Massage A Variety Of Patients For A Better Practice

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.

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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.

“World-Class” Communication In Your Massage Therapy Clinic

Communication is key with massage therapy patients.

New research is starting to show that in some cases, it may even be more important than the actual treatment.

But what about in the aspects of being a Massage Therapist outside of the treatment room?

Can the way we communicate on the phone, or even when re-booking make a difference?

It’s a skill that needs to be developed and can be the difference in not only hiring practices, but also the reputation of your clinic.

Develop The Habit of Providing “World-Class” Communication

Ok, you’ve worked your proverbial butt off to become a medical practitioner, you’ve invested time, money, blood, sweat and tears (no not the amazing 70’s music group), you dress for success and your patients love you!

You strive to ad value and content to your patients lives and you are passionate about helping someone  in pain have better quality of life.

The phone is ringing off the hook and you need to hire front-end staff and a receptionist.

Vitally aware that on average, front end staff can make up 65% of your outgoing costs after paying wages, income tax, benefits etc… how are you going to afford that?

You want to hire the best, but recognize their expected income is wayyy outside your financial comfort zone. Or it might be the case that you are cheap as chips!

Let’s think that you are the first example.

True story:

A friend of mine owns and operates his own medical clinic.

He hired therapists who are the best of the best, not hiring when he needed to make rent because the wrong people presented themselves, and in the end he has an amazing team around him… except for his front-end staff.

Don’t get me wrong, they are nice people, but they are not trained specifically for that position.

Lots of businesses hire well meaning people/staff based on the assumption that common sense will prevail and although they have no formal training in being the front line impression of the clinic, they are generally nice and this should come out over the phone or when in person.

The problem is, this rarely happens.

People have good intentions, but when stress levels increase as the business increases, people handle themselves with the attitudes and homegrown habits they already have. This may show as someone becoming a little short or curt over the phone, becoming less helpful to those requiring more assistance, becoming intolerant of uninformed potential patients and so on. 

Not quite what we are going for in representing your “World Class” clinic.

So what do you do when you start receiving comments from your patients saying that they love you, but hate dealing with your front end staff? 

They would rather book an appointment online or through you rather than through your front end staff.

Constant Reflection To Improve Your Massage Therapy Clinic

Remember that people emulate those that they look up to or perceive as being a leader.

How do you handle yourself in stressful situations, on the phone, in person with your patients?

Is it possible that your staff is mirroring you? 

Do you see yourself in the way they communicate with your patients?

It happens more often than you think. Maybe you need to develop or change some of your own habits first before asking someone to change or implement new habits themselves.

Rather than taking the time to role-play how your receptionist should communicate with patients, you must initiate the formation and implementation of good communication habits.

Instilling Belief

Remember, habits are more easily formed when there is a strong belief they are beneficial and positively impact you or someone’s life.

You must communicate to your staff your passions, your beliefs, and your purpose for helping people. More importantly, you must show this in everything you do.

Remember those mirroring neurons?

Remember that a leader lifts people up with him/her rather than pushing and prodding. Be the leader that pulls the best out of your staff, by encouraging them to perform to their highest potential.

It only creates an environment of success, caring and professionalism.

Photo by: geralt

Photo by: geralt

Changing Massage Therapy Communication Habits

You need to determine specific scripts for what you want to be said when different scenarios present themselves.

First, think about the kind of experience you want when contacting a business. How do you like to be treated? Remember, you want to be known for providing “World Class” service right?

Sure you might think you are communicating appropriately, but have you actually listened to yourself as you communicate with someone?

Reflect on how you want your staff to communicate.

What do you want them to say? How do you want them to say it? What kinds of scenarios will your staff be in and what different ways of communicating do you want them to utilize in these scenarios? Think of questions you ask when you contact a healthcare professional.

What do you want said every time for each of the following?

Sit down and quietly write out the clinics introductory speech for phone calls, basically how do you want the phones initially answered?

  • What do you want said when a new patient calls wanting information on your services?
  • What do you want said when they are interested in booking an appointment?
  • What do you want said when talking to returning patients over the phone?
  • What do you want said when a lawyer calls looking for information for a patient?
  • What do you want said when an insurance agent calls looking for reasons to provide coverage for a specific treatment?
  • What do you want said when a patient calls in to complain or inform you that they are in more discomfort after your treatment?
  • What do you want said when a patient has to cancel an appointment either within or outside your cancellation policy?
  • What do you want said when contacting your cancellation list to offer appointment times to them?
  • How do you describe your rates, your hours of operation, your location?
  • What do you say when returning a phone call and have to leave a message?

