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Basic Communication Improvements For Massage Therapists

August 22, 2016/10 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Kimen Petersen

I always tell my students “when you get into the real world… you may be the best technical massage therapist but without great communication and listening skills you may not have the most successful practice”.

I remember when I was in Massage Therapy College, immersed in anatomy, physiology and manual skills (sometimes known as the hard skills) then once a week, we would go to a class where we worked on self-reflection, communication and listening skills (the so-called soft skills).

I know many of my classmates thought this class was a waste of time and completely irrelevant to the education they were now immersed in.

Me on the other hand, I love this stuff.

Over the years I have spent many hours in training and working on crisis lines, communication, conflict resolution courses and even peer counseling.

My passion for communication and listening came from, like many of us, a pretty tough childhood and teen years. When I was 12 years old a friend of mine took his own life.

Now (and to some extent then) in retrospect and had I known how, I may have been able to stop this tragedy. This event shaped my passion for listening and communication.

But this work requires a lifelong commitment with constant work and no matter how skilled you are, you may still miss things. This became all too real to me this January when at 4 am, my phone rang, it was news that another person close to me had taken their own life.

In retrospect, I could see the signs, but they were quite subtle. This is one of the reasons I am an advocate for communication and listening.

Now not all situations will be this intense but as healthcare professionals, we need to have superior skills in the areas of communication and listening and this is why I am writing blog posts on communication, starting with the basics.

Building Rapport With Massage Therapy Patients

One of those make it or break it skills for all Massage Therapists.

If a patient does not feel comfortable with you in the first 20 seconds it may hinder your ability to really help them.

Some of the things you can do to help build rapport are:

When you first meet the person look them in the eye.
Call them by name (sometimes it’s best to ask an elderly person permission to call them by their first name.)
I normally shake the person’s hand.
I always check if they need to use the washroom before we get started.
Invite them into the room.

Remember most of the communication is not the words, in fact more than 50% of communication happens in the body language and much is also connected to the tone or rhythm of the voice.

Be on time, nothing destroys rapport more than always being late.
Watch their face, do they look calm?
When you go to shake their hand do they pull away or do they move towards you?
Is their voice quiet and timid?
When you make eye contact do they hold your contact or look away?

The best way to build initial rapport is to meet them where they are.

Don’t hold eye contact too long if they are showing signs of being uncomfortable, give them space if they pull away and meet their tone and rhythm of voice with yours.

The Interview

Set up your treatment area so it’s calming but professional.

Remember the power differential, if you sit and talk to your patient (at eye level) it is less threatening and can make the person feel more comfortable in your presence.

Utilize the space between you and the patient, if you are too far away you will seem distant and uncaring, being too close might make the person feel defensive, I find 4 feet seems to be a good distance.

Take notes during the interview and special tests but do not allow your note taking to interfere with you being present with your patient.

Be professional at all times.
Be present at all times during the interview.
Use clear communication.
Avoid using slang and overusing of technical terms (or educate the patient so they understand).
When a patient says something important, paraphrase (repeat back what they said to you) so they know they have been heard.
Clarify what they have said so you understand what they meant.
Get a detailed history around their general health, details of the current issue and any pain related questions or physical limitations due to the condition.
Ask them what their goal for the treatment is.
Finally ask the patient what they would like you to address today (every so often I have a patient come in and describe many health concerns, then, when I ask, they request work on an unrelated problem).

The interview is your opportunity to recognize any contraindications that your patient may have, create a hypothesis for the condition you believe is affecting your patient and consider the level of special testing to either confirm or rule out your clinical reasoning around your patient’s complaint.

The Assessment

We as Massage Therapists are very well trained in assessment using range of motion, manual muscle testing and other various special tests to confirm or rule out conditions.

We have to remember that every patient is unique and just because the last three people had back pain due to trigger points in the gluts, it does not mean your next patient has the same issue.

A good assessment can narrow down the cause of the issue, help speed up recovery time and most importantly get our patients get back to their normal activities.

Consider a test that could confirm and a test that could rule out the condition you suspect.
Remember to ask permission before placing your hands on the patient.
Explain your special testing before you do it.
What you are testing for?
What a positive result will feel like?
Always test the unaffected side first.
Be honest with what you find.
Remember as a massage therapist it is not within our scope of practice to diagnose a condition, although we can state that the patient is presenting signs and symptoms consistent with a condition

A thorough assessment will help create confidence from your patients, reduce recovery times and help the profession by creating consistency in massage therapy treatments.

Photo by: StartupStockPhotos

Create Your Treatment Plan

Now that you have the history and have done assessments, the next step is to create a treatment plan.

