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.

14 Replies to “Problem Solving in Your Practice”

  1. Really great information and information that is sometimes hard to admit is happening to you and your business. Dealing with students just out of school I hear a lot of similar complaints about not wanting to be pushy…but also not getting clients to re-book. Not to mention the personal hygiene issues that seem so common sense! It can be hard to do…but we all have to take a serious look at ourselves and ask what am “I” doing wrong and what do “I” have to do to fix it! Thanks for another great article!

  2. Great post, Laura. You have covered a lot of territory.

    I would like to expand upon an issue that you alluded to in your article. One question rarely addressed by massage schools is the commercial viability of various approaches or techniques.

    There are a number of obvious hierarchies here that, when addressed realistically can contribute to success. More people would prefer to lay on a table than on the floor when getting a massage. More people are looking for simple relaxation/stress reduction/circulation massage than a treatment for a particular condition. More customers are able to pay $15 for a chair massage than $75 for a table massage. Rolfing, Trager, Feldenkrais, and Rosen work (to name a few brand-name styles of bodywork) have, typically, far smaller potential audiences than more generic approaches to massage like Swedish or acupressure. There are more customers of massage then there are clients. There are more clients of massage then there are patients.

    Keep up the great posts.

  3. Couldn’t agree more!

    You say, “the most important phrase for your business is “When would you like to schedule another appointment?”” … I have therapists take it one step further, as part of my “Serve & Sell” concept.

    Therapists need to be the ‘Consultant’ rather than the ‘order taker’. If you just ask when would you like to come back, you’re leaving it up to the client to know or decide.

    Unless they are a therapist or in the health field too, the client has no idea why, when, and how often they should see you to address their needs. the therapist is the expert, therefore must advise to the client what they believe to be the best course of action regarding frequency, length of session and duration. (based on their professional, clinical opinion.)

    So, this all boils down to again, advising the client. One way to do that is to simply preface the question of “When would you like to schedule another appointment?” to something like, “Based on our session today, to get you able to lift your right arm over head again, I suggest x more visits spread over x weeks… can I put you in for Tuesday at 3?”

  4. When a client has a problem, I can go for that approach. About 1/2 of our clients don’t have a problem–they just want massage. When a client does have a problem, about half the time they have been referred by the dr who has written them a prescription for a specific number of visits over a specific period of time.

  5. Laura, if the client has a Rx from the doc, then therapist must absolutely follow the Dr’s Rx or they are being remiss.

    But even for ‘good ole stress reduction, there are recommended frequencies and durations that I think the client should be made aware of so they can get the best results. Don’t you think some clients think once every few months is enough for stress management? Granted, it’s better than nothing, but not as beneficial as regularly.

    Either way, stress, injuries, pain relief… I think it behooves the client (& ultimately the therapist) when the therapist serves the client best by “advising” rather than “order-taking”.

  6. Great article Laura with lots of great advice.

    May I add- It takes time to build any business. Over 80% of business’s fail in the first 3-5 years. In order to survive the first few years as a business owner it is important to understand the need to have planned financially for this.

    My experience in building a massage practice says that it’s normal for first time clients not to reschedule immediately after their first session with me. Rarely if ever do I find with first time clients that an instant rapport is developed and I certainly want to give them enough space to absorb the effects of the massage they just received. In particular I would feel as if I am taking advantage of their relaxed state.

    What I found works best is to first thank them for allowing me the opportunity to work with them. I let them know I love my job and couldn’t do it without them. Then I hand them a business card with a hand written note giving them a discount amount if they CALL to schedule their next appointment within 24-48 hours.

    Also when asked by a client “How often should I come?” I reply, “Every body is different. I have some clients that come once a week, some that come every two weeks, some come once a month and some come when the mood strikes them. You know your body best. How often would serve you best?” I prefer to empower my clients rather than advise or suggest. It also shows that I actually care more about them than I do padding my bank account.

    Works for me.

  7. I like what Keri expressed and that is what I essentially do. Personally it feels unethical for me to tell clients what they need. I am a therapist, not a doctor and I am not a sales person either. If a client does not call me more times than not, it is not because of anything I have done. It is because of some reason or their own. I do my best with everyone and I have a satisfactory repeat clientele for my standards.
    For years I battled with feeling competent enough with this issue. When I researched from with in I realized how much of my own self worth was hinged on being busy. This is something that got in the way of being with my clients and enjoying my work. When I addressed my own issues of feeling let down and incompetent I really started to hear more. Most of why people were not calling me or rescheduling. I was able to feel empowered and appreciate who I am. I love my career.

  8. I like Keri’s answer, and I agree. In my particular area, there is a big factor called “money.” Out of the 100 counties in NC, ours has the second highest unemployment rate. There are thousands of people out of work here. Someone may desire to come once a week and just plain can’t afford it. We realize that regardless of what treatment plan we’d like them to have, not everyone can do it. In fact, I’d say that applies to the majority. We do offer package deals–but if it’s cough up $300 for a package or buy groceries for your kids and pay the rent, then guess which one is going to take precedence–as it should. In extreme cases of need, we will offer someone a sliding fee–that is at the therapist’s discretion. Still, $60 (our normal price for massage) might be the difference in whether or not someone has the gas to get to work, assuming they have a job.

  9. I also would like to thank Laura Allen for her article and adding “Personal Hygenie” to the list of complaints from clients. Why do these people think it is OK to dress like a dirty hippie and think that people will want them to be their therapist? I have a few students I have had to tell to clean themselves up before even coming to class, and one student who went to an interview at a place I was working and the owner observed that his appearance was “askew and unprofessional.” Is it much to ask to wash yourself, comb your hair, and put on some decent clothing? Especially during an interview!!! I hope the people who need your advice will actually read it and take it to heart. There are way too many therapists in the industry that want to work, have great skills and look professional to give a job to someone who looks “askew and unprofessional.”

    As far as asking them about their next appointment, I am guilty about not doing this. I always felt that I would be pushy trying to get them to give me more money. But, I realize now that it is not a pushy statement, but more of a caring statement. “I care enough about you and your body that I would like to see you again soon.” If they do not want to book right away, then that’s OK as well…I will just give them my card and tell them to call me when you think you are ready. Thank you for breaking me out of hypnosis!! I realize I must offer myself to them instead of waiting for them to offer themselves to me.

  10. I thought this was a good article and I’ve enjoyed the ensuing commentary discussion – there are a lot of valid points here and good food for thought.

    I do take issue with one generalization made by David Palmer, “More people are looking for simple relaxation/stress reduction/circulation massage than a treatment for a particular condition.”

    This is simply not true in my experience. It might be true in his and others’ experiences, but I believe it’s far too overstated to make it a norm for the industry. Most of my clients – either walk-ins, cold calls, or referrals – DO have a particular condition they want treated and are looking for relief. I’ve been practicing 13 years, 12 of those in the small town, and I’ve grown my practice from 10 clients a month to 10 clients every 2-3 days and the smallest minority of those clients are seeking “simple relaxation . . . massage.”

    That being said, I have a self-employed rule I use whenever business is down: I do just as Laura suggests and I assess my recent situation: Have I been available?, Have I been answering phone calls in a timely manner?, Have I been too chatty or distracted during sessions?, Am I cutting sessions short or consistently running too long (not valuing people’s time)?, Am I asking if/when they want to rebook?, Have I called people who’ve cancelled to allow them to reschedule?, Am I tired and need some days off?

    Nearly always I can find an area that I need to improve and nearly always within a day or so of taking this self-inventory and beginning to address any problem areas, my phone starts ringing and my schedule starts filling again. Works.Every.Time.

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