The Evolution of Massage: PRN Massage

By Velvete Womack, PhD, LMT, CE, MI
October 16, 2013

The Evolution of Massage: PRN Massage

By Velvete Womack, PhD, LMT, CE, MI
October 16, 2013

In the past few articles, we've been discussing how to take massage therapy to the next level of professionalism, which also included a technique to use to ensure that YOU were ready to accept yourself as a full-blown professional.

There are many different reasons individuals become massage therapists, but no matter what your reason for becoming a therapist may be, you are still responsible for maintaining the integrity of the profession. And,it is also our responsibility to be "the light" and hold ourselves to a higher standard of practice to help inspire and motivate other therapist to do the same.

But how do we take our profession to the next level of professionalism as a team; as trusted and cooperative therapists? If you've been exposed to the medical world or studied medical terminology, then you are aware of the abbreviation PRN [Latin: pro re nata], which means whenever necessary or needed. As a therapist, we are missing out on this valuable practice that will evolve our practices and FREEDOM.

Operating a PRN massage practice has so much potential and endless possibilities that you are absolutely limitless in creative ideas and energy. One of my greatest adventures was the day I opened my very own PRN massage practice. My mind was blown by the number of physicians, therapists, chiropractors and even businesses that offered massage and that called for my services on a regular basis. There is no greater feeling in the world than when you fill your schedule book and are turning down three to four clients a day. That's when you realize just how you can be of service to mankind. So you find another therapist and offer them the same possibilities you have.

I have enjoyed all the therapists who have worked for (no, with) me! Together, we have promoted and built an even bigger and stronger foundation for the profession. Some moved on to do the same as I did and hired therapists that now work with them, paying it forward.

In most states, massage therapy has its own governing body and it is a must that you contact yours before you start so you can learn the rules and regulations that will be important to running a successful PRN practice. In texas, as it might be in your state, if you are a solo practitioner without an establishment license, then NO ONE can substitute for you. If you are not an establishment in Texas, you are not welcomed to even offer a room to another therapist to rent or have someone come in on the weekends. This rule might seem a bit harsh at first, but once you realize the importance of the paperwork, the responsibility of protecting your clients and their privacy, you get it. We are professionals, folks!

In Texas, you are able to hire or work for another as a PRN therapist if they hold a medical or professional license that is medically related, such as chiropractors or physical therapists; or if the person you are working for holds an establishment license. This does not mean you can hold an establishment license and run a PRN practice and work for another therapist while they are on vacation; they must hold the establishment license. However, if you have multiply therapists working for you in your PRN practice in Texas, you are required to have an establishment license for your business.

Records are extremely important in any profession and massage therapy is no different. It's upsetting when a therapist knows they need to do SOAP notes, but refuses on the premise relaxation isn't something that needs to be documented. It's extremely important to understand many therapists are the only folks witnessing changes that occur on their clients' backs, necks, head, feet, skin and a whole list of others areas. Such events and occurrences are extremely important, and the therapist needs to be aware and make sure it's well-documented.

Regarding records, it's also important to understand who is responsible for client records. If you are working PRN, then it needs to be within your contract that you are making sure the owner or the business you are working for is responsible for the client records, and that you are released of any liability for such records, outside of making sure you do your SOAP notes. It needs to be well-documented who owns the client records so there is no confusion in the future.

To establish yourself as a professional offering PRN services, it is a must that you communicate with your local physicians, physical therapists, nurses, other therapists and businesses to let them know you are ready to provide them with relief. At first, you'll just want to make sure people know you are available and build a reputation with them. They'll want to know what kind of work you currently do and will want some kind of references. It helps to have established yourself with a booming chiropractic or rehab businesses; they'll be your best marketers.

In order to better assist you in building your own PRN practice, I provide the following guidelines:

  • Establish yourself as a reputable therapist.
  • Decide whether you'll be a solo therapist or have others working with you.
  • If you decide to have others working
    with you, be sure to obtain an establishment license.
  • Write up a solid contract, adding what you feel fits your needs best. Make sure the following items are covered: non-compete (the clients belong to the person you are subbing for); the owner is responsible for all client records with the exception of your SOAP notes; fees and how you will be paid; who is responsible for supplies and equipment; cancellation policy and procedures; proof of establishment licenses and a copy for your files; proof of your licenses and insurance; notice time of service needed (can they call you 15 minutes before an appointment or does it need to be at least 24 hours? You decide.); the life of the contract; and signatures and copies.

Also be sure to add to the contract that if your pay exceeds $500 in services, they must supply a receipt for services rendered.

If you have multiple therapists working with you, then you'll want to be sure you are also keeping excellent records because the business will only need to provide the "PRN business" with documentation, not each therapist. The contract should be signed and placed in a secure filing system so you will not have to repeat the procedure. Once a therapist or business signs a contract with you then you'll just need to do business with them until the life of the agreement is over or renewed.

If you are contracting with another therapist, you are responsible for all records, payroll and 1099s. Make sure you have a solid contract that clearly covers:

  • Responsibilities
  • Payroll
  • Taxes
  • Equipment and supplies
  • Any and all rules you might want to establish about the business or non-compete
  • License and insurance responsibilities
  • Continuing-education clause
  • Dismissal clause (reasons they could be dismissed immediately)
  • Their responsibilities as they apply to your individual state requirements, local requirements, national requirements and/or personal requirements.

Maintain accurate records for tax purposes; this will be your responsibility because you are contracted with the company. It's important to stress here that all successful therapists must market themselves. If you are not strong in this, then PRN might not be for you. However, if you love working on different people each day and meeting new people every day, then this will be a win/win for you.

When I first started my PRN practice, I was concerned about the money and whether it would really pay the bills. The first thing I discovered was that my expenses only consisted of lotions and auto; they supplied everything else I needed. They were my receptionist, they did the laundry; they were my office manager and took care of all my client records; and they had to bill insurance and pay me the day of service ... no waiting for the money. I quickly discovered I could offer my services at a wonderful win/win rate because I had no expenses, and I wanted to be completely fair and honor that part of the deal as well.

But that's not all. Not only did many of the physicians / chiropractors pay me for what they said they would, but they also tipped me. And this didn't even include the tips the clients/patients would offer me, depending on the situation I was working in. If I worked for the chiropractor, patients were used to tipping; working for the physicians or PT, not so much. These clients were completely medical-based (insurance pays, not me), not service minded (I'm responsible for my own health and wellness).

It is with great joy and happiness that I provide this gift to other therapists to be the success they were born to be. You are all so very important to the evolutionary process of our profession. May life be just as good to you as you are to life.