For this treatment, then for subsequent treatments and the home care exercises (stretching and strengthening) hydrotherapy and any changes to activities of daily living.

When you give patients a solid treatment plan they are more likely to trust you, follow the plan and recover more quickly.

This is where research and experience comes very handy, if you understand the condition and the length of time the patient has been affected by it you can start formulate a plan.

When my patients come in with an acute issue I normally start them off with one treatment per week for four weeks then we reassess and back off from there but this always depends on the condition.

Discuss the techniques you will be using and why.
Discuss the areas of the body you would like to work with and why you recommend working with these areas.
Discuss a pain scale or intensity scale.
Discuss the possible side effects or complications of the treatment.
Discuss the level of dress.
Get consent to treat.

I always check in and regain consent when I am about to work with a more sensitive area like the gluts, lateral rotators, abdomen or the adductors (especially with new patients).

We are also required to monitor the intensity of treatment with the patient, so I always check in to ensure the treatment is not too intense (I am 240 pounds and have very strong hands), some patients may not tell you it’s too much unless you ask.

Before you leave the room to allow the patient privacy to dress down and get on the table, remember to discuss the level of dress and how to get on the table between the sheets with their face in the headpiece.

Don’t assume they understand the routine.

I have heard stories of more than one RMT returning to the room only to find the patient naked on top of the blanket.

Knock on the door before you re-enter the room, this way you can be sure the person had enough time to get on the table.

There is a debate in the world of massage if we should talk during the treatment or not.

I always say the difference between getting a massage and getting a massage therapy treatment is the fact that we educate the patient. After I know a patient and if they prefer I will talk a lot less during a treatment. Remember to keep your conversation within your scope of practice. Many of my students have asked me why I should be concerned about what I say or how I say it in my practice. We have to take into consideration the dynamic of the session and balance of power in a treatment. The patient (in many circumstances) is naked or nearly naked on the table (covered by sheets and a blanket) we, as the therapist, are pretty much towering above them speaking down to them. The patient (depending on the treatment) may be in a very relaxed or semiconscious state and these facts could possibly put the patient in a little too open state and cause them to believe what we say without question. At the end of the treatment, give everyone some form of home care and ask permission to send a follow up email with pictures, videos and details of the stretching and strengthening exercises.

Using Evidence Based Practice To Avoid Fear Tactics

July 25, 2016/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

Sometimes I just have to shake my head.

I’m sure we’ve all heard the same kind of things in our clinics when patients go to other practitioners.

“I have compressed discs in my spine, I’m out 14 degrees here, 12 degrees here and 8 degrees here”

Yeah, I probably have all that too, but I’m not in any pain.

“I went to this other therapist, and they said I’d probably never get better”

Well that’s not true.

Then there’s my favourite (I wish there was a sarcasm font).

“Well the muscle pain you’re having stems from something that happened when you were a child, it’s going to be really hard to get rid of it”

I’m sorry about whatever it is that happened, but that is going to take some counseling to help, you should talk to your doctor about a referral to a mental health professional to get the appropriate care.

Sometimes I wanna phone up these other practitioners and ask what the hell they are doing saying things like that to a patient but apparently I’m supposed to be professional or something.

Instilling Beliefs In Patients

As therapists we play a role in which we can be either effective or detrimental.

There is a strong correlation where what we say to a patient has a huge impact on their improvement or just instilling fear that makes them have to keep coming back in for more therapy.

Unfortunately instilling fear in patients with the language we use has become more of a marketing gimmick than using our words to help a patient.

This is called the “Fear Avoidance Model”.

The fear avoidance model shows that patients can develop pain as a result of fear and avoidance behaviour. Typically it is referring to a patients fear of movement as it might cause pain.

However studies have shown how this model can be developed in other ways.

If a patient can’t make sense of the pain (which is part of our job to explain to them), have some societal beliefs associated with past experience or have a diagnosis of something that can’t be fixed are all things that can be associated with this fear avoidance model.

If a patient comes in for treatment and already has some of these underlying issues, we have the opportunity to either correct or reinforce what is going on with them.

We can have a strong influence on those patients beliefs and in turn can influence those beliefs in a positive (or negative) way.

If we decide (and it is a decision on our part) to use negative language like “tissue damage, out of alignment, or structural problems” we can change a patients beliefs for many years to come. One study showed that it can even lead to feelings of increased vigilance, guilt and worry.

The same study showed that if we take an approach of providing reassurance, which increased confidence we could positively influence a patients movement and activity.

So, imagine if just the way you communicated with your patients, made them want to adhere to their home care and gave greater outcomes overall in their treatment?

Photo by: PublicDomainPictures

Improving Communication For Better Outcomes

So where do we go from here?

