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HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
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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