Archive for The Wealthy Massage Therapist

Massage Business -Creating Policies and Procedures

March 10, 2008 Julie Onofrio Ethics, Peer Supervision, Start Your Massage Business, The Wealthy Massage Therapist

As a massage therapist, creating a solid framework for you business is like creating a solid foundation for a building. The clearer and deeper you go, the taller and larger the building you can build.

So many massage therapists avoid creating policies like cancellation policies, late fees, no show policies and when they do they have a difficult time enforcing them.

By creating these policies it will let your client become more informed about who you are and what you do. They can then decide if you are a good match for them to work with. It also gives you the opportunity to choose who you want to work with and create your ideal massage practice. I struggled with these things too for years as a massage therapist thinking it was what I needed to do to get and keep clients. I thought that by not charging for missed appointments or working longer on people when they are late for an appointment that I was making an extra effort for them to like me and keep coming as a client. I thought I needed to take everyone as a client regardless of whether or not they fit in with my ideal client. In doing that for more than 15 years, I can now see that it was part of the causes for my burnout in the mid 90′s. Giving away your time, money and energy is just downright draining. Period. You may think it is doing the client a favor and helping them more.

I wrote about this previously and mentioned a readers poll done by Massage Magazine last year about their cancellation policies and the ways they enforce their cancellation policies. There is of course such a wide variety of ways and answers.

The thing is to find out what works best for you in supporting you as a business owner and as a person. On one hand you need to make money to pay the bills. Since the number of clients that you can see in one day is limited and having just one client not show up or cancel at the last minute can effect your income significantly. Enforcing the policy sometimes and not on others can be confusing to the clients. As Dr Phil says – “We teach people how to treat us.

While things do happen to people – getting stuck in traffic, sick kids, sick themselves, issues at work – who is responsible for the clients actions? Them or you?

Setting strict cancellation policies may end the relationship. The question is do you really want someone as a client who does not respect you or your time?

Creating well thought out policies can help you create a stronger massage practice.

-What is your policy for when someone cancels with less than 24 or even 48 hours?

- What is your policy for working on someone who arrives late to their appointment? Do you work longer if you have the time? Or do you stay to the alloted time frame?

-What do you do when someone just does not show up period. They just forgot for whatever reason. Then when you call them, they are not apologetic but blame you for not calling to remind them or say they don’t want to pay for something that they aren’t receiving?

- Do you have a cancellation policy that is clearly written and placed on your website and intake form? Do you verbally state your cancellation policy?

There are a variety of ways to handle these situations:

  • Charge a minimum fee like $35 or half your session fee for a no show.
  • Charge your whole session fee for a missed appointment.
  • Choose to work on someone who is late for the full appointment time if you have the time.
  • Give people one session to forget and then remind them of the policy and charge them for any further missed appointments.
  • Don’t charge anything or say anything and you just eat the cost for the lost time and energy.  (How does that one feel?!)
  • Allow for extra-ordinary circumstances such as sickness, deaths in the family, real emergencies.

I also just did a quick search for ‘massage cancellation policies and found a variety of ways that people are communicating their policies some of which are very interesting with one person even apologizing for having to enforce the policy.

Here are some examples that I just copied off some websites ( I know- don’t get upset.)

Everyone’s time is valuable, that’s why we have to follow a few simple rules.

In today’s hectic world unplanned issues come up for all of us. We recognize this fact, but we respectfully request that you cancel your scheduled appointment by phone or e-mail a minimum of 24 hours in advance. That way the open slot can be filled with someone needing an appointment.

Failing two scheduled appointments in a row or three appointments within six months will result in a scheduling hold for Massage Appointments being placed on your account. This means you will not be able to schedule appointments with the Massage Therapy department.

You can also just do a search yourself and use some of the examples you find to create your own policy.  The most important thing to think about is what you need to create a solid massage business.
I guess I am always amazed when people think they won’t have to pay for a missed appointment or have any obligation what so ever for their commitment (which just happened to me only for the second time in 20 years which is why I am writing about this again!) I think that people do feel bad for missing appointments but it may just be too hard to admit that they do. The feeling will overwhelm them and move them into a defense mode – blaming you, blaming traffic, blaming their boss rather than accepting responsibility. Most doctors have cancellation policies. If you book a flight and miss the flight you have to pay a large fee usually. If you get tickets to a symphony and miss it or are late, you don’t get reimbursed.

