You Matter, From Beginning To End

About 1-1/2 years ago I joined a family support group. My mother had dementia which was steadily advancing. The assisted living facility offered the monthly group and I have attended regularly, through her death and beyond. This despite the fact that the 1-hour meeting effectively takes 3 hours out of the middle of my day. The group, though quite small, has been good for me.

When I showed up for the January meeting, no one was there. I waited a bit and then went to talk to the front desk. After much hunting on their part and mine we found the small notice that (1) the group was now being led by someone different and (2) it had moved to a different day of the month.

I was angry, disappointed, but mostly I felt betrayed. By offering this group and holding it regularly they'd invited me into a space where I could be vulnerable. Where I could take my hurts and be open about the trials and tribulations of my life.

I'd been preparing myself emotionally for the group, taken the time out of my workday, and driven the 25 miles to get there. Now, I felt abandoned. Insignificant. Tossed aside. And hurt. It hurt.

Not, you'll notice, by anything that happened in the treatment room but by what happened with their scheduling and their communication.

It's easy to think of these things as separate from the "real" work and a minor inconvenience. However, the more someone creates a space where a person can be vulnerable, the more every aspect of the relationship -- including mundane things like logistics and emails -- matters. Every interaction in the relationship becomes part of the therapy.

You've probably figured out where I'm going with this. If not, let me spell it out.

The things you do to "run" your practice, those mundane (even annoying) activities like scheduling and emails are part and parcel of the therapeutic relationship you have with your client. They are all part of you to the client.

You serve your clients best when you apply your highest values and your very best self to what happens in the massage room and what happens outside the massage room. Yes, even your business practices matter.

Because if you are doing your job well, you are creating space for vulnerability and thereby for healing. Do it well -- all of it --and with compassion.

Change Your Mind

It’s not uncommon for us to have a conflicted relationship with “business”. It’s almost like our massage practices are a house with two rooms: one for massage and one for business. Different rules and values govern each room. Sometimes, even our personalities change as we move from metaphorical room to room.

For example: we’re the very heart of generosity in the massage room but we resent even the small amount of cost involved in letting our clients pay with credit cards.

As a profession we don’t even know how to think about business. Since our schools don’t give us enough to work with, we look around for role models. Should we do business like doctors? Chiropractors? Concierges? The local pizza shop??

It's time we built our own model of how to do business. How? By looking at our highest values and principles as massage therapists. Yes, massage therapy can teach us how to do business.

Get Educated. You needed an education to do massage. Why should you expect yourself to do business without any education? You don’t have to get a college degree or an MBA. But you can take basic business courses at a community college (which have more and more online options), through community organizations, and at massage conferences.

Never stop learning. The best therapists invest time and energy in improving and expanding their skills throughout the life of their career. A basic business education is good but you’ll need to keep going. There’s always something you can understand better. Spend some time and money on business continuing education.

Develop a business ethic. Our profession has at least 3 codes of ethics – AMTA, ABMP, and NCBTMB. They vary in details but agree on the basics. We can use that to develop a business ethic. For example:

• Maintain healthy boundaries in business dealings between yourself and your clients.
• Avoid dual relationships in business.
• Be aware of transference / counter-transfererence in business interactions.
• There is an inherent power imbalance in the massage room and in your business dealings. Be conscious of and respectful of that.
• Represent yourself honestly in your business dealings.

Practice business self-care. We know what we need to do to keep our bodies operating well (whether we do that consistently is a whole ‘nother conversation). How do you keep your business healthy? Set and raise rates in a professional manner. Use discounts strategically. Choose partnerships carefully. Keep up with your bookkeeping. Separate your personal and business accounts. File quarterly taxes on time. 

Use good body mechanics. The key to good body mechanics is two-fold: knowing how to use your body well and being aware of how you’re using your body. In business that means knowing what good business practices are and being aware of whether you’re doing them or not. Setting money aside for quarterly taxes. Knowing what you can and can’t deduct as a business expense. Keeping licenses – business and massage – current.

Perfection is not an option. We would all love to do perfect massages each and every time. We can’t. We’re merely human. Setting “perfection” as your goal is a recipe for disappointment and failure. Do not expect yourself to be perfect in business either. You will make mistakes. You will have days / weeks / months? where you don’t do business well. Forgive yourself for being merely human, admit your mistakes, and keep trying to do things right.

