Massage Practice Builder

One of my most favorite quotes about massage therapists beliefs about money comes from one of my favorite books written by Steve Capellini called “Making the Switch to Being Rich”.   I don’t think that many have heard of or read this book but it is very interesting in many ways.  First it is a story of how Steve was a member of the “Moonies” in the early 70′s I think it was.  They were a cult basically.  Steve’s father had him taken away and deprogrammed by a specialist.   He equates the process of deprogramming of brainwashing from his experience with what massage therapists need to do to snap out of it – it being the moneyless bubble where massage therapists gather and live in.

In it he says this about massage therapists:

If there is an entire group of people who are almost all inside the moneyless bubble, it’s massage therapists.  We want to help people and heal them.  We want to ease their aching muscles and soothe their unquiet souls.  We want meaningful interactions with our clients.  We do not, for the most part want to focus on the monetary aspects of our jobs.

Why do massage therapists equate making money with doing something evil?  Why do massage therapists so easily give of their time and sacrifice making money in order to help people?  Why do they think that it is more “noble” to live in poverty or without and help others?  Why do they think that making money for doing something so loving and caring is not right?

Money is just money.  It really isn’t worth anything anymore.  There is no gold in the banks backing up the money.  Our money is just currency – something to trade for products and services.  How we get so many hangups about money comes from the beliefs we adopt at an early age without having the opportunity to question those beliefs.

Some common beliefs about money are:

• Money is the root of all evil
• People with money must have  sold their soul to get it
• People with money must be doing something illegal to get it
• I get enough in the form of being appreciated by clients
• Living simply is a better way of life because you don’t need much
• If you are rich you are focused on materialist things and not caring and helping people.
• You can’t care and make money too.
• You are not in this for the money
• You can’t make money doing something that you love

The thing is that most of these beliefs about money just are not true.  As Steve also says in his book people become massage therapists to further prove their beliefs about money.  It is sort of a self serving prophesy.

There are a few ways to start looking at what your beliefs about money are.  You can just start thinking about what you think or say when you see people with money or driving a fancy car.  Are you jealous?  Angry even?  ( I had a client who once owned a Bently and he sold it back to the dealer because so many people were keying it because they were one of those things – jealous and/or angry) .  What do you think about the idea of being able to charge $100 a session for a massage?  Do you think it is impossible?  That no one would pay it?  That it would be impossible to stay in business or even get clients at that rate?

Beliefs are just the perspective or filter that you see things through.  Everyone has them and lives their lives through them.  Some see the glass half empty and others the glass half full.  We think something is true because we think it is true.

Understanding and becoming aware of the belief systems that you have about money and success is a process that takes time and learning more about how beliefs are formed and how they impact your every decision.  It is a process of learning to take responsibility for the outcomes of your actions that are based on these old beliefs.  It isn’t about blaming yourself for where you are.  It is just being willing to accept what happens when you make decisions and then change that response to get a different outcome.

Once you are more aware of these unconscious beliefs that drive your actions you can then begin to change your actions to get better results.  Instead of blaming your lack of success in your business or in the massage job market  you can start seeing that it is a result of your actions or lack of actions.  There was a particular online forum recently just wanting to blame everything on the economy.  Is it the economy or lack of financial preparation and planning?  Lack of marketing or not figuring out the right marketing method that works?

The reason I keep writing about this is yes I was once in the moneyless bubble mindset.  Until I started my websites and started making money online, I always just made just enough to live on.  I didn’t care for the most part either.  Now I know better.  A career in massage is not a license to live in poverty or even simply.  You can have whatever you want if you are willing to start thinking and challenging your beliefs about money.   While Meagan Holub’s book the Magic Touch: How to make $100,000 as a massage therapist is being released – what is the next level even that this could go to? Could a massage therapist make $250,000 ??  $500,000?   or become multi-millionaires like Bonnie Brown former massage therapist at Google.

Social Networking is the latest craze as many of you are well aware of.  Figuring out what is the best use of your time is important when considering participating in these networks.  How will you find the best opportunities to get new and repeat clients?