While creating these polices will be a very personal thing and enforcing them another just keep in mind that what you do is also affecting the massage profession as a whole.  Letting people get away with no shows, late cancellations and late arrivals is teaching people how to treat us (massage therapists) as a whole.  What policy do you need in place to create a successful and rewarding massage practice and profession?

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A New Earth for massage therapists

February 28, 2008 Julie Onofrio Peer Supervision, The Wealthy Massage Therapist

“A New Earth” is Eckhart Tolle’s book that is now being promoted by Oprah. They are teamed up and offering a free online class that starts on Monday, March 3rd.

When I read “A New Earth” a few years ago when it first came out, I couldn’t put the book down and it became an inspiration for me to continue writing about such things despite many massage therapists not quite getting it that they can build a massage practice using similar principles of becoming more authentic by being present.

So many massage therapists are caught up in knowing more, learning more and doing more and the client usually gets caught in the middle. Part of the problem is how we are trained to ‘fix’ in massage school and our new role with the medical profession requires us to do it even more by reporting on improvements and having treatment stopped when function returns rather than when pain is resolved.

I was at a spa a few weeks ago and overheard a massage therapist in the hallway talking to someone who had just come out of the massage room and telling her how stressed the client was and how much more work the person needed. I could feel the tension in the air. The person who had just gotten a massage was being berated for how much stress they had rather than being honored for who they are. Now I am sure I am reading into things because I don’t know the whole story but it is examples like these or other stories of massage therapists saying things like “I just need to fix their pain” or ‘it is my duty to tell people about mercury poisoning and other possibilities that could be causing their health issues or I don’t feel like I am doing my job.

What “A New Earth” talks about is our roles that we take on to protect ourselves and our egos from suffering and how that creates more. But it is suffering that can free us from our pain and unhappy lives.

The ego is not something that is bad or that we need to get rid of. He says “It isn’t wrong, it is just unconscious” We are alive today because our egos are invested in ourselves. Tolle says that ‘Our egos are just are false self. It is the unconscious part of ourself.” The way to become more conscious is to become more present and aware of our egos.

But awakening from being unconscious is a little like thawing out from having frost bite – it is painful as we start to regain feeling.

A common thing that I often hear from massage therapist that I work with is about how they don’t feel like they know enough to help people. Tolle says this is actually the best place to be. When you can admit you don’t know enough you can realize that you are enough just as you are.

Another way to become aware of your ego is to become aware of what you are feeling in your body. As massage therapists we have the unique opportunity to help people feel their bodies more. ( I actually think this is more important than any specific massage technique or method.) Tolle says “Body awareness not only anchors you in the present moment, it is a doorway out of the prison that is the ego. It also strengthens the immune system and the body’s ability to heal.”

I also so often see massage therapists who become their role thinking that they are the only ones that can help someone and that massage is the end all answer to the worlds problems. I used to think like that when I first started out saying things like ‘if everyone got a massage once a week there would be world peace” (well there might be!) I also hear them complaining about things like working for chiropractors who take advantage of them or not having enough clients because of the economy or whatever the complaint is at the moment. Tolle says that “Complaining is one of the ego’s favorite ways of strengthening itself”. It makes us feel better to complain. And clients come into us complaining about this or that, this work situation or family situation and they come in with their pain and their attachment to their pain.

He talks about roles and how we take on roles to get the needs of the ego met.
How can we as massage therapists learn to become aware of our roles and learn to just be as a massage therapist?

How can we learn to serve and become more present with ourselves and with our clients to help make “A New Earth?”

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Working for a Chiropractor

February 27, 2008 Julie Onofrio Find a Massage Job, The Wealthy Massage Therapist

One common issue that I always get emails about or see comments on my Yahoo Group or other groups is about massage therapists working for chiropractors. I actually have already started to address this issue in another post but another thing keeps popping up – that of billing insurance companies and what the massage therapist gets paid by the chiropractor.