Don’t go it alone. Even if you are a solo practitioner working out of your home, it is oh-so-wise to stay connected, even lightly, with other massage therapists. It’s also wise to have someone you can go to for supervision when you have an issue with a client. Talk to other MTs (or small business owners) about business. Share your successes and concerns. Teach and learn from each other. If nothing else, gripe together about the aggravations of running a small business!

Maintain confidentiality. We don’t talk about our clients outside of the massage room except in a professionally appropriate manner (supervision, for example). Don’t talk about your client’s financial situation (good or bad) outside of the massage room except in professionally appropriate settings (supervision, for example). No one needs to know which clients are only paying you a part of your fee because they’ve been unemployed for a year. No one needs to know which clients are unbelievably wealthy. No one needs to know which clients have maxed out credit cards or whose check bounced. What you know and learn about your client’s financial life should be kept confidential.

This is not an exhaustive list but if gives you a good idea of what I’m talking about. I think it’s time we defined what a healthy business mindset is for our profession and quit trying to blindly follow another profession. It’s time we changed our minds from “helpless/lost” about business to “solid MT values” in business.

Change your mind, change your world.

When You Can't Stop Working

Crap happens. That's probably my #1 rule about running a small (micro) business. Crap happens.

What this means is sometimes we are forced to stop working for a few days, few weeks, or (shudder) few months.

We tear a tendon. We cut our hands. We get pneumonia. We have to have surgery. Our jobs are 100% physical. If the body doesn't work, we don't work.

Snow storms. Hurricanes. Floods. Nature may be beautiful but she ain't always helpful!

Deaths in the family. Car stolen. Aging parent takes a turn for the worse. Child gets seriously ill. Partner is seriously injured in an accident. That's the downside to loving people. When bad things happen to them, it affects you.

There are things that are simply beyond our control and may force us to have to stop working now for a period of time. Except many of us really need that steady income. We don't have another source of income at home. We have bills to pay. Mouths to feed. Obligations and expenses.

So, what do we do?

We start today (ok, you can start January 1 if you'd like) to put aside a little bit of money every single week. Maybe it's $10. Maybe it's $100. Maybe it's the equivalent of one massage. Whatever it is, you put it aside every. single. week.

Your goal? 3-6 months of savings -- that don't get touched for anything else -- as your emergency stash. This assumes, of course, that you know how much you need to bare-bones sustain yourself for 3 - 6 months. For me, that's $3,000 - $6,000.

Yes, that's a lot of money. At, say, $50 a week, that would take me 1.5 - 2.5 years to build that up. At $10 a week it would be ... longer. Lots longer.

If you've got an emergency today, it won't help that you haven't being doing this for the last year or two. But if you start today, I can virtually guarantee that you will need that money at some point. And you will want to send roses and kisses to in-the-past-you who started putting that money aside.

Three steps:

1.  Decide how much money you can / want to set aside each week.

2.  Put it somewhere it won't tempt you. Set up an automatic withdrawal to an out-of-state credit union maybe? Switch it to a CD when you have enough accumulated? Don't put it in the stock market. It's not an investment. It's a save-your-butt / I-need-it-right-now fund.

3.  Don't touch it till you are forced to stop working unexpectedly (no, this isn't a vacation club account). If you retire without using it then (a) you are one lucky MT and (b) then you can spend it if you want (though I'll warn you, emergencies don't stop when you retire!).

True Confessions Time

I was working with another MT yesterday, helping her get some things straightened out in her practice. I mentioned something I was working on straightening out in my practice.

She said "oh, I'm so glad to hear you say that, I thought you already had everything working just right. There's hope for me now too!"

I do not have everything "all worked out". I have my foibles and hidden pockets of "gotta get to that one of these days" too. So, in the holiday spirit of giving, here my Top 10 things in my practice that aren't as they "should" be.

1.  My major plan for next year is to start using intake forms. I don't use them at all right now. I should.

2.  My website is 2 months out of date (which is obvious because I have material on there with a date/time stamp). Some of that is technical but most of it is just me.

3.  I share parts of my personal life with my clients (though, honestly, I only do this when I think it's appropriate).

4.  I have been out of my "new client" cards (that I give to all new clients at the end of their first appointment) for months. Since I can print them out at home, this is especially annoying.

5.  I contribute to my retirement account randomly at best.

6.  I have needed to get myself set up as an LLC for several years. It's not hard and it's not expensive. And it still needs to be done.