Once written, you need to test them out on your existing patients.

Ask them what they like to have said to them when contacting a business. Fine-tune your scripts. Your patients want you to succeed and to represent professionalism just as much as you do.

Show your patients you care about their experience and the experience of those potential new patients  they refer to you.

Once you’ve got the scripts perfected, print each one out on their own individual pieces or paper.

Give them to ALL your staff, including those who rarely answer the phones. Everyone has to be on the same page as what is expected to be communicated and how.

Next take these papers and post them right in front of the receptionist. It’s easier to refer to them rather than try to remember exactly what to say.

Remember that forming or changing habits takes time. Research estimates that it takes a minimum of almost a month and a maximum of almost 2yrs to solidify a habit. Putting in this small amount of effort will have a dramatically positive effect on your practice.

As your staff get used to saying the same scripts over and over, it slowly becomes committed to memory and before you know it, it just becomes a habit of effective “World-Class” communication!

Communicating Massage Treatment Information

Concerning specific treatment and expected outcomes, you know  your staff is not expected to know the detail you do, but you can create scripts to provide general information.

When writing these scripts out, be as succinct as possible, limiting the info to just 2-3 sentences/modality. Your staff and the patient on the other end of the phone won’t remember more than that.

Make your list of techniques/treatments you provide.

In your first sentence, describe the technique.

In your second sentence describe why it can be used.

In your third and final sentence describe what the potential outcome expected.

Remember to keep communication clear, simple and succinct. Developing the Habit of “World-Class” communication doesn’t happen overnight.

It takes self-reflection, thought, dedication, belief and time.

Massage Therapy And Direction To Pay Contracts

When I met the lawyer and he found out I did massage therapy, he immediately asked: “do you do direction to pay”?

“No”, and then I gave him a list of the reasons why I wouldn’t do it.

Mostly it was just things other friends had told me about why to avoid it.

He just stared at me blankly, then proceeded to give me shit.

As our conversation developed over a hockey game and we got to know each other a little bit we continued to discuss the topic. I was intrigued by his reasoning. He was pretty persuasive, (he is a lawyer after all) and assured me that most of my doubts were unfounded. I sat there and listed several reasons I have heard about why this was a bad idea.

He listed the reasons why I should do it, but the main one: “you’re leaving money on the table”!

We set up a time to sit down and chat and I figured I might as well hear him out.

That day forever changed my massage therapy practice.

Generating Massage Therapy Referrals From Lawyers

Direction to pay is where a lawyer sends patients to your office for treatment after they have been in a car accident, workplace injury or are on some sort of an insurance claim and need help from a therapist.

But you don’t get paid until the claim is settled with the insurance company.

I have heard horror stories about this and was advised by several RMT’s over the years never to do direction to pay.

And I’ll be honest, my opinion of lawyers was pretty jaded.

As I sat in the lawyer’s office and spoke with him and his associate, they wanted to know every reason why there is such a bad reputation with this type of thing among Massage Therapists.

I listed off most of the reasons that had been told to me in the past:

  • The lawyer calls back and tries to negotiate less money
  • You NEVER get paid
  • Sometimes it takes YEARS to get paid
  • You’re constantly chasing around the people in order to get paid.
  • If the insurance company doesn’t settle, you won’t get paid.

The lawyer sat there in disbelief.

He was shocked to hear that anything like this had ever happened. As much as I believed it was a bit of a slight on Massage Therapists when these things happen, he considered it just as much a slight on his profession.

As the meeting went on he addressed each of these issues and pointed out why some of those things could happen and then why they wouldn’t happen in our dealings.

He gave what was probably the biggest piece of advice that convinced me to get involved with him:

“just look at it like a forced savings account, honestly the first year is going to suck but then you’ll all of a sudden start getting cheques rolling in every month”

His associate (who is a former car insurance company adjuster) looked at me and said “you’re leaving a huge marketing opportunity on the table by not doing this”

Now granted, they’re also trying to get me to help them with their business, so they’re going to be persuasive. Since they were taking the time to actually have an appointment with me in their office and take time out of their day, I figured maybe there was something to this. What did I have to lose?

It was at least worth a try.

I reluctantly agreed.