When a chiropractor (or even a massage therapist) bills an insurance company for massage services, one of the common practices you will see is one of overbilling the insurance company – the person coming in and paying cash will be charged something like $60 and if the insurance company will be charged $220 or something above and beyond the charges for the person paying cash. The thing about this is there is some concern over whether it is actually legal or not to do that and it may vary state to state but as far as I know after attending a workshop put on by two attorneys for AMTA- WA last year, it is illegal to charge more for your services when you bill an insurance company. You can bill a fee that would be equal to what you have to pay a billing person to actually do the paperwork and collections which I would think a normal fee would not be much more than $20 and that is guess high. The thing is that insurance companies will and do pay the higher fees and also do not really have a system for catching such discrepancies.

Here in WA there was actually a law passed awhile ago that limited the amount a chiropractor could charge to the insurance companies. ( I think this is it but am not 100% sure so let me know.)

So then you have a chiropractor charging high rates to clients like $200 or more for a massage and the client is left paying a high copay if it based on a percentage of the fee and the massage therapist is usually paid between $25-$50 an hour. Where does all the money go? To billing? I don’t think so. The chiropractors are getting rich off of the massage therapists work.

On the other hand you also have to take into consideration that the chiropractor is probably doing all of the marketing and work to get that client. That is worth something I think – but is it worth $150 a session or more?

The other thing that seems to be going on is that chiropractors think that they need to be the boss and tell the massage therapist what to do and how to do it. Well that is fine if they are an employee – you can tell an employee what to do but it is different if that person is a sub-contractor. Chiropractors also are only trained in chiropractic methods and some are not informed of what massage can do. They also can seem to be overly protective of clients and not refer freely to massage for various reasons -like I had a client who had so much inflammation going on the chiropractor thought it would be best to wait when massage is one of the best things to deal with inflammation.

The thing is that there are chiropractors out there who are mainly interested in their patients health and will hire a massage therapist to participate in that healing process.

Part of the problem is also that massage therapists are not informed when they take a position with a chiropractor and end up complaining about something that they unknowingly agreed to.

Some things to ask a chiropractor when interviewing for a job at a chiropractors office are:

  • How much do you bill the insurance company for the massage I will be doing?
  • How long are the sessions I will be doing with a client?
  • Will I have time between sessions for self care and client follow up?
  • Is it OK to tell clients to stretch and so other self care things?
  • Is it OK to tell clients about other therapies that might work better?
  • Do you give clients the option of paying cash and receiving a receipt so that they can bill their insurance company later and be reimbursed?
  • What is your philosophy on healing and chiropractic?
  • How do you see massage fitting into your practice?

So often massage therapists are so excited about the possibility of getting a job at a chiropractors office they forget to stop and figure out what it is that they really want and find out if the chiropractor is somewhere where they can fulfill their dreams. The best way to actually know about a chiropractor is to get treated by them first as a client. If you wouldn’t go to that chiropractor or send your mother to them why would you want to work for them?

When you make an uniformed decision you often end up complaining and blaming the chiropractor. If you get stuck working in one of these offices, while you can try to voice your needs and work with that chiropractor if they are open for it. If not just learn more about what you do want and learn to focus on what you do want rather than focusing on what you don’t want by staying in a bad situation.
While it is always easier said than done – better now than later.

It is possible to find a good job that pays you well and has a respectable chiropractor as the owner who is willing to work for you.

And what about someday having massage clinics that hire chiropractors???

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Massage Therapists in a Money Fog

February 6, 2008 Julie Onofrio News, The Wealthy Massage Therapist

One of the main reasons that people are drawn to the massage profession is that they are seeking a career in which they can help others more and participate in work that is more meaningful. While that is all well and good, there is usually a whole other side to helping that people never dreamed they would have to deal with. When people come to the massage profession only to help, they seem to think that helping others will get them the money that they need to live or they may even go as far to say that they don’t need much money or that it isn’t about the money. Being in such a fog about money is usually what leads to such thinking or should I say they aren’t thinking.

