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Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
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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