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Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
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.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
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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