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Economics of Complementary/Integrative Care
Although this column doesn't usually feature a book review, we're going outside of our usual public health format to discuss a new book written by Patricia Herman ND, PhD.
Helping Infertility Patients with the Spirit Essence
As many of you know, when it comes to treating infertility, we are dealing with a patient population that is, generally speaking, in emotional turmoil. These patients often experience fear, anxiety, despair, hopelessness, grief and anger.
There Are No Secrets: Treating Complicated Conditions with TCM
Including standardized extra points, there are just over 400 acupuncture points on the body. You get 400 and I get 400 - same. Yet, time and time again treatment protocols are coveted as if they were some secret formula only intended for the right and privileged.
News in Brief
Controversial Florida PIP Law Under Review; D'Youville Chiro. Students Learning Art of Co-Managing; And the Award Goes To...; F4CP Recognizes Major Contribution by ChiroTouch.
You are What You Eat Part II: Integrative Protocols
In the previous installment of this article I discussed important ideas concerning gastrointestinal health and foundational ideas from TCM, which can provide key insights into creating effective protocols for healing the gut.
Happenings in Our Evolving Profession
Good things seem to be happening for our profession and recent developments show we are all on board. Talking about being on board, this September The Veterans Express-Purple Heart Tour is expected to make its way out of the station.
Some Thoughts on the TMJ
The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems.
Are They Finally Fixing Medicare Reimbursement?
Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.
What They Don't Say Could Hurt You
I have written previously regarding the difficulties of drawing information from patients who are poor historians, forgetful or just plain uncooperative. The thought to revisit the topic occurred recently during preparation for an upcoming seminar.
Chiropractic: The Right Choice for Relieving LBP
"Low back pain (LBP) is a common threat to medicine and a reasonable threat to all national health care systems. ... Reducing ineffective treatments is necessary to decrease the LBP associated costs."
Herbal Medicine: Go Mainstream
When it comes to practicing herbal medicine in a mainstream setting, there are a number of important points to understand when it comes to prescribing formulas. Some important questions to ask are - what method of prescribing and dispensing is most effective in this setting?
Side Effects From Big Pharma: Wellbutrin – Dangerous for You and Your Baby
Are some of your pregnant patients taking Wellbutrin? If so, it could be a danger to them and their baby. This drug is extremely popular, but it has a serious history.
Research Abstracts From the Journal of Manipulative & Physiological Therapeutics
Effect of Pain Relief on Lumbar Muscle Function and Activation; Effects of Thrust Amplitude and Duration of HVLA Spinal Manipulation; Immediate Effects of Upper Thoracic Manipulation on Cardiovascular Response.
A Building Block of Healthy Aging
Coenzyme Q10 has gained enormous attention in recent years, and with good reason —it's the Energizer Bunny of the cellular world.
SOAP Notes: It's Time for a Cleaning
I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.
Going Shoeless: The Pros & Cons of Barefoot Running
With the subculture of barefoot runners and the products catering to them growing daily, just about every chiropractor has been asked at one point or another about their opinion regarding barefoot running.
What the Science Says About Magnesium Stearate
It's often been said that scientific studies can be used to support just about anything. But discoveries are never made one study at a time.
The Spirits of the Points: The Gall Bladder Official
The Gall Bladder is known as The Official of Decision Making and Judgment. In any given day, this Official makes countless decisions – conscious and unconscious, which influence every aspect of our being.
Why You Should Get to Know the National Vaccine Information Center
Barbara Loe Fisher has been a diligent advocate for providing parents with the information necessary to make informed decisions regarding the usage of vaccinations for their children.
Correcting Kid Logic in Health Care and Research Design
A recent broadcast on public radio described a fascinating phenomenon known as kid logic.
Remembering Joe Weider (1920-2013)
With the death of Joe Weider, the world's most famous body-building visionary, crusader, fitness magazine publisher and icon, on March 23, 2013, chiropractic has lost one of its greatest friends and supporters.
Medicine Presents: A Great Opportunity
The changing nature of health care presents both opportunities and challenges. While we tend to focus on our profession, we can sometimes forget the impact other health care professions can have on us.
Peer Points: Stories of Practice Success
When patients go see Arizona-based acupuncturist Jing Liu, it is to get top care from an practitioner well versed in all aspects of Traditional Chinese Medicine.
Have a Heart: Say No to Soda
It's not enough that soft drinks and other sugar-sweetened beverages have been linked to cavities and weight gain, among other negative health consequences.
The Potter's Wheel: Reflections on Practicing in a Technology-Driven World
In my very early years of practice, an older patient named Cora would call me at home, usually late Sunday night after she had consumed an unknown quantity of beer.
Energy is a hot commodity. Society pays dearly for it and for the expertise of those who know how to cultivate it.
