Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
December, 2013, Vol. 13, Issue 12
Tremors in the Massage Industry
By Pete Whitridge
Change, challenges and consolidation have created recent tremors in the industry and I have been asked to comment on some current trends in massage education. I will address school sustainability, massage training and accreditation issues here. I will address other school and education issues in future articles.
Over the last 25 years, the number of massage schools has grown to approximately 1,600 schools. The 2008 market collapse and resulting recession have had a dramatic affect on all massage school programs. Whether sole proprietor, career training institute or corporate-owned school, enrollments have dropped significantly.
In summary, we have 300 fewer schools in the massage universe since 2009. Student enrollments are down 18.8% since 2011, and down 50% since 2005. We have 50% more schools then we had in 1998, yet we are educating a similar number of students. More schools and fewer students make for a highly competitive and fractured market.
administrators and teachers, I have identified a few factors that contribute to school closures: State school licensure requirements, Federal Department of Education "gainful employment" and "placement" requirements, lack of quality lead generation, competition with larger massage programs with better financial resources, staff and infrastructure. Practically all corporate, university and career training institutions are accredited. This fact allows these schools to out compete small, owner-operated schools by offering grants and loans.
We have more than 1,300 massage schools in this country. 52% of schools are proprietary, yet only 20% of proprietary schools are accredited. This means proprietary schools have yet to embrace accreditation as a means to stabilize their programs by accessing Title IV funding. It might be time to reassess this situation.
Does being accredited make a difference? The ABMP biennial school enrollment census suggests accreditation does make a difference. When proprietary schools are compared based on accreditation status, accredited schools enroll close to 50% more students than non-accredited proprietary schools. The differences in enrollment between accredited and non-accredited schools could be a market driver in the future.
Additionally, Career Training Institutes enroll more than two times more then proprietary schools according to the census. All CTI's are accredited and have the infrastructure to recruit students for a variety of programs. Maybe it is time to review your long-term sustainability by exploring the value of obtaining accreditation. Maybe its time to explore synergistic trainings that help establish your school as an education hub. Whether esthetics, personal training, or yoga therapy, attracting health-oriented leads may help enrollment at your school.
Is accreditation the answer for small schools? The report shows approximately 60% of massage programs hold some form of accreditation. These programs offer student loans and grants and are able to demonstrate financial stability. Accredited schools report yearly to their commissioners and renew on a five-year cycle. While many of these accredited schools are able "to withstand the bumps of competition and a sluggish U.S. economy," these schools still face limited income potential if they only enroll an average of 20 to 35 students per year!
The ABMP enrollment census outlines the average number of students enrolled per year for each category of school: CTI, college/university, corporate-owned, public and proprietary. Four of the five categories of school enroll 35 or fewer students per year, with CTI's enrolling an average of 85 students per year. Yet, the CTI's have closed programs at a larger rate as compared to proprietary schools. This means CTI's are not as profitable as they need to be and are closed. The CTI's will move on to something more profitable. I speculate that many low enrollment CTI' and corporate schools will move on to offer and focus on more lucrative programs such as respiratory therapy, fitness training or nursing education. Federal placement and gainful employment rules will also force training centers to enroll students for programs that actually provide jobs and career longevity. Education is a business and when the numbers don't warrant having a program, programs will be shuttered. Be ready to absorb market share when a program is closed in your area. CTI's can add and subtract programs based on enrollment and profitability.
Floods of Change
What about the small schools? It's clear there are hundreds of small programs in our field. Can these low enrollment programs last? Is it profitable for a program to have one to five instructors, maintain enrollments and management to compete with larger education corporations, community colleges and the newest players on the scene, the osteopathic and chiropractic colleges such as Bastyr, University of Western States and the University of Bridgeport?
The answer for some small schools owners is decidedly, "No." For example, the Core Institute in Tallahassee, Fla., has shuttered its entry-level program. They are now focusing only on continuing education and specialty certifications. The Atlanta School of Healing Arts (ASHA) was shuttered because the Federal Department of Education demanded a large bond from the school to remain Title IV eligible. The school was not able to meet this requirement and the DOE revoked eligibility. Finally, the loss of a massage school to flooding. Did this owner have reserves to survive until the location can be rebuilt? Will this school be able to re-open, enroll students and survive another day?
I encourage all small school owners to work together to support high standards of entry-level education, qualified teachers in these programs and financial responsibility so that the school has reserves to cushion a blow to enrollment. Institutional accreditation may solve some of these issues by providing guidance, support and peer review. Eligibility for Title IV funds is also an important consideration when applying for accreditation.
