Massage Practice Builder

Finding a job in massage seems to be getting more difficult in some areas of the country that are harder hit by the economy.  I have been getting many emails from massage therapists asking where are all the massage jobs that were promised in massage school.  I am not sure what people are expecting but if they have done their research they would find that massage jobs are low paying and you can’t really make a living working at one of the many franchises that are hiring massage therapists.  Most entry level jobs start at $15 an hour and you only get that when you are actually working on a client.  You get paid minimum wage or somethings nothing at all to sit around and wait for clients to call.

I have also been getting all sorts of stories about very difficult situations in massage jobs – places closing without notice and chiropractors hiring people as independent contractors when they should be employes, high end spas telling massage therapists that they should do work on people that is contraindicated, massage therapists not having any say on who they work on….the stories go on and on – low pay, no pay, no respect.  Then there is always talk of a union for massage therapists.

I actually don’t know much about unions except that I don’t think it is the answer.  That would create the same level of pay for everyone whether or not they are doing a good job or not.  What needs to happen is the massage schools need to start showing people how to create their own jobs instead of thinking that they are stuck having to take what is out there or start telling people what the job market is really like.  I guess they won’t do that because then they wouldn’t have any massage students.

What if massage therapists started taking more of an active role in creating jobs for themselves or participating as a team member in a job?   We teach people how to treat us so what if massage therapists stopped taking the low paying jobs and stopped putting up with being taken advantage of?   Would there always be someone out there who would any job and work for the cheaper wages?

What if people started thinking more about having a career in massage and following a vocation rather than just getting a job?   I have been doing some reading on jobs and the idea that jobs are just usually thought of as a way to get a paycheck.  James Hollis, a psychologist and author of the book “The Middle Passage” says:

“A vocation is what we are called to do with our life’s energy.  It is a requisite part of our individuation to feel that we are productive, and not responding to one’s calling can damage the soul.  We do not choose a vocation; rather it chooses us.  Our only choice is how we respond”.

Another of my favorite authors -A.H. Alamas in his book Diamond Heart Book One says:

Your career, interests, relationships are very important – but they are only as important insofar as they lead you toward a deeper understanding of yourself.  Otherwise they are irrelevant.

So many people do come to the massage profession with a calling like that but end up taking jobs just to eat.  I propose that there is another way if we only support each other in following the calling and start really taking the time to create our own “Ideal Massage Therapy Job” rather than taking jobs and complaining every day about it all.   That would involve a process of self discovery and maybe taking a few bad jobs so that you can know more about what you do want.  What do you envision for your self in finding a job in massage?  What do you desire?  What if you could take all the time in the world and didn’t need to make money right away – what kind of job would you really want and take?

See also the massage therapy job center on www.thebodyworker.com

Why is it that so many massage therapists think that being a salesperson will somehow take away from what they do when they do massage?  Why do people think that massage is so holy that people will just flock to their table because they have good hands or can give a good massage?

Massage Therapists who own their own business need to be sales people if you want to be successful.  Even if you have a job and work for someone else you will be doing sales.

Maybe part of the problem is the used car salesman and other sales people who give the word sales a bad name.

Sales is just telling people what you do so they can decide if it meets their needs.  It is a matter of using your skills and knowledge about health and massage and sharing it with potential clients and current clients.  Is telling clients that you recommend that people get massage once a week doing sales?  Is asking people at the end of their session if they want to make another appointment being a sales person?  It is and being a sales person can be as simple as that.  You don’t have to lie or deceive people or bring your snake oil.  Just be yourself and promote yourself because you believe in the power of massage and your skills as a massage therapist.

How does this take away from what you do?  What is it that makes massage seem so special that many massage therapists don’t want to charge for it or do sales?  Yes it is nurturing at it’s most truest sense that everyone should have gotten for free when they were in their infancy and before they were 5 but since they didn’t get it then, they can get it now unconditionally from a skilled therapist who sets clear boundaries and teaches them that they are OK at their deepest level.  Can massage do all that?  I think so and much more.  But it takes being a salesperson to get people on the table so they can experience it first hand!

No sales = No massage profession!

Through the years massage insurance billing to me has been such a mixed blessing.  I am constantly challenged by the ethical dilemmas in billing insurance companies.   Last month an insurance company told me to just make up a code to put on the bill.  They were telling the patient that no script was needed but it is in every case.

In WA we have the unique status of being able to be a contracted provider with HMO’s and PPO’s.  To me that means we do the same work and more work and get paid less!  You do get to see clients more often than you would for the most part if they were paying cash but it is as such a price.

Some of the other problems are:

• clients often no show more often because they think the insurance company is paying.  This requires having a cancellation policy and enforcing it.  I have gotten more grief from clients with insurance when I try to enforce my policy for some reason.  They just don’t respect their sessions as much it seems.  (of course there are also many who do.)
• Clients will often think that they can just get massage for anything because they have coverage.  It doesn’t cover wellness massage.  Insurance companies have a medical necessity clause that usually says something like “to rehabilitate or restore function of an acute condition. It does not cover maintenance massage”.  Of course there is no list  of what is maintenance massage or what conditions it does cover.  Doctors seem to be prescribing massage for their patients without realizing that it is not usually covered if they just have an ache without loss of function.  There are also many massage therapists out there who will do maintenance massage and also make up diagnosis codes so it can be challenging when you have to turn a client away only to be taken up by someone who will ‘let it slide’ as one guy said through the system.
• Delays in payment – having to call multiple times to get paid
• Stop payments – companies are now requesting chart notes and it seems that no matter what I write they are denied.  I have taken classes in chart noting.  They do not have any reason other than they just think everything is maintenance massage.
• It is more difficult to get clients to continue their treatments after they are better and pay cash.
• Talking to insurance companies is like talking to a wall -literally.  I had to be on a 3 way phone conversation with the patient, the patient customer service rep and me and I actually could not speak to the patient rep as a provider.  It just wasn’t allowed.
• Each year our allowable fees are reduced along with patient benefits.   While I used to get paid well over $100 for one company they now pay less than $70.  They do not raise their allowable fees very often.  Last year I got a raise of about .02 from one company.  One company used to allow over 45 sessions a year and now are down to 16 sessions a year.  They are constantly decreasing everything

The thing is that it is really difficult to change anything with the insurance companies since they have such power.  I have heard from many other massage therapists in other states wanting to know how to get on a provider list in their state.  Some companies in other states are now allowing that but it is really such a mixed blessing – How do we as  a profession gain the strength to stand up to insurance companies?  How can other states go into credentialled contracts with insurance companies with more open eyes and make better decisions about accepting insurance for massage services?

How can we get out of managed care and create our own system of health insurance or health care that will have the patients benefits in mind?  Or is there a way to participate in managed care and work to change the system?

What if the big associations had commercials on TV and radio for massage to promote massage and help massage therapists build cash businesses?  I could see it now  – an announcer about to talk really fast about the side effects of massage and they start very slowly saying something like ‘ well you will just feel better’.

To help other massage therapists understand and do massage insurance billing I do have quite a bit of information on how to do it on my website.  I leave that info up with mixed feelings also but I think massage therapists need to know how to bill so they can see just what it is like  so we can begin to make changes in the system.