We are always going to have other therapists and practitioners who use scare methods like I mentioned at the beginning.

I’m pretty sure a little piece of me dies inside whenever a patient tells me about these things they’ve been told.

In the case of the patient saying they have compressed discs and are out of alignment, well I’m pretty sure if they x-ray’d me they would find the same thing however I’m not in any pain. In fact Todd Hargrove wrote a great article on the topic that we have used on this site, which you can read here and is a good reference to show a patient when they are worried about imaging and disc issues.

The way we communicate has to involve positive reinforcement, with good explanations of what is going on with the patient.

Being able to describe to them that pain is just the nervous system reacting, not tissue damage, is a hell of a lot better than reinforcing some old beliefs or scare tactics.

There is a new model of rehab being developed that outlines four elements that could lead to better outcomes:

Knowing the person and building a supportive relationship
Effective education and information exchange
Goal setting and action planning
Fostering positive, realistic, cognitive and self framing.

Those four steps represent a golden opportunity for us as Massage Therapists.

All four steps are well within our scope of practice and we quite frankly have the opportunity to reinforce those steps more than any other practitioner due to the time we get to spend with patients. Because we get to spend so much time with our patients our ability to build that supportive relationship is paramount to what we do.

Even being able to read the mood of our patient who we have built that relationship with can make a difference in the outcomes of their therapy.

As much as the terms “evidence based”, or “research based practice” gets thrown around (I know some of you don’t like it), there is sound justification to making this a part of your practice. Research is actually showing us the importance of how we communicate with our patients. There is even studies that show how contextual factors like a therapist and patients features can contribute to outcomes. Now I know there is no way you can do anything about your features, but you can do something about all the other things we discussed. Staying up to date on new research, working on communication skills and not being afraid to “forget” some of the things we used to know goes a long way to establishing ourselves as the more trusted source of therapy in our communities. Being able to educate a patient when they come in, helps to build that supportive relationship and puts you at the forefront of their healthcare as a professional. Help your patients to set goals aligned with their home care by making them positive and realistic. Our biggest job is always going to be education. Educating our patients and explaining what is happening to them is a key factor in getting them back to their activities of daily living. Unfortunately as other practitioners use fear to market their practice, they make our jobs just a little bit tougher.

Tips For Writing Amazing Massage Therapy Blog Posts

July 11, 2016/34 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy, Social Media/by Jamie Johnston

The first one took me hours.

I mean loooong hours to write.

I hired a professional writer I know to help me get into this whole writing thing, read books on it and even debated taking some classes.

My professional writer friend gave a great piece of advice when he looked at me and said:

“Jamie, writing is like a muscle, you have to use it and develop it to make it strong”.

Blog articles still took me hours to write, I wanted them to be perfect (but honestly not one of them ever has been).

However as time goes on things got a little easier, sort of like a new workout program. At first you’re sore all week, then a month later you’re getting a bit of a high after each workout and the pain goes away. But just like that workout, it’s usually better if you have someone coaching you and helping you.

So here are some methods to help you start getting some blog posts out for your clinic.

Getting Started With Massage Blogging

Before you get going, make sure you are setup to be distraction free and in a comfortable space.

Choose whatever you like best, computer or pen to paper. If it’s pen to paper you prefer, get yourself a really nice smooth writing pen to make it as enjoyable as possible.

If it’s keyboard you prefer, do your best to stay disconnected from the internet so you’re not tempted to constantly check Facebook, twitter or play angry birds.

I always like to have a really good cup of coffee and put some music on.

I know some people like to put on some hip-hop or reggae, but for me it’s George Strait.

Okay, now that you’re set let’s get going.

Telling Your Story

While blogging is a great way to educate your patients, the real thing you want to do is entertain them.

Tell them a story, tell them your story.

If you’ve been following this blog for a while, I try to start every post off with a story as it is a great way to intrigue a reader (and hopefully keep them reading),

A good example is the post I wrote about dealing with someone who has had a stroke. I started off the post talking about a real life situation where I helped a friend of mine who suffered a stroke. It’s effective because it gets the reader involved and adds more weight to the post than me just simply saying: this is what you will see.

“It was around 1am Monday morning, when I realized there was an issue.

That night, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.

As we walked to the First Aid shack for a coffee, I asked how he was feeling:

“not good”

How was the weekend?

“I don’t remember, apparently I didn’t show up to work on Friday”

Did you leave the house to go to work that day?

“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”

As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.

Can you lift your arms above your head for me?

The right arm went up, left one didn’t move.

Can you kick your legs out for me?

The right one kicked out, left one stayed put.

We need to get you to the hospital.”