Twitter is one of the easiest to use and get results with.   If you don’t know what twitter is yet, it is an online network that you sign up with for free.  Create a twitter account to just be used with your business.  Twitter is unique in that it only allows you a few sentences of space to use to communicate with people.   But who are you communicating with?   People can sign up to ‘follow’ your postings.  But where do you get people?   The best place is to put a twitter feed on your website.  You can get the code to put a twitter badge on your website by going to the Settings page.  In about the middle of that section there is a place for you to put your website address but right under that is a link that says:

(You can also add Twitter to your site here)

Click on that and click on the other tab (or one of the others if you are using one of those systems for your website.)  Click to create a badge.  You can add what you want it to say on the top or whether or not you want to create a flash badge or a html badge.  The flash badge will be interactive and show people’s reply ( I think!) So just copy and paste the code into your webpage where you want it.  I have mine on my homepage above the fold (near the top) where it is the highest profile and also on my services pages.  I also just created a twitter page that people can go to directly.  You can see how I am using it at www.massageseattle.net  I actually just started using it last week and have already gotten 3 new clients.  I also have quite a few visitors to my website and it already gets me a lot of calls but I think it will help even more by making this info of my schedule availability more public.  I am also sending a series of posts based using “you know you need a massage when you ….” and then will do a top ten reasons for getting a massage or something like that and see how that goes.

Facebook – Facebook is fairly time consuming.  It is really important to set up a business only listing.  What facebook is better for is finding your old high school buddies and long lost loves.  You are supposedly not allowed to set up more than one facebook profile.  They do have a way to make a business page and have it connected to your personal page but to me it is not private enough.  I personally don’t mix clients and friends.  You can use facebook to create more messages and even use it like a mini website if you don’t already have your own.  You can search facebook members to find businesses and doctors or other people who you want in your referral network and ask them to be your friend.  You can write a small newsletter like posts.  People can post on your wall or you can opt to not allow people to do that.  The thing I don’t like about Facebook is that people who become your friends will also have access to see each others profiles which may not be a good thing for your clients who want their privacy.  I did find a facebook group for my office building when they were having an open house that I could become a fan of and post my message about being the massage therapist in the building.

Linkedin in works sort of the same way as facebook but it doesn’t connect you with all of your old friends.  Linkedin is more of a professional networking site.  They also have a section where people ask questions like yahooanswers but it is much more professional than answers is.  You may possibly find someone looking for a massage but it is more like looking for a needle in the haystack.

I am not a big fan of social networking because of the time it takes to put into it all.  I would rather be writing a new article for my website to educate people who are already interested in getting a massage.  My website is found for the keywords that I have chosen – downtown seattle massage and it comes up first on Google and most of the other major search engines so writing there is more targeted advertising.  Also writing more content and educating people about massage and muscles and how the body and massage work together is a way of building trust with people.  When they read a website full of information and research they will get the feeling that you know what you are doing and trust you enough to make the call.

So if you are using one of these or other social networking sites successfully I would love to know what you are doing!

I just read that AMTA Massage Industry Research Report says:

Nearly sixty percent (57.8 percent) of school administrators responded that the average age of students has declined at their school in the past five years, according to the 2008 AMTA Massage School Survey. School administrators estimate that the average student is 30 years old, with 36.6 percent being 25 years old or less.

The National Average for massage therapists was 45 and is now about 40 and is continuing to decline according to these facts. (that of course are not public information – another of my AMTA pet peeves!)

What does that mean for the massage profession?

I have been seeing a trend through my website www.massage-career-guides.com where I talk about what it takes to become a massage therapist that more people right out of high school are wanting to go to massage school.  Their main question is ‘do I have to take math?’  If people are coming to a career in massage just to get out of taking math classes what will that do to the profession? Do they have the maturity to hold the therapeutic relationship?

Careers in massage are becoming more appealing to younger people but with only a 500 hour training program I for once don’t think it is enough.  I come from the camp that less education is really better and that anyone can take a 100 hour massage school training and provide adequate relaxation massage and also bill insurance companies if they want to learn the ropes on how to do that as massage for stress is applicable to just about everything!

But thinking about high school kids wanting to become a massage therapist I usually tell them to go to college and get a degree in business and marketing and then decide later if you still want to go.