I also get a fair amount of massage therapists emailing me or sharing their stories on various forums about how they are underpaid and not taken seriously by their employers. They initially agreed to specific terms without really knowing what they were getting into and are left feeling resentful when working on clients or dealing with the employers.

Mikelann Valterra in her book “Why women earn less” (which I think really could be called ‘why massage therapists earn less”), she outlines some things to think about to see if you are in a money fog:

Do you regularly balance a check book?

Do you know exactly how much you are making each month?

Do you know where all of your money goes?

Do you know if you are saving enough for emergencies and retirement?

Many high school students today are researching careers and jobs and the first thing they ask me on my site www.massagetherapycareers.com is how much can I make as a massage therapist? The massage schools will tell them that massage therapists are charging $60-$80 per hour and more but fail to leave out the fact that this is not really what you make as a massage therapist. If you are working for yourself you need to deduct expenses or if you are working for someone else you usually get about 20-30% of that which isn’t much after you pay taxes on it all.

It is good that high school students are asking today. I know when I went to college a very long time ago, I never went with the intention of how much money I could make.

Choosing a career based on your need to help others is really also saying something else. Why are you wanting to be a massage therapist? There is usually really an unconscious deeper need being played out which is usually really a need for love, attention or acceptance. Choosing a career without knowing or caring how much you can make could mean that you are in a money fog.

You can best do that by taking a look at what you charge clients for your services as well as what you charge for no shows or last minute cancellations. I read in one of the massage magazines awhile ago a survey that asked how many people charged for no shows and most said they didn’t and always made excuses for the client. I was quite shocked. (I’ll have to find that again.) That’s a great example of money fog.

The way to get out of a money fog is to track just how much you are spending and become more aware of your spending patterns and money blueprints. Also joining or starting a peer supervision group can assist you in becoming more aware of issues like this which is the first step and basically the answer to changing your beliefs about money. I am starting an online peer supervision/mastermind group very soon – hopefully next week and will start taking applications from interested participants so stay tuned for more information.

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Burnout in the massage profession

January 7, 2008 Julie Onofrio Ethics, Peer Supervision, Self Care, The Wealthy Massage Therapist

There are not any clear statistics of how long a massage therapist lasts in this profession and there aren’t any studies on the reasons why people leave the massage profession, but burnout is definitely one of them.

Burnout can show up in many different ways. You may feel drained after working with clients. You may feel stressed when you don’t have enough clients to make ends meet. You feel fatigued and may develop physical injuries or other conditions that prohibit you from practicing massage. You think that your work is not valuable and you don’t charge enough so you end up feeling resentful. You never seem to get enough clients to make ends meet. You never quite get the hang of marketing your practice and asking for what you want – clients.

No matter what the cause or the issues around burnout – isn’t it ironic that massage therapists whose role is usually to assist in helping others to avoid burnout in their own profession are plagued by it themselves?

So many massage therapists come into the massage profession thinking that it will make them happier to be ‘helping’ others. They think that in doing so they will feel better about themselves and have more meaningful work. While massage can do that in some ways, it is more about the massage therapists perspective on their work and how the massage therapist takes care of themselves so that they can work with others.

The thing is why don’t massage therapists do what they need to do for themselves? Most massage therapists are taught to get massage themselves and to eat right and to exercise. They are taught to tell clients that and to support clients on their path to being healthy. The problem really lies in the basic core beliefs of the person. ( It is really not just about massage therapists but anyone who is not getting what they want in their lives.)

Your actions (or lack of actions in this case) reflect your basic beliefs about yourself that were created in your early childhood and infancy in your family of origins. When you know you should be taking care of yourself but are not there is usually something more going on there. Most massage therapists know what they need to be doing – eating right, exercising, getting regular massage, getting your needs met outside your practice, taking vacations, etc.

Are you rebelling and trying to control at least one thing in your life? Are you wanting someone else to do it for you (on a conscious or unconscious level)? Are you eating the wrong foods and not exercising because you are seeking comfort and not wanting to do things that are difficult?

Whatever the reason for not taking care of yourself, you can begin to become aware of the way you take care of yourself by participating in peer supervision groups and sharing your stories and histories to learn more about the shadow side of helping.

www.thebodyworker.com

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