Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
October, 2012, Vol. 12, Issue 10
Understanding the Difference Between Clinical and Spa Massage
By Christy Schumacher, NCTMB
As most of us in the massage profession recognize of late, we are splitting into two fairly divergent, yet equally important industries. The most prominent and popular industry is the personal services massage industry.Many refer to this as "spa" or "relaxation" massage (for the purposes of this article I will refer to this as spa massage). The second and more recently emerging industry is "clinical" (or medical) massage therapy. These and other terms get thrown around a lot, and can cause a tremendous amount of confusion for massage therapists, but more importantly, for consumers. I hear many massage therapists and consumers denigrate spa massage as lesser than clinical massage, and each time it makes me cringe; all professional massage has therapeutic value! However, I also hear an equal number of therapists misrepresent clinical massage. I would like to provide clear and reasonable distinctions to these two types of massage, and hopefully help move both industries forward in a productive way.
It is important to understand that the type of modality that is practiced, from Swedish to Myofacial Release, from Cranio Sacral to Proprioceptive Neuromuscular Facilitation, or from Trigger Point Therapy to Lymphatic Drainage, in no way puts a massage therapist in one category versus another. A spa massage therapist and a clinical massage therapist can, and do, practice all types of modalities in both industries. The ultimate difference is the focus. In spa massage, the therapist is ultimately focused on the satisfaction of the client. The session is often intuitive and compassionate. The environment is private and often includes luxuries that put the client at ease. essions are defined and charged by a set number of minutes the hands are on the body, and tipping is expected. Attention to details such as music, table warmers, aromatherapy and high-end linens is common, and often required to stand out to consumers to get them to return.
In clinical massage, the ultimate focus is on functional outcomes. There is an evidence-based reason why a therapist applies one modality over another and most importantly, results must be measurable. Client satisfaction is often not assessed until the completion of a limited number of treatments, referred to as "treat and release," or the achievement of a specific therapeutic outcome. Finally, the length of the session is often shorter and the number of minutes that are spent with the hands on the body is not a focus point for the session (no more clock watchers!). Prices are defined more often by third party payers (insurance companies), in 15-20 minute increments, and tipping is rarely involved.
Training is another important difference between clinical and spa massage. Basic massage education (often around 500 hours) rarely provides the education required to practice in a clinical setting as a new graduate, but is sufficient for many spa settings. This allows for a new therapist to begin practicing, build their skill set, and most importantly, make money! A new therapist can get a spa massage job and gain the necessary experience and continuing education to tailor their future career to what works best for them. A typical massage graduate requires a period of professional practice and substantial continuing education to be qualified to practice in a clinical setting. Knowledge must be gained that includes assessment and proper documentation of functional pain, lifestyle and ranges of motion. Advanced understanding of pathology and kinesiology also is important.
Credentialing is another important distinction. To practice spa massage, a therapist often is required to be licensed and carry liability insurance. In many clinical settings, additional credentialing is often required such as National Certification, additional professional certificates, continuing education hours and sometimes even professional licenses such as nursing or physical therapy may be helpful to bill insurance (in the interest of full disclosure, I have been a Director for National Certification for Therapeutic Massage and Bodywork since 2009).
Most importantly, various details of ethics must be observed and practiced with care. This includes knowing not just your scope of practice as a massage therapist, but also the scopes of practice of your fellow allied health professionals. Clinical massage is often practiced in team-based settings that include colleagues such as physical therapists, occupational therapists, acupuncturists, psychologists and orthopedic physicians. Referrals are important. Knowing when to refer your client out and how to communicate that effectively is an important part of clinical massage. Likewise, communicating to allied health colleagues about their patients, and when your skill set may be a more suitable therapy, takes time and patience to develop.
This is certainly not to say that a spa massage therapist does not require proper ethics training to ensure public trust and safety. Basic massage education will include training on maintaining proper records of informed consent, contraindications and limited SOAP note documentation. However, for spa massage, documentation of time and place of a session is often ethically sufficient. When the focus is on measurable outcomes, documentation is just as important as the session itself.
The Bottom Line
I come in contact with numerous massage students and recent graduates at my integrative health clinic. Almost universally, these students and professionals will tell me that they have no interest in working at a spa and want to practice massage that actually "does something." Spa massage does accomplish something! The ability to provide essential relaxation and stress relief is a powerful therapeutic tool. In fact, stress and tension is often the root of physical pain, and needs to be addressed concurrently with any clinical or spa massage.
As a new massage graduate, it is important to recognize that the differences between spa and clinical massage are quite muddy for consumers. If you want to develop your career as a clinical massage therapist, there are important steps to take. First of all, recognize that the best way to get there is getting your hands on as many bodies as possible to develop your skills. A job at a spa is a great place to do this.
Communicate with your clients about why they are on your table and track lifestyle or stress outcomes. If a client comes in with low back pain, ask them on a scale of 1 to 10, how bad is it now? How bad does it get when it’s at its worst? Ask them what number they are at after your session. If they are coming in for overall stress relief, ask them what their stress does to restrict or impede their lifestyle. How is their sleep, anxiety levels and depression levels? Assign a numeric scale to these questions, document your findings and ask these same questions again on a follow-up visit. Upon their return, ask them the same question and remind them of their previous answers. And above all, DOCUMENT.
Those of us who have been in this industry for a long time recognize that a lot of massage therapists want to be a part of clinical health care teams. More and more opportunities are becoming available, but will require dedication and commitment from the next generation of massage therapists if they are to grow in number. Continue your education. Learn what your allied health colleagues can do to further improve your client’s pain, lifestyle and range of motion limitations. And above all, recognize that any massage you provide for your clients, whether it’s at a fancy spa or in a semi-private clinical setting with bright lights, you are providing them with an invaluable tool to improve their lives.
Christy Schumacher is a medical ethicist and massage therapist who works with integrative health care practitioners to improve access to and utilization of professional massage therapy within conventional medicine. She has a strong background in public health, evidence-based medicine and outcomes-based models of care.
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