7.  I have fallen behind on my bookkeeping badly this year. I chalk it up to a very rough year emotionally (the theme of this year has been "death" and "grief"). I'll spend part of my Christmas vacation going through a year's worth of bank statements and paper receipts to get myself updated. And I know I'll still miss some deductions.

8.  I signed an IC contract a few weeks ago without really reading it or negotiating. It's for a very short-term relationship -- it ends mid-December -- and I just didn't want to be bothered. On the plus side, I know the owner very very well and knew exactly what I was getting myself into.

9.  My session notes are free-form (that is, not SOAP), done in Word, and mostly for my own benefit. But one of my goals this year was to actually do them consistently and I have.

10.  I haven't backed up my (electronic) business files in weeks. I'll be doing that as soon as I post this blog.


We've all got a list, long or short, of things we "ought" to be doing. Every small business owner does. We're just one person (is that grammatically correct?).

Perfection is not an option.

But working away at that "ought to" list is. Here's hoping I get a few of the things on my "ought to" list knocked off in the next few months and have a shorter list to report this time next year.

Which Type of MT Are You?

How would you define a "massage therapist"?

That's actually an important question in our profession. The answer governs how:

• professional organizations serve us.
• states write massage regulations.
• schools structure their professional training programs.
• national chains work with us.
• we talk to each other about what our profession needs
• we see the future of our profession.
• continuing ed is (and isn't) developed and offered to us.
• we want the public to see us.
• we identify and work on problems in our profession.

Here's the thing: there isn't one definition of "massage therapist". There are at least 5 valid "sectors" of MTs (based on my experience and observation; there could absolutely be more). As long as we fail to recognize that, we've got problems in all those situations I listed above.

Each type:

• defines its goals differently.
• attracts clients for different reasons.
• has its own priorities when it comes to initial and continuing education.
• has a different vision of the future of our profession.
• has different financial opportunities.
• even has its own language / vocabulary.

And each of them are a valid way of being a "massage therapist".

By the way, these sectors are not exclusive. There is overlap between many of them. Massage therapists can also practice in more than one sector.

Medical / clinical MTs are deep into the physical anatomy. They are drawn to solving problems and helping people improve their physical functioning. You find them in chiropractor offices, working with PTs, sometimes in hospitals. They are drawn to working with athletes, the ill, and anyone else with a condition or problem to solve.

Asian medicine MTs work with clients primarily through the modalities from the Eastern traditions. Ayurvedic. Shiatsu. Acupressure. They can be similar to the medical / clinical crowd but they're using different tools.

Energy healing MTs are drawn to working with the energetic body -- chakras, auras, etc. They are the "woo-woo" community in our midst.  :)  Reiki, Brennan, Donna Eden, chakra clearing are all types of energy work.

Spas are environments that work to provide a specific kind of relaxing, soothing environment for the client. These MTs are also more likely to do skin treatments. They don't exclusively provide relaxation -- the often include offerings from the other sectors -- but they provide a lot of relaxation. This is the "feel good" segment of our world.

I've left health & wellness for last because I think this may actually be the biggest sector. I call them the jacks/jills-of-all-trades. They combine a hodge-podge of modalities in their work and address a broad spectrum of clients. A lot (most?) of our group practices are in the health & wellness because they often try to provide the broadest range of possibilities. The MTs who fit most snugly in this category aren't drawn to specializing in one of the other sectors. They like to mix it all up.

There are also our cousins / neighbors who are developing training and products specifically for us as well as those who are providing all that business development consulting.

A friend of mine is a librarian working in corporate environments. In her industry, there are recognized sectors / sub-specialities of librarians that have their own professional organizations, their own issues and challenges, and their own training. They don't, generally, fight among themselves about who's a "real" librarian and who isn't. They recognize each other as deserving of the title "librarian".

Why don't we do that? Why are we still fighting with each other about what a "real" massage therapist is? How much energy would be freed up if we stopped these arguments for something more productive for our profession?

Based on some of the invective I've seen and heard, the answer is "a lot of energy".

I'm definitely in the "health & wellness" sector with my other foot in training and business development. My clients come for relaxation, to have pain reduced, to live more peacefully with long-term conditions, and often just to cope with living long enough to have age-related issues. I use more clinically-oriented techniques like myofascial release but I'll also do some chakra clearing if that's called for. I'm eyeballing training for next year in lymph drainage, reiki, and acupressure.

