Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Fish Oil: A Key Component to 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?
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
June, 2014, Vol. 14, Issue 06
By Cherie Sohnen-Moe
The spa industry has expanded in new and exciting directions over the last two decades. While the image of the local day spa remains most familiar, spas have also become common vacation destinations and are desirable amenities at resorts, in luxury hotels and on cruise ships.Dental and medical offices are including spa treatments to make their procedures more pleasant and attractive to their patients. Many spas have expanded their scope from simply furnishing beauty services to offering healthcare services. Estheticians, massage therapists, aromatherapists, acupuncturists, reflexologists, yoga teachers, nutritional consultants and energy practitioners are commonly found in these spa settings.
As public demand has grown, even the image of the local day spa is growing and changing with corporations like the Red Door Spa and franchise systems like Massage Envy Spa, Elements and Massage Heights getting involved in promoting day spas at the national level.
Online forum chats overflow with comments about the good, bad and ugly aspects of working for spas. Franchise organizations seem to bear the brunt of the negative remarks. Practitioners complain of the poor working conditions and the low wages. The people posting in these forums often claim these companies are making it difficult for independent therapists to survive. I have to question that. Because of these companies, many people are now receiving massage that wouldn't have even considered it in the past, and probably weren't aware of the benefits even a year earlier. These companies provide thousands of employment opportunities for massage therapists, as well as tremendous visibility at the national level. For example, in 2012, Massage Envy Spa provided 14.5 million services to 1.17 million members and 2.6 million guests. In 2013, they provided 56,000 services per day. And that is only one of the many national franchise organizations today. I see this as being analogous to the hair styling industry. Yes, there are many franchises such as Supercuts, where you can receive a haircut for about $15. Yet, many people still go to other salons where they pay closer to $60 for a haircut.
Most people working at a franchised day spa earn more than $25 per hour, including tips. So, if you are working 25 hours per week, that's about $30,000 per year. Plus, many of these companies offer benefits such as health care, paid time off and educational opportunities. That is much better than the average worker receives. Also, while some therapists have a college degree and extensive training, others enter into this field with a mere 500 hours of schooling. This is a good return on investment.
Part of the problem comes in when people think about how they could charge between $50 to $60 per hour (even more in some cities). Worse, they fail to consider the cost of building and maintaining a business. That $30,000 salary starts looking better when you factor in rent, utilities, equipment, linens, supplies, front desk staff, marketing, taxes and insurance. Just the cost per session (e.g., linens and lubricants) is between $2 to $6. Even the bare bones minimum cost to operate a small practice is about $12,000. And that amount doesn't include taxes, staffing, health insurance, continuing education or other benefits. Finally, this number includes a barely existing marketing budget — which needs to be dramatically increased when building a practice.
If you want to work an equivalent of the 25 hours per week at a franchise spa, then you really will only have time for 15 clients per week, as you will need at least 10 hours per week (and a lot more in the building phase) to manage and market your practice. Let's say you charge $50 per hour and work 50 weeks per year, seeing 15 clients per week. Your gross revenue would be $37,500. Then deduct the $12,000 for the base operating expenses and you are now making $25,500 per year. Realistically, your net profit will most likely be closer to $20,000 — and you have to bear all of the risks.
Of course, you can change those numbers by working more hours, charging higher fees and selling products. Yet, many people don't have the desire or personality to run their own business. According to CG Funk, Vice President of Industry Relations and Product Development for Massage Envy Spa, working for a franchise spa may be a good option for practitioners who are new graduates, those that want to supplement their private practice income, those that don't want the responsibility of operating their own business or those who simply want to work part time.
Overall Success Strategies
Working in a spa requires conforming to a corporate image and structuring your treatments to align with the company's schedule, treatment protocol, policies and philosophy. Marketing is another area that is often a source of conflict. In a spa, you don't have to do marketing or schedule clients, but there's no guarantee your work hours are filled. Many practitioners discover to their dismay that to increase the client flow they need to market their services themselves (this is more so in a local day spa than a destination spa).
To be successful in these environments, a practitioner needs to understand employer expectations and understand the rationale behind the policies and procedures set by the employer. Certainly these measures are set up to protect the client and the company; very often they are set to protect the practitioner as well.
Good communication skills are vital in this environment. In addition to client interactions, practitioners need to communicate well with the front desk staff, management and co-workers.
The Work Environment
Creating an ethical working environment is, of course, the mutual responsibility of spa management and employees. Ideally, spa management acts diligently to protect and serve the rights of both employees and clients. On their side, spa employees ideally commit themselves to quality work at all times and in all circumstances and express loyalty to the organization by cooperating with policies and procedures and avoiding conflicts of interest. Difficulties arise not just with actual lapses in these ideals, they also arise when suspicion and distrust surface within the organization. Both management and employees, therefore, need to practice transparency, honesty and integrity in communications with one another.
On one hand, the relationship between spa management and employees boils down to a question of autonomy. In most spas, practitioners don't have a choice about how many clients to see in a day, which clients they'll work with or even what type of work is to be performed. Serving the customer is the spa's priority. Management expects employees to work to an assigned schedule, to expand their therapeutic repertoire by learning spa treatments outside their specialty and to conform to the corporate image. On the other hand, spa management may offer the employee numerous benefits such as compensation based on seniority, commissions on product sales, health insurance, paid vacations, paid sick days, pension plans, profit sharing and reimbursement for continuing education.
Perhaps the most serious ethical concerns in the spa environment surround issues of inappropriate touch and sexual misconduct. Management usually has a zero tolerance policy, meaning that if a client complains of sexual misconduct on the part of a practitioner, that practitioner is terminated without recourse. A similar policy might exist regarding practitioner complaints against clients who sexualize a session. Management needs to examine whether their policies disempower practitioners in these situations, while employees should know the limits of their legal rights.
The next sections highlight some of the ethical considerations shared by spa management and spa employees to create an atmosphere where cooperation and ethical behavior are encouraged and supported.
Ethical Guidelines for Spa Employees
Ethical Guidelines for Spa Management
Destination spas and day spas are here to stay. The growth rate continues to be strong for these companies. The question really isn't, "Are these companies good for the profession?" The question is, "Are these companies good for you?" Evaluate your goals, style and personality before you decide to work for a spa on a part-time or full-time basis. Then evaluate each specific company to see if you mesh well with their corporate culture. Find out if they follow the above guidelines. Keep in mind that even though a company might be part of a larger corporation, every manager or owner has their own style and may run that specific location differently than others.
Click here for previous articles by Cherie Sohnen-Moe.
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