There I was, fresh out of massage school, working alongside chiropractors and physical therapists as the only LMT in a professional medical office. I remember working my tail off for $9.50 an hour in those early years. But I didn't mind the long hours and low pay at all because I was so happy to be doing the rehabilitation work I loved.

I've always enjoyed working side by side with chiropractors. Over the years, I've worked with nearly a dozen different chiropractors, each with their own specialty and their own way of treating the body. And with each one, I gained experience, knowledge and a lot of respect for the profession. This relationship with chiropractors has given me a valuable resource for information and referrals. In fact, one of the reasons I'm able to enjoy such a successful practice today is because of developing and maintaining these relationships.

Now, 14 years later, I still have a deep respect for the relationship between chiropractic and massage therapy. So, why is this relationship so historically contentious? I got a glimpse of the real issues when I had the honor of speaking at the Florida Chiropractic Association National Conference. With my background in a chiropractor's office, I'm always curious about what soft tissue modalities chiropractors are recommending. And I always like to ask their views about working with massage therapists. Not surprisingly, the results were a mixed bag. About 50% of the chiropractors I spoke with believe so strongly that bone manipulation is the answer that they dismiss massage therapy as a form of treatment altogether.

This isn't something massage therapists should take personally. In most cases, the chiropractor in question simply attended a school where soft-tissue work was not part of the protocol. The good news is, this is more of an old-school approach that is rapidly changing. The other 50% of chiropractors believe in the benefits of blending these two modalities to improve client outcomes. Yet even among these, there was a palpable hesitation around working with massage therapists, and an outright pessimism around hiring therapists to work in-house.

Unfortunately, when there is a divide between our two modalities, everyone suffers. Clients aren't getting the best outcomes, chiropractors aren't getting much needed support, and massage therapists aren't getting enough clients. So, here are the top five reasons chiropractors don't hire massage therapists and the simple strategies you can use to build a successful professional relationship with a chiropractor.

Reason #1

Although a chiropractor may believe in the benefits of massage therapy in theory, they've seen mixed client outcomes working with therapists. The solution is to hone your skills as a therapist. There are a lot of modalities out there. If you want to work with chiropractors, be sure to pick the ones that match this field most closely. Choose grounded anatomy courses first before more Eastern types of therapies. Many therapists believe that learning just one more modality or technique will give them an edge. This often comes at the expense of true mastery in any area. Here's a tip: Chiropractors aren't looking for the therapists with the most tools in their toolkit. They're looking for the therapists who know how to use the tools they have masterfully. And don't forget your anatomy!

Reason #2

Far too many chiropractors I spoke with felt therapists sometimes undermined their treatment plans. Here's what one chiropractor shared with me, "I hired a massage therapist because I knew patients would benefit from having soft tissue manipulation, but once I gave the referral, the patients stopped coming for chiropractic treatment. I found out that the therapist was even seeing patients in her home." When I asked the doctor if he would consider having another massage therapist in his office, he just shook his head, "Why should I hire another therapist, it doesn't benefit our office in the least." The solution is to show professional courtesy. When you go into an arrangement with a complimentary colleague, show that colleague the professional courtesy and respect they deserve. Honor not only the letter but the spirit of the agreement you've entered into and work as a unit for the benefit of your shared patient.

Reason #3

As massage therapists, we don't like things to feel too "clinical." We like for people to be relaxed and at ease. We love soft lights, beautiful aromas and enchanting melodies. But if you are brought in to work in a professional medical office, you've got to act the part. Here's what one chiropractor had to say about her recent experience with a massage therapist, "My husband and I were just getting our office started and thought it might be a good idea to have a massage therapist join us. We gave her a room and a very small rent, and she turned the room into a dark lit room with candles and incense. She came in poorly dressed and then one by one talked our clients out of chiropractic. We believe in soft tissue work, but the therapists really seem like they are on another planet. I mean once we gave her a place to work the relationship immediately changed. It was like we were the enemy."

The solution is to dress and behave like a valued part of their professional team. In the medical community that means being well dressed and well groomed. Don't transform your treatment room into a dungeon or burn incense that could bother other patients. Don't come in smelling like cigarette smoke. If you have tattoos, keep them covered. And don't ever undermine the physician that gives you the job or referral. Renting within an established space is like living under Mom and Dad's roof; you've got to respect their boundaries.

Reason #4

Without advanced degrees to our credit, it's sometimes hard for massage therapists to gain acknowledgement and respect from chiropractors and other members of the medical community. But that doesn't mean we can't play an important role in treating patients. The solution is to establish mutually beneficial relationships by letting everyone do what they do best. Chiropractors have the ability to run tests and determine a diagnosis for the patient. This diagnosis informs the treatment plan and allows therapists to achieve even better results for our clients because we know more about their condition.

This is a win-win-win. You get a new patient, the patient gets better and the doctor has a valuable therapeutic resource to offer his or her patients. The more the chiropractor trusts you and sees the results in the work you're doing, the more work he or she will gladly send your way.

Reason #5

I've had countless conversations with massage therapists complaining that chiropractors don't pay well enough. Many feel that the percentage is too low. Some even told me they thought chiropractors were making too much money off of their labor. We all deserve to be treated and paid fairly. And as a talented massage therapist, you should absolutely negotiate a fair agreement that you can feel good about. But there is one issue that massage therapists who feel that they're not being treated fairly often overlook or underestimate. And that is overhead. As a spa owner myself, I can tell you firsthand that this is something I always underestimated when I worked for others. But between rent, lights, laundry, insurance, taxes, marketing and the occasional "unexpected" expense, overhead can easily eat up to 90% of your profits. (No kidding!)

The solution is to negotiate a fair agreement for yourself and never complain or speak negatively about your compensation, especially in front of clients. If you feel that the agreement you have now isn't fair, ask to speak to the chiropractor about it. Set up a meeting to review your compensation. But keep the money talk confidential. Too much chatter about money, and too much complaining in general, will get you fired, let go or downsized. So don't do it.

Here's the bottom line: There's no doubt that when massage therapists and chiropractors work together everyone benefits. Use these tips to help you create mutually beneficial relationships based on professionalism, loyalty and trust. The results will be well worth it!