If people are coming to the massage profession just to get out of taking math or they are also drawn by the so called ‘ high wages’ that of course is not true – where has the passion and a calling to help people gone?  For me being a massage therapist is a lifestyle and a way of life and a great road for personal and professional development.

I think it is about time we do start thinking about creating 4 year college programs like Japan or 3 year training programs like Canada for these younger people.  My concern is that will massage just be massage – in the totally pure physical sense without the emotional, mental, and spiritual healing aspects?

Who is studying these trends and working on keeping up with them in our massage training programs?

When I first started out 20 years ago, there was no such thing really as a job in massage.  People became massage therapists because it was more of a lifestyle choice.  People were looking for independence and the freedom to do as they pleased while making a good living.

Today while the statistics from ABMP and AMTA don’t quite reflect the increase in job opportunities websites like www.citytowninfo.com make it out to be.  Our professional associations still say that more massage therapists start their own business.  I am not sure if that is still true or not.  These type of career and salary sites show such a wide variety of salary ranges it is impossible to really know what is going on out there.

I do know that having more massage franchises has opened up more job opportunities but with the rate of pay so low is that really an advancement?

I get more emails from massage therapists asking me to hire them or tell them where the good jobs are which show me they are really lacking in job seeking skills to begin with.  But the trend from being self employed business owners to more employees seems troublesome to me.   People looking for jobs are seeking security in the form of a job and income.  While there is nothing wrong with that really, it is the rest of the things that go with it.  Massage used to be more of a calling and a way of life.  People came to the massage profession wanting to help others and learned to be of service to others.   Now people are just looking for a job to fill their time and get paid.

How will these recent job trends influence the massage profession?  We don’t even really know since we seem to get such conflicting statistics.

I was also wondering about the increase in the number of Massage Envy like places and was wondering if it would be possible to have franchises that charge more and pay the massage therapists more and also use tools like supervision (not in the usual sense but as in clinical supervision ) which would seem like more of an advancement to me.

I was also reading a really good book by Robert Kiyosaki called “The Cash Flow Quadrant” which describes the employee, self employed person and business person really nicely.  You can read more about it on my blog but it got me thinking that maybe more Franchises are needed that do provide better working conditions, better massages, and charge a reasonable fee (as compared to the cheap fees of some franchises.)

Since jobs seem to be on the rise we may as well figure out how to provide more and better paying jobs.

I came across an interesting thread on the indeed.com job forums (very enlightening reading!) asking what to do about being bored when doing massage.  I have to say that I was quite shocked to think that people are bored doing massage.  I have been doing it for 20 years and I have to say I have been a lot of things – burned out, frustrated, sad, excited, sick, tired but never bored.  There is too much going on to be bored.

In The Heart of The Soul, Gary Zukav says,

“Boredom is a flight from what is important. Like workaholism and perfectionism, it is a way of distracting yourself from inner experiences. It occurs when you look outward and do not find anything to engage your attention. Instead of feeling your emotions – becoming aware of the functioning of your energy system – you become bored. Boredom … is a flight from your higher potential. It is fear of the transformation that wants to occur, and will occur in you, when you explore your emotions. It is your resistance to spiritual growth.”

When I posted that on the forum I got people telling me that boredom is genetic and all sorts of things. Then one person said she has gotten massage from someone who she knows is bored and she couldn’t tell the difference.

I for one would not want to be going to a bored massage therapist.  I can tell when people are working on me what their focus is for the most part.

It is hard for me to understand why people remain in a profession if they are bored.  Time is too short to waste.

If you are bored and are looking for some answers the quote above seems like a good place to start.  I guess I am never bored because every person seems like a new situation to me even though I do have weekly and even clients who come 2x a week.  I focus on what I am feeling in my hands, the clients body and my body and time flies.   I work with people to engage them in the process of massage often asking them to compare sides after working one arm or asking them how things feel when I feel tightness.  Letting them give words to what they are feeling helps people focus inside.

