Thursday, May 30, 2013

A Piece of Bad Legislation Dies

If you are licensed or practice in Washington DC, here's some GREAT news from the president of the AMTA-DC chapter! The AMTA-DC chapter has been fighting this frustrating fight with the city for two solid years:

"Chairman Mendelson's office confirms that the Massage Establishment regulations are unenforceable, and licensed massage therapists are not required to obtain a Massage Establishment License for their practice operations in DC.

Additionally, the DC Council's passage of Section 524 specifies that any regulations pertaining to practice facilities for LMTs must be affirmed by the DC council."

This removes (in practical terms) the barriers to sharing our offices / businesses with other massage therapists and allied health professionals. I think that these collaborative kind of business arrangements are the Next Big Thing in our profession and I am delighted that we've defeated the Massage Establishment License requirements here in DC.

Wednesday, May 29, 2013

A New Marketing Effort

Just got home from an evening of seated massage. This year I'm providing seated massage at fundraisers as a marketing tool. And I'm having a good time!

How it this a marketing tool?

1.  I focus on organizations that will get me out in front of people who live or work within 4 miles of my office. They also have to be organizations or events I would like to support.

2.  I ask the event host (if possible) to publicize the fact that they'll have seated massage there to help with the fundraiser.

3.  People pay for the massages because I want people to experience my work in a context where they also pay for it. Freebie massages have not been a good marketing tool for me. Sometimes I post a price list, sometimes it's a freewill offering.

4.  I have a sign with my practice information on it. I give everyone a business card. I talk to people about their history with massage and, if appropriate, tell them more about my practice or offer to help them find an MT closer to them.

This kind of marketing is fun for me. It satisfies my urge to volunteer while also promoting my practice. Win/win in my book.

Wednesday, May 22, 2013

Strangest place to hand out a business card?

What's the strangest place you've ever found yourself handing someone your business card?

My biz partner, Kitty Southworth, found herself handing them out at a funeral. She has a thriving geriatric practice but that means her clients die sometimes. At a client's funeral, people naturally asked her how she knew the deceased. She ended up handing out all the cards she had on her!

I'm in the hospital this week with an obstructed bowel, likely from scar tissue  from the surgery I had in December. This morning my nurse and I got to talking about scar tissue. She asked how I knew so much. I told her about being a massage therapist. She mentioned she'd just gotten her first-ever massage 2 weeks ago.

We spent about 10 minutes talking about massage, what to expect as a consumer, how to find a good therapist, how to find MTs that have alternative pricing options, etc. I heard her talking to another nurse out in the corridor about our conversation a few minutes later!

When she comes back tonight, I'm going to hand her a few copies of my card, the link to my Pay What You Can page on my website, and specifics about my practice.

What's the oddest situation in which you've found yourself handing out your business card?

Saturday, May 18, 2013

Can you apply "intention" to business?

I think Rebekah Blowers is a growing light in the field of business practices for massage therapists. Her most recent blog post talks about how we can apply the idea of "intention" to how and why we do business.

It's a short read but worth a few of your seconds and brain cells.

Monday, May 13, 2013

I spoke up. OK, technically I grunted.

I had an amazing massage experience last week.

I was in Alexandria LA visiting a friend who is in prison. After the visit, I needed a massage. Went to the AMTA Find A Therapist site. Found Charles Randall Monk. Liked what I saw. Booked an appointment.

I did something I don't normally do -- I let him know I was a massage therapist. We spent about 30 minutes in conversation before the session. Some of it talking shop (of course). Some of it talking about what brought us to massage. A good chunk of it talking about why I was there and what I needed from the session.

During the session, there were a number of times when the work hit a "hot spot" that was painful. I found it easy to speak up (OK, let me be more specific, I grunted). Charles responded immediately and appropriately. He's quite good at discerning the difference between a "oooooh goooooood" grunt and a "owwwwwww, too much" grunt".

So, why was it easier to speak up last week then it was 3 weeks ago? When I sat quietly with that I realized: because we'd taken the time to establish a personal connection.

During the intake, Charles took the time to really listen to me, to all of me, and to show that he was listening. Because I felt that I'd been heard and understood, I was much more comfortable speaking up / grunting when I needed to.

Every intake does not have to be 30 minutes long. Every intake does have to be structured in a way that both parties feel heard, truly heard. We have to establish a connection. That requires more than just "what hurts; ok I'll work on that".

We don't have to establish permanent long-term heart connections that will endure through the ages. We do have to establish the kind of personal connections that let that other person know that we are truly present for them and that we are honestly listening before, during, and after the session.

It will make a difference.

p.s. It was a 2 hour session, which was so wonderful. And he charges a flat rate! He's got a fascinating business model. I'll be writing more about that soon.

Wednesday, May 1, 2013

The Art of the Intake (aka: how to get them to talk to you)


In my last blog entry, I talked about why simply saying “let me know if it hurts” is not effective. Yet, we still need feedback from our clients. We honestly can't always tell when something hurts.

So, what do we do? I think much of the answer lies in our intakes.