Seeing how this person moved and was reacting to our conversation paints a better, more realistic story than me just explaining what the symptoms of a stroke are.

So if you were doing this as a post for your clinic, using a real life experience of how getting a massage has helped you in the past, or how you have helped someone else with a particular condition. It will make your reader engage and think “yeah that’s exactly how I feel”, now you’ve hooked a potential or current patient who recognizes you as the professional and the Massage Therapist who can help them.

Always try to lead with a good story.

The Disney Method For Massage Therapists

One of the toughest things about writing is how hard we are on ourselves.

If you’ve ever tried to write anything there is a constant voice in your head saying:

“that was terrible”

“no one is going to read this”

“you’re like the Adam Sandler of serious writing” (okay maybe that one is just me, but you get the point).

This happens to everyone when they start trying to write, it’s our internal editor and it’s harder on us than anyone who reads our writing.

The hardest thing to do is turn off that internal editor, but to start that’s what you have to do, you can edit after you’ve actually written something down.

The Disney Method is how Walt Disney used to come up with ideas and he made it a three phase process.

It consists of:

The Creative Phase (or dreamer phase)
The Realist Phase
The Critical Phase

Once you start to practice this, it can make the whole process of writing a blog a lot less daunting and time consuming.

1. The Creative Phase

Pick a topic, it doesn’t have to be fancy, pick something about massage therapy you’re passionate about and know a lot about, it’s a good place to start.

Just start writing.

Write with reckless abandon, like there is no chance anyone is ever going to read this.

Turn off that internal editor and just let whatever thoughts are in your head pour on the page or the keyboard, whatever your choice is for writing.

Be the most creative you can be, don’t worry about spelling, grammar, mistakes or anything and for god’s sake don’t hit the delete key. Use whatever tone comes natural to you because at this point it doesn’t matter, just let it pour out.

In the example I gave about the person having the stroke, when I sat down to write that, it was full of swear words (I kinda have a mouth like a sailor) because I remember that night and couldn’t believe my friend and mentor was in that condition.

It was a rough and I mean rough draft.

But that’s fine, you can clean up anything you write in the next phase, but you have to get that first draft out.

2. The Realist Phase

In the realist phase you want to make sure your story flows.

You’re going to go through and edit that rough draft with very broad strokes to make sure your story makes sense. Don’t worry so much about grammar and spelling at this point, just see if sentences need to be changed to give the story some real body.

Does a sentence work better a few paragraphs up or down?

Does a paragraph need to be moved?

Just shape your story to make sure it flows in a logical sequence and put the big pieces together so it makes sense to your reader.

In the stroke article, the story was the introduction, then the body of the post was video that gave instructions on how to deal with a stroke in your clinic. Go through your post and make sure the story ties in to what you can do for your potential patient with whatever topic you picked.

Now your potential patients are starting to put together how you can help them and why they should be coming to you for treatment.

3. The Critical Phase

Now it’s time to rip things up.

Go through and get ruthless with your editing.

Sentence by sentence trim what isn’t needed. Line by line slash what isn’t needed.

Take out any and every word that isn’t needed.

See if you can take as many words as possible out of each sentence without changing it’s meaning or tone.

When people are reading blogs they skim through them, it’s rare they get read word for word (seriously, you aren’t reading these posts word for word!?).

Go through and take out the word “that” wherever possible along with phrases like “in other words”. And don’t ever say things like “in my opinion”, we know it’s your opinion, you’re writing it.

You get to be creative in the first phase, but now is when you need to be critical (but don’t be super hard on yourself, remember writing is a muscle).

This is also a good place to go through and add any research you think is applicable that you have done for the post. It’s always good to add some kind of research into a post to give it legitimacy, especially if you’re writing for patients, it will reinforce you are the professional.

When adding your research to a post, you don’t have to use specific referencing styles, you can just add hyperlinks in the appropriate text of your article.

It’s a blog, not a research paper.

Photo by: fancycrave1

Coming To Conclusions

Now that you’ve gone through and edited things and the post is looking great, you’ll need to come up with some sort of conclusion.

A conclusion is a great way to wrap up the post and highlight the main points.

The conclusion is also a great way to leave an impression on your reader. Always try to leave them with a smile on their face, it will make them want to come back for more. This is how I wrapped up that post on dealing with strokes:

Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:

“Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)

“You should thank that little jerk, he saved your life”

I’ll be honest, that took some editing because the language he used was a lot stronger than “little jerk”, but you get the idea. While it can be tough getting into blogging for your massage business on a regular basis, if you start making it a practice it will get easier. If you try writing and you get stumped, take a break and go do something else, go for a walk, play angry birds for 15 minutes, just get a break. It’s amazing how much your ideas and writing can change with even a 10 minute break. Also, don’t be too hard on yourself if the first one takes you a bit of time. Set a timer for 20 minute time intervals. Use each interval to go through the Disney method to be the creative, the realist and the critic. See how your article looks after each time interval and continually build it up until you’re happy with it. Feel free to share your posts in the comments below when you try it. Hopefully before too long we’ll be able to get a guest post on theMTDC from you.