Will accreditation help my school? Isn't it expensive? How much paperwork is required? The Commission on Massage Therapy Accreditation (COMTA) is working to help schools wishing to obtain accredited status by formulating a pre-accredited status where a school would work toward full accreditation over a two year period by applying with COMTA, demonstrating activity in alignment with a Self Study Report and reporting back to the commission yearly. The COMTA commissioners met on October 23, 2013, and I understand the group is very interested in supporting schools in this area.
I encourage all school owners, administrators, CE providers and LMTs to volunteer as peer reviewers with COMTA to experience the process of traveling for a site visit and evaluating fellow school programs. Peer review volunteer opportunities are available throughout the year. You can apply as a volunteer whether you are an educator, LMT or compliance wonk like me. COMTA also has three commissioner positions open for election this year. They are recruiting commissioners in the areas of esthetics practitioner, an employer position and a public member. If interest, visit www.comta.org/about-comta/commissioners-elections-appointments/.
Want more students? Need to compete with within your market? Accreditation could make the difference. Evaluate your school curriculum and administration compared to the COMTA standards. Using these standards will help you as you plan for future sustainability. Even if you just volunteer as a peer reviewer, you will have a better understanding of the process and can evaluate the pros and cons for your school.
A historic school closes and sends shock waves across the education community. The Boulder College of Massage Therapy announced in June 2013, that they would be closing their doors. Many educators and therapists shuddered deeply. Even after an angel investor helped temporarily reopen the school, BCMT permanently shuttered its doors on September 26, 2013. For more information, visit http://bcmt.org/.
This is a big issue in our field. The reasons stated on the BCMT site are chilling and unfortunately, familiar.
"...This is the second closure of BCMT in the last six months. The first closure was the result of multiple factors related to the financial health of the school over the past several years. However, in the last 18 months, BCMT had increased enrollment, revamped its curriculum, raised job placement rates and improved its financial solvency. Despite these efforts, the school was unable to overcome a constellation of issues related to the previous years of financial losses and the decrease in value of the real estate asset, the BCMT campus. Multiple attempts to reach an agreement with the real estate bondholder, as well as multiple attempts to be acquired by larger educational entities, were unsuccessful."
We would be wise to reflect further on what forces brought such a fine program to close. "As a founder of the International School of Bodywork (IPSB), I find BCMT's recent closure especially troubling. My school was born of a similar ilk of human potential and spiritual seekers. Both schools have attracted individuals wanting a top-notch vocational education balanced by artistic and humanistic values. Both schools have similar approvals, institutional objectives, established and award-winning faculty," said Carol Osborne.
Carole also outlined more issues all massage schools face:
Despite these challenges, many schools have adapted and enhanced their programs to meet the needs of the 21st century student and the current marketplace. Yet, many graduates still struggle to establish an economically viable practice in these weak financial times. Interestingly, we also hear from many spa and massage franchise owners that there are not enough quality massage therapists. The somewhat contradictory nature of these developments can be bewildering and they merit some meaningful discussions between schools, educators and employers.
How can we have so many schools, yet so few "quality" therapists? Looking over the data from the 2013 survey, four of the five categories of schools have less the 25 students per year and even the career schools average only 85 graduates per year. I speculate that these smaller programs have only one or two teachers in the classroom and the teachers may not have extensive teacher training but are rather content experts; a successful therapist in town.
This scenario has played out many times over the past decade as massage schools expanded into Corporate/CC/University settings. These schools tend to hire content experts with some experience in the field and then recruit from alumni when seeking replacement teachers or teaching assistants. Teacher pay is not known to be more than $25/hour at most colleges and universities. Teachers in these small career training or community colleges are operating without much peer support and tend to have a high turnover rate.
Growth within the massage education industry has ended. Will your school thrive, survive or close? Could acceptance of voluntary accreditation and the imposition of strict standards for licensure, training and enforcement create more consolidation, weed out weak schools and force the remaining schools to step up their game? Massage as a "growth" center peaked back in 2010, and has been on a downward trend ever since.
In future articles, we'll look at entry-level education, an ongoing issue for the last few years. I will offer a report on the ELAP project, the recommended standards and their ramifications for massage schools, teachers and administrators.
Pete Whitridge currently is the President of the Alliance for Massage Therapy Education (AFMTE). He is a faculty member and former Director of Education for the Florida School of Massage in Gainesville, Fla., and past chairman of the Florida Board of Massage Therapy, and past legislative chair for the Florida State Massage Therapy Association.
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