Massage Therapy Jobs

When I first started doing massage back in 1987, no one really thought of trying to go out and find a job in massage. There just weren’t that many. Becoming a massage therapist meant that you started your own massage business right out of massage school.

The current salary statistics that I mentioned in an earlier post on the future of massage  don’t make the massage profession look very appealing. One of the problems is that we don’t really have accurate statistics about massage jobs because there are so many massage therapists who do start their own practice.Today there are more and more places hiring massage therapists - Franchises like Massage Envy, Day spas, destination spas, hospitals, chiropractors, clinics, hospices, nursing homes, dentists, chair massage places.  With more places hiring massage therapists, the more competitive the job markets.

I am also seeing a trend through my website www.massagetherapycareers.com of more high school students looking at massage therapy careers.  The current average age of massage therapists is 45 according to ABMP and AMTA.  With more younger people joining the work force they are taking the entry level jobs that pay $12-$15 an hour.

So what is the key to finding a massage job that pays $30-$45 an hour which is a fairly decent wage level?

People seem to be blindly searching for massage jobs out of fear and desperation rather than taking their time to figure out what it is that they want for themselves.

One of the things I recommend to massage therapists that are just starting out is to go to a variety of places and get a few massages there.  Find out what it is like to work there by being a client there first.

What kind of place do you want to work at?  A spa, chiropractors office or other clinical setting?What are the current employees like?

What is the atmosphere like?

Is this a place that you would like to work for?

After you know more about a place you can then set up informational interviews with the managers of the places that you would most like to work for.  Ask them questions about the business so you can get more information about whether or not you want to work there or not.

Most people go about it the other way approaching places looking for a job and waiting to see if they get hired there without really knowing what they are getting into.

The other thing that massage therapists seem to forget is that even though they are going to work for someone else, they are the reason why people come back for more massages and refer all of their friends and keep the business going.  You still have to have good customer service and marketing skills to educate clients as to why they should come more often.  You also have to be able to tune into clients and find out what they really need.  Spas are more difficult to work at in some ways because you only get one hour to make a connection with a person as many are only coming in for that one a year massage treat.  All massage businesses depend on repeat clients and referrals and is mainly a result of how good the massage is, the connection between the massage therapist and client and the client getting their needs met.

I am in the process of writing a new ebook on finding a job in massage therapy.  What challenges did you or are you having finding a job in massage?  What things are you finding from working for a massage employer that you didn’t expect or do not like?   What are you finding out about the massage job market and employers that you would want others to know so that they can look out for these things in an interview or informational process?

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The future of the Massage Profession

With so many concerns of the economic challenges that are being faced and will be faced with what does the future hold for the massage profession? As a massage therapist for the last 20 years and an avid participant in the many online groups and through contact with my many readers, I can see that most of the massage profession struggles to get by. (Maybe it’s just because you don’t hear as much about the successful stories. They are out there though, I am sure.)

ABMP reports in their metrics section at www.massagetherapy.com that :

Average massage-related income for massage therapists in 2005 was $18,950, with a median income of $14,500 (2005 ABMP Member Survey)

Total earnings by massage therapists, including their earnings from other employment, were $32,506 (2005 ABMP Member Survey).

First-year practice average income was $9,589, reflecting the challenges of establishing a professional-service practice (2005 ABMP Member Survey).

ABMP estimates some 50,000 massage therapists leave the profession each year.

The average age of ABMP members graduating in 2007 and entering the profession is 44. The median age is 45.

Close to 83 percent are women and 54.5 percent are married.

As massage therapists look for other ways of making a living they are choosing to take low paying jobs just to get by. Massage Envy was one of the top franchises last year and this I just found online so I am not sure how true it is “As of this month, Massage Envy, which was founded in 2002 and reported nearly $100 million in sales last year, has 120 locations and 248 more under development in 30 states.” They pay their employees $12-$15 an hour from what I have heard -plus tips.

They are choosing to accept insurance as payment or join discount insurance networks just to get by. I am a provider here in WA State and have been since about 2000 when they started allowing massage therapists to be contracted providers with insurance companies. When it first started there were a few companies who paid fairly well but some who paid poorly -(less than the average of $60 for a massage in the US). I have yet to see them raise their allowable fees and most are reducing what they pay and also the allowable benefits. Each year it gets less and less and gets harder to get paid. Managed care makes it harder to make a living.