What about you? Where do you find yourself, most or all of the time? What excites you and governs how you understand the massage therapy world?

Comparing Apples to Lawn Furniture

You're looking at your options:

Setting 1: your work for yourself out of your home. You charge $80 / hour.

Setting 2: you work in a group practice. They charge $80 / hour. You get 50% of that ($40).

Setting 3: you work for a chain. They charge $65 / hour. You get $20.

It's obvious that working for yourself out of your home is the absolute best way to go and you'll definitely make the most money that way, right? Why would anyone work for someone else??

What you've just done is compare, head to head, apples and lawn furniture and used the results to decide which type of car to buy.

It absolutely matters how much money we make. You know what matters even more? How much money we get to keep and how much work it takes to make that money!

If you want to have a good life as a massage therapist, you have got to look at more than "how much money do I make per massage". That is one small part of the equation. Here's the full equation:

How much money can I make as a massage therapist?
 
minus
 
What will it cost me to run my practice?
 
divided by
 
How much effort will it take me to make that money?

Let's take a look at each of these questions in a little more detail.

How much money can I make as a massage therapist?

This a good place to start. This question has a little equation built in as well:

How much per massage x how many massages + tips

That first part -- how much per massage -- is where too many of us stop. But you're still reading so let's keep going.

How many massages? When we compare private practice to group practice to a massage chain, there really is a difference between how many massages you're likely to do in a week.

In private practice, some of us have full schedules most of the time. Many of us don't. It takes constant marketing to fill your schedule. That takes time and energy.

In a group practice, having a full schedule depends on how good the owner is at marketing the practice. Read manymessage boards and you'll learn pretty quickly that lots of owners aren't necessarily any better at filling the calendar than we are.

One of the things a massage chain has going for it is that they do marketing really really well. And they've got the budget (and national office support) for it. So you're more likely to have a full schedule at a decently-run massage chain.

Let's look at tips then. Lots of clients have a complicated chart in their head when it comes to tipping. Are you the owner? Are you working out of commercial space (i.e., do you have a lot of overhead)? Are you a health necessity or a luxury? It seems those first two -- owner, commercial space -- affect the tips the most.

I find that in my home office, I get very few tips. Your experience may vary. I figure about 10% of my clients tip me.

When I worked in a group practice, I got more tips. Not 100% of the time but probably 50% of the time.

From the conversations I've had with people working for corporate massage chains, tipping is the norm. Closer to 100% of the time.

What will it cost me to run my practice?

We really don't think this through well enough! Often because we don't want to think about it. It makes us feel nervous, uncertain, incompetent, uneducated, overwhelmed (not to mention frustrated). It can make us feel lots of unpleasant things.

Plus, it involves the not-fun part of math (that is, the subtracting-from-what-we-make kind).

Calculating the costs of running a practice often comes down to the difference between being self-employed, an independent contractor, or an employee.

Working out of my home means I am self-employed. Here's a rule of thumb for being self-employed in virtually any profession: 50% of your income will go to your expenses.

Yep, I said 50%. Ouch. But I can also say that having analyzed years of my own business bookkeeping gives credence to that number.

Again, ouch.

Why? You buy your own massage supplies and office supplies. You pay for all of your own marketing. You pay for the laundry. You pay 100% of your taxes. You pay for all of your licensing and continuing ed. You pay for your scheduling software and credit card charges. You drive to the bank. You suck up the discounts. Etc. Etc. Etc.

It's all you, baby.

If I work for a group practice, the odds are I'm an independent contractor. Some of my costs go away / are covered by "the split":  space rental, massage equipment, some office equipment, some marketing expense, laundry. You've still got your license, continuing ed, taxes, some of your marketing (because you should still be putting at least some effort into marketing yourself).

When I worked for a group practice as an independent contractor, I found my expenses were more like 40% of my income.

Most people working at massage chains are employees. Virtually all of the expenses (beyond your license and about 75% of your taxes) are paid for by the employer. Plus you might (depends on the chain) get paid health insurance and paid time off, something you pay for yourself as a self-employed MT or an IC.

So your expenses drop down to more like 20-30% of your income.

How much effort will it take me to make that money?

You know, none of us have endless energy or endless time (if you do, don't tell me, it'll just depress me). So we really do ourselves a disservice when we don't take the amount of time and energy it takes to run a practice into consideration.

