customer service-oriented, than to hire the best massage therapist on the planet who thinks it’s all about them.

Once I hired a young couple fresh out of school who were honest with me about the fact that they wanted to work for me for one year to save enough money to move to the beach. They did a great job for me, and I was sorry to see them leave but wished them well, and they’re both successful at what they do. They still check in with me occasionally. I lost one other staff member who just got burned out on doing massage, and I lost another one who was seriously injured in a car accident. That’s been it. I’ve kept an average of a dozen people employed for the past 5 years or so.

I think there are several key factors in assembling an excellent staff, first and foremost being the positive attitude I’ve already mentioned. I’d have to say that money is right behind it. I’ve had business consultants tell me I’m crazy for paying my staff members what I do. The pay in my facility ranges from $30-$45 an hour, plus gratuities, which I neither encourage nor prohibit. The therapists all do pretty well in that respect. In reality, I could be a lot wealthier than I am if I didn’t pay people so much and let all those profits stay in my pocket, but that’s not the way I roll. In the general scheme of things, not having any staff turnover and having staff members who are happy and who look forward to coming to work every day is more important to me than the money I give up. I had a spa owner tell me that it takes 18 people to staff her spa, and that in one year’s time more than 100 staff members came and went. What a nightmare. I’m better off being a little less prosperous and not having to deal with that kind of problem.

I think the third key to excellence in staffing is clear and direct communication, delivered in a polite way. I expect people to arrive on time. I expect thorough intake procedures, excellent charting skills, keeping their own treatment rooms spotless, giving the client their full amount of time, cultivating excellent people skills like listening to the client, politeness, neat appearance…and I have made that clear at the outset. A couple of  times a year, I call a staff meeting and order in lunch for everyone, and we air any issues and do some problem-solving and planning for the future.

One thing that has really worked for me is giving my staff input. Yes, it’s my business. But I couldn’t run it without them. My staff members are what make my business, and they’re the ones who keep clients coming back. When I’m considering participating in a community event, or holding an open house, running a special, or any other number of mundane things, I’ll say “What do you think about us having a booth at the Octoberfest?”  or “What do you think we should do for our open house?” I get everyone’s opinion. I could just announce that we’re having a booth at the Octoberfest and that’s that,  instead of gathering opinions, but by doing it this way, my staff feels involved. I keep them apprised of my goals for the business, too, which I find is paramount in meeting them. They feel like they have a part in meeting those, and they do.

My main advice is this: treat people well. Pay them what they’re worth; otherwise, they’re looking for the next best deal and you’re going to have the turnover problems. Don’t take advantage of them. Don’t call someone an independent contractor and then expect them to scrub the floor when they’re not booked or to sit there in your lobby off the clock if they don’t have clients. Don’t be a gestapo boss. Communicate what it is that you want in a polite way. State your policies and procedures up front. Train them in the way you want them to go. Set the example. Keep YOUR space clean. YOU dress neatly. YOU model the customer service. Give some signs of appreciation. Give them a card or a small gift on their birthday. Treat them to a free massage once in awhile. Just say thank you. It works for me!