Since the median age of massage therapists is 45 according to the recent ABMP survey, where does that leave massage therapists as they move into their retirement years? Most massage therapists are coming into the massage profession as a second or third career and thinking of it as a way to supplement retirement or slow down until they retire. They are seeking a more fulfilling career working with others.

And where are all the men in the profession? With low paying jobs how can men support their families? With men as a minority in the profession it shows that there are still many preconceived notions about touch. Women don’t want to be massaged by men and men don’t want to be massaged by men. With this challenge men are leaning away from the massage profession for better paying jobs where they are more accepted.

With such struggles along with the physical, mental and emotional demands of being a massage therapist, many see this as a part time profession. They also perceive it to be more of a calling than a way to make a living and lack a clearly defined business model. Is massage a hobby or a business?

I also have been receiving many communications through my website www.massagetherapycareers.com in the frequently asked questions section from high school students looking into careers in massage. They ask about what jobs pay and where can they get a massage but their main questions are things like “Do I have to take math or science classes?” which makes me think they are just looking for an easy career (which massage is not.) Since most massage schools are just looking to fill their classes they tend to make massage careers look glamorous and appealing. While in the past most massage therapists have started their own business, many more are now taking those low paying Massage Envy jobs which will be affecting the whole massage profession and changing it from one of healing, compassion and learning to just another job.

The massage profession also is in the midst of a big controversy over licensing and legislation issues. How much training and education is required to become a successful massage therapist? How is massage and medical massage defined? We have yet to define these things for ourselves so now insurance companies are doing it for us. (In WA State there is one insurance company creating a special massage credential that defines how much education is required for a massage therapist in their provider network.)

So what is in our future? How can we take more control of where we are going as a whole and not let the economy and money over-ride client/patient care?

The Future of Massage - Whitney Lowe

Posted in Building Your Practice, Health and healing, Licensing and Legislation, Massage Therapy Jobs, Starting Your Practice | No Comments »

Working for a Chiropractor

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???

Posted in Massage Therapy Jobs | 13 Comments »

Massage Training Controversy

One of the big issues in the massage profession has to do with the number of hours of education that one needs to become a professional, licensed massage therapist. While many states have adopted 500 hours of training as the basic amount of hours of massage school, there doesn’t seem to be any proof of what is really needed.

There seems to be two schools and probably many in between but the two basic versions are:

• 100 hours of basic massage training focusing on giving massage
• 500+ hours of extensive training in anatomy, physiology, orthopedic massage or some advanced systems of massage

When I went to massage school back in 1987, the basic requirements in WA State were 250 hours of massage school which did include anatomy, physiology, pathology and treatment massage for working with various basic conditions such as sprains/strains, headaches and common conditions. I was in the last group that was let in under those requirements of 250 hours. The number of hours of training that was required was going up to 500 hour of massage school where it stands now. I was very glad to be in the last class at 250 hours because I didn’t want to spend the extra time and money. The reasons for the increase in the number of hours of training was just an arbitrary thing that the state board seemed to come up with at the time. The massage schools were actually requesting it for no other reason than that they could make more money by getting students to stay longer. Keith Grant in his white paper on “Issues in Massage Governance” which he wrote in 2002 described this situation exactly. I have spoken about it here and really recommend that anyone who is interested in the future of the massage profession read it. It is quite lengthy and I have summarized this before on the blog.

Basically what he says is the same thing - that 100 hours of massage school is enough training to do massage and become a massage therapist.

People who think differently seem to have such an extreme reaction to this statement but don’t seem to have any proof or references to back themselves up other than statements like:

• People can’t do medical massage with only 100 hours of training
• People can’t give a good massage with only 100 hours of training
• People need much more anatomy and physiology than could be fit into a 100 hour training class

There is a whole other controversy over the issue of medical massage. Does medical massage require extra training or is it just the ability to be able to bill an insurance company for massage services which only requires knowing what paperwork is needed and how to show improvement in a massage session. Anyone who can do basic massage and can create a change in a muscle can show improvement in a condition.