Why YOU Should Blog For Your Massage Therapy Business

July 4, 2016/16 Comments/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Social Media/by Jamie Johnston

Sometimes I just sit here staring at the screen, trying to write.

It’s tough.

Blogging is tough.

In fact it may be the hardest thing I’ve ever done. The first time I hit “publish” it scared the bejeezus out of me and still scares me a bit to this day.

However as they always say, if it was easy, everyone would be doing it.

The thing is, everyone should be doing it and using blogging as a tool to promote and advertise your massage practice. We live in a generation where information is currency and it’s valuable currency.

As I said, blogging is tough but it CAN be done.

Most of you reading this right now are probably thinking “you just finished saying it’s hard and plus, I’m not a writer!”

Well, guess what? None of us are writers.

Very few people who started a blog sat and thought to themselves “yeah I’m a damn good writer, this is what I should do”.

Most people who got into blogging had something they were passionate about and decided it was time to start a discussion on their passion.

But there are some other reasons why you should start blogging, especially about your massage practice.

Marketing Your Massage Therapy Practice

Any time you decide to market your practice you should be looking at the ROI (return on investment).

There are a few platforms now where you can set up a free site to start your blog (wordpress, wix, weebly to name a few). Down the road you may want to invest money into a site and developer but the free ones can at least get you started.

So really your biggest investment is time.

Here are some stats from Writtent’s 45 Reasons to Blog that might convince you to get started:

Small businesses that blog get 126% more lead growth than small businesses that do not blog. (Source: ThinkCreative)
Companies that blog have 55% more website visitors (Source: HubSpot)
B2C companies that blog get 88% more leads per month than companies that don’t (Source: HubSpot)
71% of survey respondents say blogs affect their purchasing decisions (Source: HubSpot)
60% of consumers feel more positive about a company after reading custom content on its site. (Source: CMI)
78% of chief marketing officers think custom content is the future of marketing. (Source: Hanley-Wood Business Media)
Brand engagement rises by 28% when consumers are exposed to both professional content and user-generated product video. (Source: comScore)
90% of consumers find custom content useful, 78% believe that companies behind content are interested in building good relationships. (Source: TMG Custom Media)

Looking at that list, the big ones that stand out to me are that blogs affect purchasing decisions, consumers feel more positive about a company after reading their content and consumers believe that companies behind content are interested in building good relationships.

Think about what those three things alone can do for your massage therapy practice.

Now google other Massage Therapists in your area and see who is actively blogging. Go ahead, I’ll wait.

That’s right, barely anyone is doing it because it’s hard, or some have a couple of posts from 2013 and then gave up.

So imagine that if you started doing this consistently and your blog started having the above affects in your local area. All of a sudden, they’re purchasing from you, feel more positive about your company and want to build a relationship with you.

There is no other marketing scheme that is going to do that. Yellow pages, billboards, bus stops, signage, none of these things actually contribute to building a strong relationship with a potential or current patient, it’s just noise.

Establishing Yourself As A Massage Therapy Expert

Whether you’re a new grad or been in business for sometime, you need to establish yourself as an expert in your community.

It takes a bit of a mind shift to start thinking like this, since most of us are pretty humble people. However you need to get over the imposter syndrome and start putting yourself out there (here’s some tips on getting over imposter syndrome).

Pick whatever aspect of massage therapy you know the best and start writing about it. Do research on the topic, pick your favourite aspects about the topic and know them inside and out.

For instance, let’s say you like doing pregnancy and infant massage. Come up with a list of every issue you can possibly think of dealing with pregnancy and write a story associated with that, and how massage therapy can help.

When people in your city or town who are pregnant start doing searches for local healthcare providers, they are going to come across your blog. As long as they can relate to your stories, they will come seeking you over any other therapist in town because you have just answered a majority of their questions and gained their trust.

In my case, I was pretty confident I knew more about first aid than your average Massage Therapist. I also knew I had a ton of stories I could use to convey my message and relate it to therapists on how to handle medical emergencies in their clinic.

So that’s what I started writing about.

Now I’m actually traveling around teaching first aid courses to other practitioners.

The reality is, there is at least one topic you know and you probably know it better than most other therapists.

Start with that.