Direction To Pay Contracts For Massage Therapists

Together we developed a contract that would be an agreement between the two of us.

The patient is only part of this contract in that they agree to the stipulations provided within it. The contract itself is between me and the lawyer.

It took a little time to develop and I used some information from our local association as they provide things like that for us. Eventually we came up with a contract that I would go on to use with every patient he sent me.

Here is a pdf copy of the agreement for you to download in case you’re interested in doing this kind of work (just make sure to use your name and clinic name etc). The patient fills out the first part when they fill out their intake form. They put their name in the first part, then they lawyers name and the date of their accident.

The form is sent to the lawyer to sign the bottom half of the form. I keep this on file with any other document regarding the patient.

The nice part about this arrangement is the patient cannot take off without paying their bill at the end of the settlement.

The lawyer negotiates a settlement with the car insurance company only after getting the invoice from you and adding the total to the claim. Your invoice amount is added to the claim and the money is deducted by the lawyer before the patient sees any money from the settlement.

With so many therapists that I talked to over the years, one of their biggest complaints was that once the settlement was done, they would never see the patient again and the money was gone.

However in most of these cases, the therapist entered into the agreement with the patient, not the lawyer.

The patient would come in and make claims like “yeah my lawyer said to get you to just do direction to pay and we’ll pay you at the end”.

In many cases, the therapist didn’t even know who the lawyer was and also went on a verbal agreement with the patient without a signed contract.

Do not let this happen. If this is something one of your current patients wants to do, make sure to get the name of the lawyer and enter into an agreement with them, not the patient.

Unfortunately even though you may have built a relationship with a patient over the years, it doesn’t mean they are always going to be honest.

Make sure you protect yourself first.

Massage Therapists On A Team Of Experts

As I mentioned before, the lawyer was trying to get me to help him with his business.

This brings up a very valuable point.

Entering into an agreement like this is helping the lawyer with their business, so they want to do things right. If at any point something goes wrong in this agreement it looks bad for them and their business.

When they have a new claimant come in for their advice and are able to lay out how they are going help them deal with the insurance company and can say they have a team of practitioners who will help them through all of this, how do you think that looks to the new claimant?

It instantly puts the persons trust in the lawyer, knowing their best interests are being taken care of.

However you also need to make sure your best interests are being taken care of as well.

Make sure if you are going to enter into this type of arrangement with a lawyer, that it is a reputable lawyer.

There are lawyers out there who will take on any case in the hopes that they’ll make a buck off of it. Seek out a lawyer who focuses in this area and maintains a good reputation. If they are sending people to other practitioners in town (i.e.: chiro, physio, other massage therapists) ask if you can contact them to see what the experience is like.

In fact some lawyers actually consider having you and other practitioners as a “team of experts” on their side in representing their clients.

One of my friends asked me “what if the claim doesn’t ever settle?”

In asking the lawyer the same question, his response: “we don’t take on claims where this is a possibility of no settlement”.

Remember, the reputable lawyers are looking out for the best interests of their client but are also looking to build a successful business. They don’t want false claims or bad dealings with their network to harm that reputation.

Here are a few resources to use if a lawyer approaches you, or you’re looking for a lawyer to work with.

Photo by: unsplash

Photo by: unsplash

Getting Paid

It is true that sometimes it can take a while to get paid for your work, depending on how long a settlement takes.

One of the things that got me hooked when starting this, was when he said “look at it as a forced savings account”.

The first year was tough as he predicted. A few times a month I would get an email telling me that a new person would be coming in for treatment.

That has consistently built up over the past year or so and now various claims are starting to settle.

Cheques are coming in and I’ve had the opportunity to help some people that I may not have never met otherwise.

Now as the settlements come in, I’m able to take that money and apply it to my tax account or designate some of it for holidays or any other savings/purchases that I need to cover.

One of the great things about this is, at the beginning when you start with a new patient you can take the time to explain how the whole process works to them. Explain that if they no-show an appointment it will still be billed with their settlement. They are much more likely to show up for appointments if they know they are going to be billed and paying for the appointment.

Remember, the contract is with the lawyer and part of the contract is that no-show appointments are still paid.

I do have some accounts that will take well over a year to settle and some that may go longer.

But so far, for every claim that has settled, I’ve been paid in a very reasonable amount of time.

As I’ve mentioned so many times before, a big part of being a Massage Therapist is building relationships.

The same applies here.