We Get Letters & E-Mail
Patient Perception and the Farce of "Fast Relief"; A Fly in the Ointment; Persecuted for Choosing to Practice Chiropractic.
Helping Patients Through Pregnancy Loss
There is a lot of focus in the acupuncture world on fertility and helping women get pregnant. It's exhilarating to hear the news that a patient is expecting a baby. The other side of that is pregnancy loss. That includes abortion, miscarriage or stillbirth.
February, 2010, Vol. 10, Issue 02
12 Simple Ways to Generate Income in Your Massage Practice
By Donald Quinn Dillon, RMT
Many massage practitioners provide care based on the time and labor-intensive model they learned in school. If our desire is to make a reasonable living from practicing massage, this 60 minute, all hands-on model limits our capacity to provide care, induces repetitive strain over time, and limits our ability to generate sufficient means for ourselves and our families.
But what if we could challenge and re-engineer the well-accepted one hour model to provide better care for even more patients/clients in a day, while reducing stress and strain and improving our income potential?
In this article, I challenge some commonly held beliefs massage practitioners might have about the difficulty of earning a living in their chosen profession. Moreover, I challenge the sacred cow working model of the one hour massage, and present 12 profitable, complementary models for generating income in a massage therapy practice, many of which require little or no hands-on effort. Before I go into these 12 opportunities, I need to provide some context so these opportunities become more relevant.
Massage in Western culture emerged as a modality to be used in conjunction with hot baths, herbs and other remedies for general wellness. Massage was utilized in physiotherapy applications post World War II to rehabilitate injured soldiers, and in nursing to relieve lymphatic congestion and fundamentally to soothe the patient in distress. Massage also has been incorporated in the spa and aesthetic industry and you see all these versions of massage applied today.
Was massage intended to be an independent methodology applied on its own for 60 minutes of labor-intensive work? I have wondered this as I read complaints in chat rooms and on Web sites about massage practitioner incomes. I wonder as I read numerous articles and listen to webcasts about practitioner injuries, burn-out and attrition, and chronically cash-poor practitioners who joke, "Was I supposed to make money at this?" Some practitioners proudly proclaim "I'm not in this for the money" as if they wear their unsustainable business model as a badge of courage. It seems that this one-hour time and labor-intensive model is not working very well.
Even therapists I would classify as immensely successful emit a sense of "haven't quite made it." I think we've told ourselves a story that practitioners should be able to give 40 hours of hands-on care per week and that we should be making a lot of money doing it.
I've personally experienced cycles where I sabotaged my efforts - working hard and earning a lot of money, burning out and cutting back my hours, only to repeat the cycle. Again many practitioners, "I'm not in this work for the money," and resolve to the position that massage practitioners must live at the poverty level or relinquish the idea of making a full-time living and resolve to providing massage as a hobby. None of these positions is helpful to the practitioner or the public they serve.
I don't think it's helpful for educated, effective and empathetic therapists to constantly wonder if they can keep the doors to their business open and feed themselves. After all, would we rather be philanthropists -- earning more than enough money so we can give away to worthwhile causes -- or starving artists?
What I want to say to all practitioners who struggle ceaselessly with insufficient cash flow and sore hands is, it's not you...it's your business model that's not working. Let's do the math: To make it providing massage as the model currently exists requires either higher fees for service than we're applying to account for the time and labor-intensive nature of the work, or we have to rethink how we're applying our care so that it can be less harmful to the therapist and more lucrative to her or him financially.
Massage, by its very time and labor-intensive nature, forces a limited capacity on the practitioner and as a result, a limit on their income. But what if we looked at massage as it was originally intended...a methodology adjunctive to other health care or hedonistic approaches? What if we didn't require of ourselves 60 minutes of hands-on work, but incorporated other modalities to supplement our care?
Or, if we like the 60 minutes of hands-on work model, what if we relegated massage to our part-time vocation, and supplemented our income and our service to society in other income-generating, massage-oriented ways? What if you could work full-time in the profession and not have to supplement with an outside job...would that be worthwhile?
"But I'm already selling products and offering hot stone (or other modality), and I'm still not making enough." That may be, but do you look at each of these ancillary offerings as a separate business, indeed as another source of income? Do you have clear financial statements showing income and expenses from these various activities outside your regular bodywork? Do you have a business plan with specific goals and a promotional campaign to educate the marketplace on the benefits of your varied offerings? Do you have mentors to guide you in cultivating these new sources of income? If you do not, then you may not be giving your ancillary money-making muse a chance to prosper.
Each opportunity is like a part-time job; a role to fulfill with its associated tasks, objectives and measures. When we stock retail items or add various techniques to our business cards and brochures without the experience of a mentor, a concerted marketing campaign, clear accounting and a solid business plan, we're operating more like a flea market than a business focused on providing service and meeting marketplace needs. And what do people expect to pay at a flea market? They expect to pay bottom dollar for low-value products and services.