A good intake is, in essence, a skilled interview. A good interview is one part technical skill and one part art form.

By “technical skill” I mean skill in structuring your questions in such a way that you elicit the kind of information most useful to you. A good instructor can teach you the basics but you only get good at it with practice. You hone this skill over time.

By “art form” I mean the ability to structure the more subtle elements of your intake to create a relationship where you and the client are naturally inclined to open communication and connection. Some of this can be taught in a classroom. Most of this comes with time and maturity.


Technical Skills



My undergraduate degree is in journalism. I spent a lot of time learning what to ask and how to ask it. That's the essence of the technical skills of a good intake.


Think about the kinds of questions asked by news people. Compare the “at the scene of the crime” interviews conducted by your local news station to, say, a “60 Minutes” or Barbara Walters interview.


Usually, no comparison. The “60 Minutes” team and Barbara Walters look prepared, they look experienced. You can tell they've done this before.
 

“60 Minutes” and Barbara Walters are also much better at follow-up questions. They recognize when an answer is incomplete, vague, or (ahem) smells funny. When that happens, they keep asking. They come at the question from a different angle. They point out discrepancies in the answers.

While a good intake should not feel like you're being grilled by an investigative reporter, there are things we can learn from these interviewers.


1.               Breathe. Before you ask your question and after the client answers, pause a few beats and say nothing. It will force you to slow down and it will help you focus. It will also give you time to actually process the question / answer.

2.               Ask both open-ended and close-ended questions. Sometimes you need a specific piece of information (when was that surgery?). Sometimes you need to create space for your client to share an experience (what happens to your life when your lupus flares up?). Think about when you need data vs. when you need to understand an experience.

3.               Know why you're asking the question. One of my ongoing complaints with health history forms is asking for information the MT can't possibly need. For example “List all the dates you've had PMS”. “Do you or have a family history of diabetes?” “How much do you weigh?” If a client asks you why you asked the question you just asked, you need to be able to show them how that information is useful to you; specifically, how will the answer feed into the massage they are about to receive? A bad answer is “because they told me to in school” or “because all the MTs I know ask this question” or “because I see this question on my doctor's health history”.

4.               Get clear on the information you can actually use. This is a follow-on to #4. Let's say you ask me if I smoke. When I ask you why you need to know, you say “because smokers often are more prone to bronchitis and have more problems with lung congestion”. If you want to know if I have bronchitis or lung congestion, ask that. Do you really need to know if I've ever been pregnant or do you need to know if I've ever had C-section?

5.               When they’re on the table and you encounter a lot of tissue resistance, ask “how does that feel on the inside?” rather than “does it hurt?” “Hurt” has a lot of baggage around it. Asking them to find the language to describe their experience brings them into it. If they say something vague like “it’s OK”, ask them to be more specific.


The Art Form


Asking great questions in a well-suited environment massively improves the odds of good communication.

1.               Sit down and face each other. You can't do a good intake by tossing questions over your shoulder while you change the sheets on the table. Your client often needs to physically slow themselves down so they can be present to the session. Maybe you do too. Sitting down helps. Looking directly at your client (as opposed to looking primarily at the health history form) makes a huge difference.

2.               Take as long as it takes. When someone feels they’ve really been heard, they listen better themselves. Sometimes that means letting clients tell you the “story” of their physical condition, even though you can tell they've told it so many times it’s now coming out like a recording. Think about how many people don’t listen to them, especially health care practitioners. Be a better experience for them than that.

3.               Learn how to be comfortable with silence. You don’t need to have a response for everything they say. Sometimes body language that indicates that you’ve heard them and are still listening is enough.

4.               Explain what you mean by “pain”. The odds are that even two massage therapists don’t define or explain it the same way. What are the odds that you and your client understand it exactly the same way? I talk to clients about “productive” and “unproductive” pain.

Maybe you like the “on a scale from 1 – 10” approach. That works….if you’ve define what 1, 5, and 10 mean in terms that work in the client’s world (not just yours).  What would be the signs – in the client’s awareness – of a 1, 5, or 10? I was joking recently with a client that 1 = you hear a dog barking a couple of houses down, 5 = you hear the dog barking next door, and 10 = you hear the dog barking under your chair. Goofy but memorable enough to possibly be useful.

5.               Tell them why you need to know if it hurts and what you will do if they speak up. That’s not as obvious to our clients as you might think. They may also be concerned you’ll stop massaging an area if they speak up.

6.               Don’t assume the health history has captured their reason for getting a massage. Health history forms tend to capture medical data. People come to massages for reasons other than physical pain. Your health history may not have asked a question about the specific thing that’s hurting them if they are here for pain relief. Ask them directly why they decided to schedule a massage today. At the end of your intake, summarize what you believe to be the goals the client has for the session.

Professional journalists spend their entire professional career honing their interview skills. We should too.
P.S. Several of my favorite interviewers can be found on NPR. Terry Gross (Fresh Air). Diane Rehm. Bob Edwards. Kojo Nnamdi. If you want to hear the skill and the art of a good interview, give them a listen.
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