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Massage Today
August, 2007, Vol. 07, Issue 08

All Systems Go

By David Kent, LMT, NCTMB

As a practicing massage therapist who receives referrals from hospitals and physicians, I find fulfillment in helping my patients return to their normal activities of daily living (ADL).

Yet, years of clinical practice have taught me that treating my patients involves more than just the application of massage. Whole-body wellness requires an integrative approach to health care. As a massage therapist, there are many integrative methods I can utilize, including referring out when a condition falls outside my scope of practice; educating my patients about self-care; staying current on the latest massage research; and maintaining comprehensive systems so I stay organized in my massage practice.

Patient and CSA going over forms on a clipboard. - Copyright – Stock Photo / Register Mark I recently was thinking about systems and how they are part of every aspect of our lives. Just as the universe is made up of systems (planetary, gravitational, thermodynamic, etc.), the human body is made up of systems (muscular, skeletal, fascial, digestive, nervous, etc.). Even our country is made up of systems: legal, educational, economic, etc. In short, virtually everything around us is composed of one system or another. Without systems, our lives would feel out of control. In fact, when these systems break down, things often do feel chaotic until order is restored. Take the body, for example. When the body's systems are in a state of homeostasis, we feel healthy, but when the body's systems are out of balance, we become sick and therefore, our lives are disrupted.

Patient and CSA going over forms on a clipboard. - Copyright – Stock Photo / Register Mark Systems also are important in a massage practice. In my own practice, systems are necessary for maintaining my livelihood, as well as educating my patients and engaging them to play an active role in their own healing. When my practice systems fall out of balance, this generally impacts every aspect of my life - and usually not for the better. Implementing effective massage practice systems and continually evaluating them to ensure they are working is a key component of a successful practice. Whether you are in private practice, perform outcalls, or work in a spa or clinic, it is important to have established systems of practice that will support both this growing industry and your needs.


The philosopher Heraclitus wrote, "Nothing endures but change."1 While change can be positive, it is not always comfortable. Therefore, it is common to resist and continue to follow systems that are not always in the best interest of our personal and professional lives. We might continue to do things a certain way because we've "always done it this way." But consider for a moment how updating some of your practice systems - or creating new ones - might give way to a more streamlined and successful massage practice.

Since I opened my practice in 1992, I have continually been evaluating my systems. In doing so, I ask the following questions:

  • Is the current system necessary and/or working?
  • Is the current system being followed correctly?
  • What could be improved and/or eliminated within the current system?
  • Do I need to implement a new system?
  • What are the steps I need to take to follow through on the answers to the above questions?

Are your practice systems working for you? Are you fulfilled in your career? If the answers are no, it might be time for you to improve your systems or create new ones altogether. Remember: The past does not equal the future; you are capable of changing direction at any time. Below are some suggestions for improving your practice systems.


REVIEW your current systems. Take a good look at all of your systems from marketing to charting. Could your patient retention be higher? Perhaps you need to develop new methods to keep your patients coming back. Education is one such method, which I discuss below. Are your patient files in disarray? In my clinic, I have created a simple systematic approach to maintaining my clients' files to document and show their progress.

REORGANIZE your structures. In assessing your systems, you may discover that some of your educational materials are out of date. Part of helping your patients, and subsequently retaining them, involves staying informed about current massage research, utilizing current clinical methods and tools, attending educational seminars and learning assessment techniques that can save you time.

REDESIGN your methods. If you have grown accustomed to giving a massage and then cutting your patients loose, it might be time to take a more proactive approach to treatment. One way is to actively educate your patients so they understand the cause of their pain and how you can help.

In my seminars, I incorporate a balance of auditory, visual and kinesthetic teaching techniques to appeal to every type of learner. I also use a balanced combination of these techniques to educate my clients:

  • Visual - Charts, photographs or videos can assist greatly in educating your clients. They also can help you determine the best course of treatment. I will take digital photos of a client's posture or refer to a chart to illustrate the location of a trigger point to show how I will treat an area. Photos allow me to assess static posture and document my patient's progress over time, while charts enable me to easily determine which tissues are involved.
  • Auditory - Inform your clients about their conditions and your treatment methods in detail and at a level they can understand. A nurse might understand what the clavicle is, but a layperson may not. Additionally, verbally remind your patients that regular massage is part of maintaining their overall health and wellness.
  • Kinesthetic - Assist your clients with stretching and performing range of motion. Establishing a baseline utilizing orthopedic tests and pain scales pre- and post-treatment will not only assist you in formulating a safe treatment plan, but it will help the client understand the need to return for subsequent treatments.

REDEFINE your goals and then design your systems with specific outcomes in mind. For example, instead of setting a goal such as, "I want to make more money," set a specific goal: "I want to make $10K more this year." Once you have clearly defined your goals, you will have a better idea of how to achieve them.

REINVEST in your practice. Purchase the tools you need to quickly educate your patients so they understand the importance of committing to a series of treatments. Selling products such as topical analgesics or exercise bands not only gives you the opportunity to further educate your clients, but it helps bring in additional income.

REACT. Don't delay - change starts now! To get started on improving your systems, check out my article, "The Power of a Minute," in the June issue of Massage Today, for a wealth of simple practice-building techniques. Visit or for additional resources.

Until we meet again ... all systems are go. You are cleared for a successful practice.


  1. "Nothing Endures but Change." Heraclitus (540 BC-480 BC). Diogenes Laertius, Lives of Eminent Philosophers. (Available online at

Click here for previous articles by David Kent, LMT, NCTMB.


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