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Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
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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