I’ve taken the time to build this relationship with the lawyer and there has been very regular communication between us throughout this whole process. He’s even given me free legal advice on some other questions I’ve had.

He considers me to be an important part of his business, but more importantly, an important part of helping his clients get better after an accident.

While this type of work may not be for every therapist out there, it’s definitely worth taking a look at. I honestly wish I had started doing this right out of college, it would have gotten me busy a lot quicker. When you look at different avenues to market your business and how much it costs, this is a very lucrative form of marketing. It doesn’t cost anything, just some patience and money management while waiting for payment. However when I think of the first couple of years while I built my practice, there was typically several spots a week that were empty (especially at the start) which could have easily been filled by the lawyer. I wasn’t making any money in those spots anyway, so I could easily have used a “forced savings account”. If you do decide to get into this type of work, take the steps to make sure you’re dealing with a reputable lawyer. Ask friends and patients, consult legal websites, cross examine the lawyer and get your questions answered by them. Don’t be like me, don’t listen to every massage therapy rumour out there, do the homework and research for yourself, it can make a significant difference in your practice. 

Massage Regulation: What is the Point?

Seems like almost daily, on one of my networks, someone will post the question of “what good is massage regulation really doing?”

They often throw up points like “prostitution still exists,” and of course it does and it always will.

Other complaints are about how much money the state revenue department, or the licensing board, or the Federation, or the testing company is making.Then we’ve got the complaints about taking CE to satisfy the law, and how that’s just a money-making racket.

As a CE provider, believe me when I say I’m not getting rich off of it, and very few are. But back to the question, what is the point?

The point of licensing in any profession is basically quality assurance for the public, for their own safety and protection. 

To get a license, you’re supposed to have x number of hours of education.

You’re supposed to pass an exam proving entry-level knowledge .

In most places, you’re supposed to get the continuing education in order to keep it. You’re supposed to agree to abide by a code of ethics and uphold standards of professional behavior. You’re supposed to first do no harm. You’re supposed to act in the best interests of the client.

There are now only a couple of states that are the last holdouts with no regulations in the works or already in effect…anyone may call themselves a massage therapist or any other derivative indicating massage, whether they actually know anything or not.

In reality, it’s hard to find out exactly how many members of the public have been harmed by massage therapy. 

The insurance companies and professional associations don’t like to release that information.

Many of the state massage board websites do have license verification online, and some do list disciplinary actions, but in most cases that will only show up if you already know the name of the therapist that has been found guilty of some infraction.

It must be said that not every single person who has been found guilty by a board is really guilty…there were times during my own five years of board service that I did not believe the accused person was guilty, but the majority voted that they were. 

It must be also be said that some therapists who are in fact guilty never ever get reported and thus keep preying on the public. There just aren’t any guarantees, just like with any other walk of life or profession.

There are people in every profession that are dishonest or predatory, and massage therapy is no different.

All things considered, I think licensing has been a valuable thing, and personally, I’d like to see it in every single state.

Yes, there are still people who will practice illegally. There are still prostitutes who will hide behind massage. But I think on the whole, licensing has brought a healthy amount of awareness and credibility to massage therapy.

I’m not resentful of having to get a criminal record check to get a massage license. If we were being singled out I’d be upset, but every other health care provider in our state has to do it.

Photo by: geralt

Photo by: geralt

I’m not resentful of having to take continuing education…I love learning and I actually look forward to taking CE. However, I do think there comes a point in time when that should be optional.

Realistically, should someone who has been practicing for 20 years need to attend an ethics class the same as someone who has only been practicing for a year and may not have even faced any kind of ethical dilemma yet?

I’m not happy with the present state of the CE environment, anyway.

I think a person who is taking science-based classes or classes designed for public protection deserves more credit than people taking fantasy-based classes. With the long list of inappropriate classes that are currently approved, I really don’t see how attending a class in shape-shifting is doing anything to protect the public.

Some state boards are self-supporting. Some are at least partially subsidized by the state. Some try to educate the public. Some don’t. Some pursue illegal massage more than others.

Nothing’s perfect.

The point, to me, is that the majority of us, by paying for that license and jumping through the hoops, are proving that we have at a minimum, the entry-level knowledge to practice massage safely. The majority of us have taken the education, and passed the exam, and meet our CE requirements. The majority of us are practicing ethically. The majority of us are trying to keep massage and sex separated. The majority of us abide by the rules. The majority of us are just here to take care of our clients and do the best we can. There will always be some bad apples, but I think requiring licensing has weeded out a lot that might otherwise be here. Just my opinion.