Becoming a regular blogger also makes you stay on top of your game. When you’re writing and researching topics regularly, that imposter syndrome will start to fade and you will start to feel like you are becoming an expert.

You never know what other Massage Therapists may end up learning from you as well in this whole process.

You just need one topic you’re passionate about to start, then you can start to branch out into other topics as your confidence builds.

Photo by: geralt

Differentiating Yourself

This is another important aspect of what blogging can do for you and your business.

It makes you different.

When someone is doing a search for a therapist, there are no end to the options. Blogging can help make you the BEST option.

Say you work in a clinic with several other therapists. A potential patient goes to the website to book in and sees all of your profiles, there has to be something that makes them want to book in with YOU.

Blogging on a regular basis gives you this opportunity and it is just that, an opportunity.

It gives you the opportunity for your target patients to become not only engaged with you, but to keep wanting to come back to you. If you set things up properly and use social media and email subscription services properly, you will be able to stay at the top of your patients mind.

There is no other marketing effort you can make that will do that.

It provides the real opportunity for you to build a following, to build your patient base.

For those of you who are clinic owners and are thinking you don’t want your people doing this, you should be encouraging this.

In fact I’d be encouraging everyone in your clinic to write one blog post per month for your clinic, plus writing one for their own personal sites.

If you’re worried that if one of your practitioners is blogging and could “steal” patients away if they moved, you have to change your thinking. If a patient really likes a therapist, they’re probably going to move with them anyway. If you try and restrict the patient from knowing where the practitioner is, they will do their own work to find out.

It took me two years to finally launch this blog. It wasn’t that I didn’t want to do the work, it’s that I was afraid to start putting myself out there. So far some people have called me out on things I’ve written because they didn’t agree, but it hasn’t happened near as much as I thought it would. There’s nothing wrong with other people having a differing opinion than yours, in fact it’s a good thing. It will help differentiate you. While blogging is a lot of work, the rewards from doing one are immeasurable, especially if you’re using it as a marketing technique for your massage therapy business. You’ll be surprised at the opportunities that start coming your way. Don’t just try to sell, try to inform your potential and current patients, trust me they’ll thank you for it. If blogging is something you’ve been considering but haven’t started, get over your limiting beliefs and jump in. Just be consistent and you’ll start to find your voice. And who knows, maybe soon I’ll be taking a course you’re putting on!

Avoid Becoming A Bully Massage Therapist

June 20, 2016/2 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

He pulled me to the side and I was immediately uncomfortable.

It used to happen all the time. One of my friends dad when I was growing up was a bully.

He was REALLY old school and believed that he was always right. It didn’t matter if he was blatantly wrong.

The worst part was when he would force his opinion on you and expect you to respect whatever his opinion was. He would regularly use intimidating factors to push his way around, especially if you ever had the nerve to question him.

Then the day came that I had enough.

When he pulled me aside that day, we were at a graduation party in a different town and he didn’t like the environment and the way other people were conducting themselves.

The reality is he just didn’t understand their culture so that made it wrong in his eyes.

However, he was going to enforce his opinion and demand this group of people change their behaviour and do what he thought was appropriate. The worst part was, he wanted me to go tell them to change, he didn’t want to do it himself.

I got my back up and wanted to go toe to toe with him (except he was way bigger and I don’t know how to fight). When I told him I wouldn’t have anything to do with it, he got angry and I mean really angry. He got in my face and looked at me saying “I’m a parent, not you, what I say goes”.

I had to put my foot down and tell him he could do whatever he wanted, but I would have no part of it.

A Balance Of Power

In this case there was a major imbalance of power.

This guy thought he had the right to impose his opinion on not only me, but every other person who was at this graduation party.

The problem is, he was blatantly wrong.

According to bullyingstatistics.com these type of people use their strength or position to harm, control and manipulate others, especially when those others have a difficult time defending themselves.

Do we consider this when we are dealing with our patients? Is there a balance of power there?

According to the College of Physical Therapists of BC “There is an inherent power imbalance in favour of the physical therapist, because the physical therapist has a disproportionate amount of knowledge compared to the patient, and the patient relies upon the therapist for care”

When we have a patient on our table we have to be careful of our communication and whether we are expressing opinions or fact. The two could be easily misinterpreted.

We must not impose our opinions on our patients.

It’s not only wrong, it’s against our ethics as Massage Therapists and healthcare professionals.

We see a variety of patients every day who walk into our clinics, some of us see a new person everyday, especially when we are trying to build our practice. Regardless of your background each one of the people who come to see you have a different background or come from a different culture that you may or may not be familiar with.

Whether we disagree with their lifestyle, religion, sexual orientation or anything else, we are medical professionals that must treat each person the same regardless of our opinion.