Yes and staying present is the goal and challenge at all times.  Sometimes it is easier than others.  Presence is what creates the therapeutic relationship which is really the basis for healing.  Having presence requires that you are able to look at your own feelings and have them without acting on them.  Clients will be able to heal better and faster when in the presence of someone with presence.  It will enhance your ability to use your intuition in massage sessions.  It is also the key to preventing burnout which is so common in the massage profession.  Working with presence can leave you feeling refreshed after a day of doing massage.  Creating presence allows you to go beyond your techniques and connect with people on a very deep level.  It is also the key to overcoming boredom while doing massage.

Suzanne Scurlock-Durana talks about it on her blog here at Massage Magazine and  her website  www.healingfromthecore.com which has a few really great articles on creating presence.

Just wondering if there are others out there are bored and why or what are you doing about it or are you just fine being bored doing massage?

My post a few weeks ago on the $100,000 massage business seemed to create quite a stir.  The idea that a massage therapist can make that much money seems too good to be true for most.  Many come to massage careers saying it isn’t about the money or that they just want to help.   Underneath the idea of wanting to help is usually another side of our profession that is not really talked about. The deeper reasons underneath wanting to help (which is also usually sacrificing our needs to make money) are usually what lead to giving too much and eventually burn out.   Since massage therapy is considered to be one of the many helping professions we have a lot to learn about our needs to help others.

I was first exposed to this idea early in massage school in 1987 when reading a book called “How Can I Help” by Ram Dass.  I actually didn’t think much of it at the time and didn’t think that it really applied to me at the time.  In the book he says:

The more you see yourself as a “helper”, the more need for people to play the passive “helped”.  You’re buying into, even juicing up, precisely what people who are suffering from want to be rid of: limitation, dependency, helplessness, separateness.  And that is happening largely as a result of self-image.

Often what is happening when we feel a compulsive need to help is that we have to get rid of someone else’s pain because it is hurting us too much. Out of helping usually comes feelings of power, respect and a certain knowing that we did all that we could for someone to try to take away their pain.

While helping can truly come from compassion, it is often confusing.  When we help it makes us feel like we are important and are appreciated.   Being able to tell the difference will mean the difference between your success or having to change careers because of being burned out.

Fast forward 15 year of working as a massage therapist and feeling burned out myself,  I read this series of articles by Jack Blackburn called “Caretaking vs Caregiving” and it all came together:

” When we caretake, we assume responsibility for our clients’ healing.

When we caregive, we support clients in assuming responsibility for their own healing.”

Caretaking comes in many shapes and forms.  It can be seen when you charge less than you need to make or don’t have any cancellation policies (or enforce them).   It can be seen when you give advice instead of just listening.   Caretaking has it’s roots in early childhood and usually in the way you learned how to attach (or not attach) to your caregivers.  When your early needs for attention, appreciation and love are not met, many people give up their needs in order to get that attention.  It continues on into adulthood and shows up in relationship, money and career issues and somehow seems to really show up in helping professions.   Setting your needs aside for others benefits while it may seem viruous and noble, usually is not really helping anyone.

I actually used to be one of those people who didn’t want much and didn’t charge much for my services.  I didn’t want to do any marketing or sales because I was shy and hated promoting myself.  I lived a simple life (and still do) but making money became as important as helping since I couldn’t help people when I was feeling burned out or didn’t have enough to take care of my needs. The more I learned about caretaking and ‘noble poverty’ ( the idea that having money is somehow wrong), the more I could see how I created my underearning to support my lack of self confidence.  The thing with underearning, noble poverty and caretaking is that they are really unconscious patterns and you don’t really see them until you are forced into looking at them.  Some people may never get to looking at them and that is OK too.

My basic message today is that caretaking is a big part of our profession.  As you become more aware of how caretaking influences your clients lives and your life, you can begin to make different choices that support caregiving (healing).   You can live simply but you don’t have to live in poverty and wonder if you are going to get by.  You don’t have to make $100,000 a year but you can make what you need to make to pay the bills, live debt free, take nice vacations each year and save for retirement.   The process of unraveling caretaking from caregiving will be a contining challenge.   It shows up in how you care for yourself financially – Do you raise your rates each year?  Do you have a cancellation policy and enforce it?  Do you give away your time to clients by doing longer sessions or excessive volunteering?  (What other profession gives away their time for free?)    It shows up when you are challenged by becoming friends with clients, by undercharging, by not doing the things you need to do to promote your business.  It shows up when you take low paying jobs thinking that is all that there is.