I guess I must have my own personal definition of medical massage because I have been doing it since 1989 when I started my practice with 250 hours of massage school. From the very beginning I was able to bill insurance companies and be paid and was also very successful in working with clients. That doesn’t mean I didn’t get more training through the 20 years of being a massage therapist.

I am not saying that having more training is not good and that all of those years and thousands of dollars that are spent are not worthwhile. I am not saying that more education can improve your chances of being successful.

What I am saying that anyone can be taught to do a basic massage in 100 hours of training. How successful they will be depends on them, just as it does with someone with 1000 hours of training. There are so many massage therapists that do have training and still are not successful. ABMP reports that about 50,000 massage therapists leave the field each year and though they don’t say why, I would guess that most are due to being unable to make a living whether that involves getting injured or sick or what.

The thing is that we really don’t know what is required as far as education in creating a massage therapist who can be effective and successful. As a profession we have not created any studies that show that 100 hours or that 1000 hours is the best.

I don’t really know what the answer is to the issue but am really open to hearing about solutions such as studies that could help create more successful massage therapists. Keith Grant’s solution is apprenticeship programs which seem to be put on the wayside to make room for the big massage school conglomerates such as Cortiva, Corinthian Colleges and the like. And with the increase in massage franchises that only pay massage therapists $15 an hour, I just have to wonder what exactly is going on.

Posted in Massage Research, Massage Schools/Students, Massage Therapy Jobs | 4 Comments »

Massage and Chiropractors

Massage and chiropractic care is a great example of complementary medicine. Chiropractors work with the alignment of the bones which influence the position of the muscles which influence the tension of the muscles. Massage therapists work with the muscles which when tight, over or under developed create stress and misalignment of the spine.

Many Chiropractors will hire massage therapists to work in their clinics either as employees, subcontractors or sub-leasers of their office space. The relationship between the two can really work together towards a patients healing process.

Working for a chiropractor often brings up many challenges with issues over pay scales, the massage therapists role or skills and other issues.

Chiropractors also seem to have a negative image of being more of a salesman and only out to get money. They are able to see a patient and treat them in a few minutes and they charge high fees for those few minutes. When they hire a massage therapist they are often able to charge high fees to the insurance companies and get paid that amount and seem to be notorious for taking most of that fee and not giving it to the massage therapist. Massage therapists often end up feeling resentful especially when it was not clear that this was the arrangement from the beginning.

If you are a massage therapist who is looking for work in a chiropractic clinic there are many things to look for in finding a respectful chiropractor that you can build a working relationship with. The most obvious thing is to become a client first to see if you agree with their philosophy and methods of healing. So many massage therapist are tempted to just take a job with a chiropractor without first doing their research and determining what they want most. The financial pressures add to this with massage therapists taking jobs that turn out to be not what they were looking for. It is important to take a good look at your values and what you want before looking for a job with a chiropractor or any massage job for that matter. Your values will tell you what action to take. When you start taking actions like working for a chiropractor that does not pay you what you need to make, you start becoming unhappy and start blaming the chiropractor for your less than ideal choices.

The way to approach a chiropractor about a job in massage is to become more like a researcher and collect information first about whether or not you want to work for this person/place. Interview a handful of chiropractors and get adjustment sessions from them. Do you like the way they work? How often do they ask people to come in for sessions? What is your perspective on how often someone who is injured should come in? Is the chiropractor just trying to increase the bill or does the patient really need that treatment? Are their clients getting better? Do they keep coming back? Do they do anything to change their lifestyle and their beliefs about health and healing? or are they still smoking and not exercising and not taking care of themselves?

The other thing that is a common issue is whether or not the massage therapist is considered to be an employee or a subcontractor. This is a legal issue to be determined by an lawyer but in general be concerned if you are told you will be a percentage of the fee which may be considered a kickback. If you are also told what hours you need to work that is usually more of what an employee would need to do.
There isn’t much legal help for the massage profession in learning to figure out if you are supposed to be paid as an employee or are you being confused to be a subcontractor. Business owners tend to look at the massage therapist as a subcontractor so they don’t have to pay for employee benefits and pay taxes for that employee.

1. Make sure you are getting paid what you are worth
2. Be clear about what you are responsible for
3. Get clear on what you want and be prepared to ask for what you want
4. Join or form a support group for you to be able to talk about your issues

See also: subcontractor vs employee

Massage Business

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