This also applies when speaking to them about other healthcare practitioners. We have to choose our words carefully.

We have all wanted to look at a patient and say “well your doctor is an idiot” but again this would be expressing an opinion, which could be potentially damaging to not only our relationship with the patient, but the relationship they have with other practitioners.

Remember the patient relies on us for care, not our opinion.

Applying Research

Staying up to date on research can be a difficult road to navigate.

Quite often it is going to challenge some long standing beliefs we’ve had, which can also change the way we treat and our relationship with a patient.

However it is part of our responsibility as healthcare professionals.

I saw a quote on Facebook the other day where someone said they had lost the passion for their practice because research has proven a technique they loved wrong. This could be debilitating for some, especially when we are talking about some long standing beliefs.

It is important to understand that the technique hasn’t necessarily lost its effectiveness, but our explanation of what is happening has to change. If our understanding has changed and we don’t relay the information to our patient this could be considered a form of harm.

Our patients look to us to stay informed and assume that we are doing everything in our power to provide quality care.

With so much information readily available to us nowadays we should be able to find a few ways to incorporate research into our practice for the benefit of our patients.

Whether it’s via Facebook groups, blogs or just searching for research online we should be making this part of our regular practice.

Take some time and check out a couple of blogs and websites. A few that I like are painscience.com, the international journal of therapeutic massage and bodywork, pubmed.com and rmtedu.com which all have some great information on various areas of research and evidence based resources.

Photo by: Foundry

Communication Outside The Treatment Room

“If I wasn’t standing there, they would have had my daughter booked in once a week for the next two months!”

When I hear things like the statement above I think a little piece of me dies inside.

There is a drastic difference between a treatment plan and fear mongering.

Telling patients that they must come in for extended periods of time, without even knowing how a person will react to your treatment is a bullying tactic and it has to stop.

So does using terms like “well I only have one spot left, so you better take it before it’s gone”.

I get it, we all want a full practice but trying to tell someone you know how their body will be reacting two months down the road isn’t a treatment plan, it’s ego.

A proper treatment plan involves continual assessment and re-assessment to gauge progress.

As we move towards a patient centered healthcare system, these choices will more and more be the patients decision. Laying out a sound treatment plan and then incorporating the patient as part of the decision is how we will gain more respect in our medical community.

A patient should never feel pressured in making their healthcare decisions. We have to remember, even though it may not seem like it, there is a balance of power between us and our patients. We have responsibilities not only with our treatment but also in the way we communicate. Using any kind of communication where a patient feels pressured to book back in is an abuse of that power differential. As we strive to be more a part of mainstream healthcare all of these factors come in to play. Staying on top of relevant research can be intimidating but it improves not only our relationship with patients but also with other healthcare practitioners. It is our duty to stay informed and keep our patients informed so they can make the best decision for their healthcare. Just make sure you’re never in a position where a patient has to put their foot down with you.

Massage A Variety Of Patients For A Better Practice

May 30, 2016/1 Comment/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

When I decided to become a Massage Therapist all I wanted to do was work with athletes.

While in college, I signed up for every sport outreach available and started volunteering with a local hockey team.

I remember my first hockey game, there was a certain pageantry about it. I was so excited to have the opportunity to be a team member behind the scenes.

Immediately I texted buddies because of the sheer excitement of being there. This was what I wanted, this is what I went to school to do.

Then I started signing up for more sport outreaches. Anything or anyone I could get my hands on with sport, I was in.

I graduated and started working at a rec centre, all with the hopes of working with athletes and sport minded people, helping them perform better. Then I sat quietly in my clinic room. I watched people work out in the gym. The odd time they would come up and ask me questions in the hopes of getting some free advice. None of them booked in.

Then I met an elderly gentleman one day.

He told me he used to get regular massage when he lived in Edmonton. We got to talking for a while and he booked in.

He booked in every two weeks for the next few years.

But I wanted to work with athletes?

A Lack Of Funding And Sport Massage

Pride and dreams are a funny thing.

I stood proud during that first hockey game, proud that I had taken the chance to ask and was taken on by a team as a student. Proud that I was working in my favorite sport. Proud that I was the only one in my class doing this kind of thing.

As I progressed with that team, each week I would work with the team Chiropractor, Athletic Therapist and Sport Med Doctors.

I never brought up the issue of money, I was a student gaining experience after all.

But the topic did come up one day. I learned that all of those healthcare professionals were there volunteering their time. The common theme among all of them “We do it for the kids on the team”.

WHaaaaa?? No one is getting paid?

Things started to get clearer. Working in sport was not going to be the sole way I could earn my living as a therapist (at least to start). Amateur athletes don’t have much money and the majority of the money they do have, comes from funding from other organizations.