Each income generating opportunity you bring on must be cultivated with a business plan, promotional campaign, clear accounting and strong mentorship.
The Potent Dozen
1. Provide - Supplement your hands-on work by providing modalities for 30 percent to 50 percent of the one hour session. You're still providing excellent care and getting results, while reducing your labor has the affect of increasing your workload capacity by two or more appointments per day, hence your income potential.
Rehabilitative modalities include ultrasound, TENS, acupuncture, pain/inflammation balms, remedial exercise or personal training, athletic taping and more. If you work in the spa, there are body wraps, facials and various hydrotherapy and skin aesthetic applications. With proper training and certification you could provide life coaching or other coaching/counselling methods to increase your capacity to serve while reducing your personal strain.
2. Retail - There are literally hundreds of products massage suppliers provide that can be resold to your clients or patients. Pain rubs and analgesics, hot packs and compresses, skin creams, portable saunas, personal TENS and ultrasound machines, ergonomic pillows and other devices, relaxation recordings...the list is virtually endless. And by providing these products, you're making it convenient and cost-effective for your client or patient to access these beneficial products, with the added bonus to you that they now see you as adding greater value to your services.
3. Manage - You've worked hard to establish the most important assets in your business - location and reputation. Why not lease the fruits of your labors to bright and eager practitioners looking to start their practice? When you employ practitioners, you increase the range and availability of services, increase your marketplace competitiveness, grow your profit potential and give a new therapist a chance to fast-track their success. What's more, one of your valuable employees might some day become an investor or partner in your business, or may even purchase the business when you are ready to retire.
4. Administrate - Practitioners tend to hate paperwork...they'd much rather provide care. Another non-hands on, massage related role you can profit from is to provide administrative services such as data entry, market research, reception, bookkeeping, marketing and general office duties for a massage clinic or for several independent practitioners. You can easily schedule this work around your existing practice so you can still enjoy providing care while doing the undesired work of other practitioners...and earn an income while doing so!
5. Instruct - If you have sufficient experience in the industry, perhaps you would like to pass your wisdom on to the next generation of therapist. You can teach at a massage school or offer corporate wellness lectures in posture, health and stress management at a fee.
6. Innovate - Find ways to help massage practitioners do things better, faster and make more money. Examples are online booking and practice management software, new tools/technologies to save thumbs, various analgesics and aromatherapy products, educational charts and DVDs...take a problem the industry is having and offer a great solution. You'll be paid well for it!
7. Broker - Organize speakers for massage practitioners to fulfill training and continuing education requirements. You can bring in some big names or local talent, charge for admission and provide a valuable service.
8. Researcher - There's a growing requirement by insurance companies, government and other health care providers for massage therapists to have evidence-based practices. To help, there are grants available from Holistic Health Research Foundation and the AMTA Massage Therapy Foundation to conduct research. You can help massage practitioners gain access to better funding and develop credibility by conducting research and proving efficacy...while making a decent part-time income from your involvement.
9. Regulator - As massage therapy becomes regulated in more provinces and states, these regulatory bodies will need experienced members of the profession to serve in a regulatory capacity. These individuals often are paid per diem and expenses. Shape and guide the profession while protecting the public and earning a part-time wage.
10. Mentor/Coach - I think one of the biggest problems in our profession is the lack of a formalized apprentice structure. As a result, the learning curve to sustainable and successful practice is too steep and many talented practitioners fall away before reaching a sustainable business.
If you're a seasoned elder in the profession, why not teach new practitioners to develop better and faster: You can encourage them emotionally and professionally and improve the quality of practitioners we're putting out in the world. Your services could be paid or bartered for something you need. New therapists would benefit greatly and you can supplement your income with your wisdom.
11. Author - An impressive line-up of massage-specific textbooks has been added to our educational curriculum over the last decade. Practitioners with seasoned skills can put pen to paper and author articles or textbooks to advance the education of our profession, all the while earning a little extra income on the side.
12. Investor - With the advent of massage franchises and larger spas, you can take some of that money you've been disappointed in the stock market with and invest in these businesses. According to Michael Gerber, author of The E-Myth Revisited, 80 percent of businesses fail within the first five years, while 75 percent of franchises maintain their franchisee licenses. Franchises might provide a solid opportunity for a savvy investor looking to take advantage of the popularity of massage.
In this article I have argued against some conventional beliefs that I contend are limiting to the growth and income potential of massage practitioners. I challenge readers to examine business practices and tightly held convictions and to explore new ways to work boldly in the vocation they love.
Donald Quinn Dillon, RMT is the author of Better Business Agreements and the self-study workbook Charting Skills for Massage Therapists. He is also one of the founding members of Massage Therapy Radio (www.massagetherapyradio.com). His Web site, www.MTCoach.com, provides a variety of resources for massage therapists.
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