This is really a very short post about a very broad and intensive topic.   I would recommend that you begin reading about this in some of my favorite books and free online articles I have posted on my website.

Recommended Reading List

The Code of the Caretaker

Noble Poverty - Mikelann Valterra’s Website

Jack Blackburn’s articles “Caretaking vs Caregiving”

In the Service of Life – Rachel Remen.  This is one of my favorite articles that also started my interest in this topic.

The thing is that once you get started in exploring these issues with either a regular therapist or in the process of supervision you will most likely see your massage business grow.  The steps in building a business gets easier as you clear up some of the unconscious programming and beliefs about money and success.  So you can make $100,000 or more even if you want.  Making that much money isn’t a crime.  The more you make, the more you can actually help by doing things like setting up non-profit groups that offer free and low cost massage.

Last night when I was watching Oprah I was so moved by the story of the guy who was a singer who would rent out theaters to perform in and then go out on the street with a CD player and let people listen to him singing and sell tickets to his shows.  He started with a small theater that he rented for $3000 without actually having the money in the bank and went and sold tickets all weekend so that he could have the money deposited by Monday when the check went through.  He of course made it.  The most interesting part really is that he rented a theater in Chicago for $18,000 and was attempting to do the same.  He put a video up on Youtube and invited Oprah and Gail to go to the show.   Gail showed up at the theater and invited him to be on the Oprah Show.  The thing is that he had the video up for awhile and was really hoping and counting on Oprah showing up.  The day before Gail showed up he had given up hope and he said he was actually crying all day in his room.  Gail showed up when he had given up – surrendered.

Marianne Williamson who is a teacher of the Course in Miracles is also another story like that.  She taught for free for years before becoming a well known speaker and writer.  She just had so much passion for the material and lessons that she just kept with it not knowing or caring if it did become anything.

It got me thinking about just how much passion is really needed to make things happen. While I know some massage therapists have that, others don’t and I think it is the reason that so many struggle to start and build their massage business or even find a job.

What would you do to build your massage business?  What would you do to find a high paying ($45 an hour) with good benefits job in massage?

Offer free massages for a month?   Offer to work for someone for free for a month to show them how much you could improve their business?

I also keep thinking of a story that I read in a book but can’t remember where about a story about a Chiropractor who was wanting to start a business in a small town of about 6000 people that already had many chiropractors.  He went door to door in the community and asked people about their health and what they needed.  He focused on the people.  Of course his business was full right from the start even though he didn’t actually promote his business in the inquiry.  He was just gathering info about what his community needed so he could provide it.

Would you go door to door to everyone in your area to find out what they want in a massage or massage therapist?

Would you offer free consultations?  Go into offices and offer free consultations?  Work for free for a month or as long as it took to build the trust and respect of your community?

Would you set a massage chair or table up on the street in front of your office offering a sampling of your work and selling appointment times until your business was full?

Would you offer free massage classes for couples or friends until your massage business was full?

Would you work for free at a hospital, spa or medical office to show them just what you can do for their customers and how you could enhance and increase their profits?

What would you do to make your massage business a success or to get the best job in the massage profession?

There is some contoversy over working for free.  Massage therapists struggle at fairs, conventions and such giving away free massages.  Some people who get free massages just want free massages.  But I think if you change the context of the free massages and look at it as an informational gathering session or come into it with so much passion in your heart that people can just tell what massage means to you – that it is an amazing healing method that can help to heal a persons physical and mental/emotional injuries.  It is different from behaving like a used car sales man (who always get the bad raps!) who is selling and conniving just to get something.

Do you love doing massage so much that you would stand on the street and offer free samples and ‘sell appointments’ like the guy sold tickets to his own performance?  I guess you also have to see the Oprah show where they showed him visibly moved by all that happened and how passionate he was about singing.  He was just born to sing. Here is a clip.

Were you born to do massage?

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.