This changed everything.

Athletes have become something in my career where I make decisions based on my heart rather than my pocketbook.

While I get a variety in the clinic that are athletes, most of them have other jobs where their benefits package is paying for their treatments. Working with teams in the area is something I still get to do and is still one of my favourite things to do but have to work with them based more on my passion for it instead of basing my income on it.

Quite often teams are underfunded or don’t have the extra funds to put towards a full time Massage Therapist.

In order to work with teams it has become either a strictly volunteer option or part paid, part volunteer, but nothing I could make a full time living on.

Sadly the pocket book has to win out.

Extended Benefits And Massage Therapy

I have often said a Massage Therapist around here could build a practice on hospital workers.

Their benefit plan is phenomenal. They get unlimited massage therapy as part of their benefits package. That’s right, UNLIMITED.

But that almost changed.

Recently their union was at the bargaining table and one of the topics for discussion was their benefits. Rumour has it, there were some in the union that were billing a ton of massage therapy hours to their benefit plans and the company wanted to scale it back.

Last I heard everything stayed status quo.

What if it had changed? What if they did scale it back?

It would have affected the businesses of probably every Massage Therapist in the province.

If all of a sudden this population of people who came in for regular treatment couldn’t afford the same frequency, there was the potential for a massive drop in business for every Massage Therapist.

Several other insurance companies put a cap on the amount of treatment one person is allowed to use throughout the year and they book in according to what the plan covers unless they suffer some sort of injury as the year progresses.

It never fails at the end of the year, people book in around November and say “I’ve got $500 I have to use up, book me in until it’s used up!”

While that’s great business wise for a month or so, it’s not sustainable because you usually don’t see these people until the same time next year.

Cash Based Massage Therapy

That elderly fella that booked in every two weeks was a gem.

Going through college I hadn’t focused much on different populations, just sports.

Other classmates were signing up for outreaches that focused in these areas, working in old folks homes, extended care medical facilities, other charity events and whatever their interests entailed.

I wanted none of it.

Since being in practice and meeting people like the elderly gentleman I mentioned, I realized how much fun it can be working with the elderly. In fact now, some of my favourite, most regular patients are elderly people. The beauty part is how much you can learn from them. I love how most of them don’t really care what people think of them, they’re comfortable in their own skin and pretty much say whatever they want.

I find if refreshing (and pretty damn funny).

While many of these patients have extended health that covers them, the majority don’t.

But they still love coming in for treatment.

Could you build an entire practice on them? Maybe, but it’s doubtful, or would take a lot more time.

This enters into the realm of cash based therapy.

There are a few different blogs out there that specifically target marketing ideas and methods of setting up a cash based practice.

To some, the title is probably a bit off putting, thinking you’re just getting patients in the door for cash. But this couldn’t be further from the truth.

The reality is, you probably have to give these people more value than those with benefits.

I know some people are losing their minds reading this and saying “you can’t treat one patient different than another, you have to give the same value to everyone”.

While this is true and I totally agree, the point is more to the fact that people who are paying cash out of their own pockets (who don’t have extended health benefits) aren’t as likely to come in for a weekly maintenance appointment to stay on top of things.

They are probably going to come in when something is wrong and need it fixed asap. The luxury of maintenance appointments to stay on top of things isn’t typically something affordable for them. When they come in, chances are it’s because they really need it as opposed to having the luxury of benefit coverage.

This is where many of your other skills (assessment, clearer communication, interviewing) come in to play that aren’t always used for those regular maintenance patients.

There are more insights to setting up a cash based practice that can be found in Paul Potters blog if you want to check it out.

Chances are we all have different interests when it comes to our practice and would like to focus on something specific. Over the years if you can build up a patient base that is predominantly part of your interest it will make going to work a lot more rewarding. However there is still the ugly side of life where we have to pay the bills. Focusing into one specific population may make that a bit tougher, I’m not saying it can’t be done, just that it will be tougher. Don’t be too quick to rule out different populations as a group that you’re not interested in working with. They could end up making your practice a more profitable one. The other thing is that you never know what you can, or what you need to learn from various populations booking in with you. Yeah I love working with athletes, but the amount I learn from my elderly patients far outweighs what my athletes have taught me. Not only about life but also about being a therapist. Usually when I work with my athletes they come in, look at me and say things like “I need my gluts, quads and low back worked on”. They are in tune with their bodies and know specifically what they need more often than the general population. It’s with my elderly people, weekend warriors and everyday office workers where I need to do orthopedic testing, muscle tests and sharpen my interview skills. Take the time in your practice to see several different populations of people. Remember variety is the spice of life. And it will probably help the business too.