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Massage Today
July, 2010, Vol. 10, Issue 07

The Initial Treatment: Generating Thousands to Your Practice

By David Kent, LMT, NCTMB

After nearly two decades of owning a clinic, managing therapists and treating patients to this day, I have learned to never underestimate the potential income of a new client, when their initial treatment includes the appropriate education.

A client who is well-educated on the tremendous benefits of consistent massage will more than likely become a regular client. And potentially, after an initial treatment, one client can generate tens of thousands of dollars to your practice.

In the early 1990s, a client was referred to my clinic with symptoms of pain and restricted range-of-motion (ROM) in their neck and low back. During that initial treatment, I provided pain relief along with education to help the client understand why he was in pain and how continued treatments would help improve his quality of life. To this day, that same patient spends hundreds of dollars in monthly self-care treatments when he visits Florida. This adds up to thousands of dollars annually, and tens of thousands of dollars since his initial visit.

Whether you work for yourself or someone else, the initial treatment often determines the number of future appointments scheduled, the purchases of other products or services, future referrals and possibly the amount of your gratuity or bonus. This article will cover various ways to educate patients during their initial treatment to build your practice and attract patients who will spend tens of thousands of dollars.

pain intensity scale - Copyright – Stock Photo / Register Mark Fig. 1: A pain intensity scale makes it easy to understand, remember and target the client's key complaints. Investigate

During the initial treatment the patient is evaluating whether they should invest future time and money on more treatments. Since you only get one chance to make a good first impression, make it count. Start by being thorough and have clients complete health intake and pain intensity scale forms to document their past and current conditions. On a diagram of the body have the patient shade the areas that hurt, indicate the pain type (e.g. aching, dull) and intensity (0 = no pain / 10 = excruciating pain) they are experiencing. (Fig. 1)

These essential forms will help the patient to clarify and the therapist to quickly understand: When the pain started and what may have caused it? What has been tried in the past for relief and the results? Do they believe the condition is temporary or permanent? What movements aggravate the pain? If there has been a medical diagnosis: when, by whom, and what tests or imaging were performed? What activities of daily living (ADL) is this pain effecting and how has the pain modified those activities? What are their goals for today's treatment? (Read "Questions with Direction" MT, September 2008.)

postural analysis charts - Copyright – Stock Photo / Register Mark Fig. 2: A picture is worth a thousand words. Use postural analysis charts and the built-in digital camera on your phone to evaluate and educate clients of muscular stresses and how they lead to the formation of trigger points. Assessment

Clients should feel confident that you understand the origin of their pain and have the information needed to implement an effective treatment. It only takes a few minutes to ask clarifying questions regarding information on their intake forms, check range-of-motion, perform prudent orthopedic assessments and take postural analysis photos.

Postural analysis grid charts make it easy for clients to see asymmetries of the body. While large charts are appropriate to hang on a wall, digital versions of charts are perfect for when wall space is limited or when you perform outcalls. And along with the digital age we live comes various digital applications to choose from. I show patients the correlation between their posture and their pain by using the screen on my cell phone. (Fig. 2) (Read "Getting Comfortable With Posture Analysis" MT, July 2008.)

trigger point pain patterns - Copyright – Stock Photo / Register Mark Fig. 3: Showing clients the trigger point pain patterns they are describing gives them confidence in your knowledge and abilities. A muscle movement chart allows you to immediately identify the muscles causing their postural distortions, limited range-of-motion and pain. This chart lists the muscles that shorten and contract producing movement in every joint of the body so you can breakdown any postural pattern. It also allows you to confirm the normal degrees of range-of-motion for each joint.

Review the trigger point (TrP) referral patterns that mimic their symptoms. If a client reports they have headaches that start in the temple or behind the eye, which then radiates behind the ear and into the neck, they are describing the referral pain pattern for TrP #1 in the trapezius muscle. This is one of the most common TrPs found in the body. Showing clients their pattern on a trigger point chart lets them know you understand the pain and have a plan to help. (Fig. 3)

Portable trigger point and muscle movement flip charts - Copyright – Stock Photo / Register Mark Fig. 4: Portable trigger point and muscle movement flip charts allow you to give professional presentations in any environment. Portable trigger point flip charts provide a professional presentation in any environment and are easily moved from one location and/or treatment room to another. The best flip charts on the market have laminated pages to prevent oils and lotions from damaging them. Note: Look for chart systems that are logically designed, easy to use and includes a muscle movement chart. (Fig. 4) (Read "Tools to Succeed for Massage Therapists" MT, May 2009.)

Training and Treatment

A solid knowledge of anatomy is key to delivering effective hands-on treatment techniques. Dissection seminars are the ultimate learning experience allowing you to see, touch and understand every tissue of the body. Attending this level of education sets you apart from other therapists. Physicians and other health care providers in your area will respect this level of study and be more willing to refer. Your therapist bio should be updated to reflect your advanced trainings. Certificates should be placed in your reception area, treatment room and/or your Web site.

Homestudy DVD programs are excellent support tools. The best dollar valued programs cost more; however, they come with accompanying photo manuals. This allows you to watch the DVD while reviewing your manual. Some systems include cross-referencing to trigger point, muscle movement and other charts.

Review and Recommend

Upon completion of the treatment, explain that it makes sense to you that they felt the aches, pains and symptoms that caused them to seek your services. Share that during the treatment you palpated the muscles, assessing and confirming your other objective findings. Review very briefly their postural analysis photos, correlating the photos to their pain intensity scale and trigger points that were identified during the treatment. Conclude your treatment with a few tips and recommendations to help them avoid this pain from returning. Show them stretches, the proper use of ice, and the ergonomic modification to be integrated into their daily routine. Now that they feel the relief of one treatment, explain that a series of four, six or more would provide much greater benefit. This is the time to explain the specials or packages that would be best for them.

Clients also realize we have extensive experience using various creams, lotions and topical analgesics. They respect our judgment and purchase the same products we use during their treatment as gifts for themselves, family or friends. Most products have a 50 percent markup and can add significantly to your annual bottom line without requiring you to perform any additional hours of therapy.

Never underestimate the future potential income a new client can generate. Be proactive and prepared by investing today for the tools and knowledge you need to educate yourself and your clients. Before you can expect clients to make a large long-term financial investment in your treatments, you must show and tell them all the reasons this is a wise and worthwhile investment. Integrating the proper patient education into your initial treatment can reap patients that spend tens of thousands of dollars with you over the years.

Good luck and please let me know about your experiences in the treatment room.

Click here for previous articles by David Kent, LMT, NCTMB.


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