This is an entirely personal calculation -- how much time and energy (and interest) do you have for the business of massage -- but let me give you some numbers, short and sweet, based on my experience and lots of interviews:

Self-employed home-based practice: 40-50% of my time and energy goes to managing the practice. This includes the time I spend randomly worrying about whether I'm doing the right thing or have forgotten something or should be trying something new or....

Independent contractor in a group practice: 20-30% of my time and energy goes to worrying whether the owner is keeping my schedule full, doing my bookkeeping, staying on top of my license and continuing ed, paying my quarterly and annual taxes, helping with laundry, and (if the owner isn't keeping my schedule full) worrying about whether I should jump ship or wait for things to get better...

Employee in a massage chain: 15-25% of my time and energy goes to keeping up with the schedule (every hour on the hour!), worrying about whether I'm being taken advantage of or could be doing better elsewhere, possibly stewing about being expected to do too many massages in a day, and filing my annual taxes.


How much money can I make as a massage therapist?
 
minus
 
What will it cost me to run my practice?
 
divided by
 
How much effort will it take me to make that money?

Sometimes working for yourself is the best way to go. Sometimes working for someone else is. You have to ask yourself deeper questions about what you're good at outside the massage room, what kind of energy and enthusiasm you have for running a business, what the rest of your life needs from you, etc.

Don't start and stop at the "how much money do I make per massage". You deserve a better-thought-through answer than that will  provide.

At the end of the day, all you have is your time, energy, and skills. Spend them wisely.

They're Not Out To Get You

When you opened your doors, what other practice were you hoping to put out of business? Whose clients were you planning to steal? What were your specific plans to have complete control over your area?

What?? Those weren't your goals when you opened your practice, were they? You weren't out to conquer and defeat every other massage practice in a 10-mile radius, were you? You weren't trying to put anyone out of business, you were just trying to take care of yourself I bet. Me too.

So why do we take it so personally when another massage practice opens up in our area (corporate chain or not)? Why do we assume they have it in for us, personally? Why do we assume they live and breathe (and structure their fees) specifically to put us out of business?

We don't think that, you say! Oh, yes we do. Lots of us think that if a practice in the next neighborhood offers deep discounts or a fancier spa experience, it's because they want to drive us out of business. We presume that Massage Envy / Hand & Stone / Massage Heights / etc. looked around with a wicked gleam in their eye and said "you, yes you!, I'm putting YOU out of business by stealing ALL of your clients!" And then they probably rubbed their hands together maniacally while chuckling "bwahahahahaha!"

Most people, even most chains, open their doors because they see an opportunity for themselves to make money. They see a need not entirely being met. They've structured their business (including their rates) to attract the people they think will be most profitable for them.

Just like you did (I hope).

Now, there are businesses that will specifically target their competition with the firm intent of putting them out of  business. I could tell you the story of an outcall business that moved into DC about 15 years ago and very intentionally set out to drive the pre-existing outcall business out of business. And they were nasty and underhanded about it (and they were that way in most of their business dealings, which is why they had a terrible reputation among the local massage community). Those people do exist, unfortunately (and, quick Google search, yep they're still in business in Washington DC though I haven't heard anyone talk about them in years so I suspect they aren't doing a lot of business in DC).

But they really are the exception (which is why I remember them so well). It's rare for a massage practice (yes, including a massage chain) to open with the express purpose of putting you out of business. Oh, if they've done their homework they know you exist and they have an idea of the size and strength of your practice. But they probably think there's enough business still out there for them to thrive as well.

It's not personal.

Does that mean having competitors doesn't affect us? Of course not! And we affect them (didn't think about that, did you?). It's part of being in business.

So what do we do about competition? I'd suggest, first, quit thinking of it as "competition" and start thinking of it as "the marketplace" in which our clients (or potential clients) move and make choices.

You are part of the marketplace. Other MTs are part of the marketplace. Other remedies for their particular woes (gym, personal trainers, talk therapists, physical therapists, acupuncturists, chiropractors, etc.) are also part of the marketplace.

How well are you making yourself visible in that marketplace?

How do your offerings (and hours and rates and scheduling processes and payment options, etc.) stack up against the others in the marketplace?

How well are you getting your message out to the people who are your ideal clients?

How well are you integrated with others in the marketplace?


"Competition"  It's not personal and they aren't (or at least rarely) out to get you. Take it as an invitation to keep yourself sharp. Take it as an invitation to stay focused on keeping your practice alive, relevant, and healthy.

(Because they're not going away.)