Does Massage Therapy Need To Rebrand Itself?

 

“Why can’t we just be called Registered Manual Therapists?” – Kelsey Matichuck RMT

“There has never been a better time to rebrand ourselves” – Anita Wilson RMT

Masseuse, Masseur, Full Service, Happy Ending.

We’ve all heard it and gotten pretty annoyed by it.

For reasons that have nothing to do with us, our profession has a little dark side that quite frankly none of us like. In fact we’re all pretty done with it.

Why our profession, why not another one?

Why did other establishments choose massage therapy as the avenue they would use to lure clients in for acts of prostitution.

Its time for a change, time to permanently separate ourselves from these establishments.

Defining Exactly Who Is A Massage Business

With a recent change to our local code of ethics there was some heated discussion at our AGM.

A good friend of mine made the statement:

“The word “massage” in our title sexualizes the treatment environment. We can’t erase the history and connotation of the word “massage” with the sex trade and massage parlours” – Jenny Slauenwhite. 

We even had a blog post on here a couple of weeks ago telling the story about people targeting Massage Therapists for sexual reasons.

In doing research for this blog (I’m not going to cite the reference because its demeaning to our profession) I came across a blog from a person who worked in a massage parlour, explaining their experiences.

In it they described the services offered and included “Therapeutic Massage” as one of the options in addition to the sexual services offered and then stated “WE ARE A MASSAGE BUSINESS”.

Unfortunately anyone reading this site could associate what we do with what’s going on behind the closed doors of various establishments simply because of the name. Again, we’ve all heard the jokes and are getting pretty sick of it.

As healthcare professionals, what we offer is so drastically different than what is being advertised by parlours. The reality is, we are the massage business, what they are doing is not massage therapy.

Our code of ethics differentiates us from these establishments (in addition to the fact that we would never perform such acts).

We have a duty to our patients (not clients) to set appropriate boundaries and provide not only competent treatment, but also a duty to our profession.

In our code of ethics it is stated:

“sexual misconduct” means:

  1. sexual intercourse or other forms of physical sexual relations between a massage therapist and a patient,
  2. touching, of a sexual nature, of a patient by a massage therapist,
  3. behaviour or remarks of a sexual nature by a massage therapist towards a patient, or
  4. sexualizing the treatment environment,

but does not include touching, behaviour and remarks by a massage therapist to a patient that are of a clinical nature appropriate to the massage therapy service being provided.

  1. Massage therapists must set and maintain appropriate professional boundaries with a patient.
  1. Massage therapists must refrain from taking advantage of a patient for the massage therapist’s own personal, sexual, emotional, social, political, or financial interest or benefit.
  1. Massage therapists must not engage in sexual misconduct with a patient.
  1. A massage therapist must refrain from entering into a close personal relationship with a former patient unless:
  1. a reasonable period of time has elapsed since the therapeutic relationship with the former patient was terminated, and
  2. the massage therapist is reasonably satisfied that the power differential inherent in a therapeutic relationship no longer exists.

While I know this is nothing new for any of us, this information could be new to potential patients as they may have seen (or possibly partaken in) what goes on at “Massage Parlours”.

But how do we get the point across, so we never have to deal with these situations?

How do we educate the general public who may associate our practice with these places?

Massaging A Name Change

I wish I could take credit for it, but the idea never came from me.

I was sitting at work one night supervising in the student clinic when my buddy Kelsey looked at me and said “why can’t we just change our name and be done with all of this”?

I don’t know if he was surprised by the look on my face but i’m sure it was one of shock.

He went on to voice his annoyance with our name and the connotation that sometimes follows it and said “why can’t we just be called manual therapists? “

We are never going to be able to change what everyone else is doing or thinking, so let’s just take some control out of their hands.

Ever since I was in college there has been discussion on how to improve our profession and get it the respect it so vitally deserves.

It’s doubtful this discussion will ever end and we have come a long way over the last several years. I have heard this idea circled around a little bit with the argument that we have done so much to improve, but we can’t turn our back on the past.

There are those who have fought and struggled to gain respect for our profession.

The ones who spent years researching, writing textbooks and truly put their heart and soul into improving massage therapy.  Everyone of them deserves our respect for what they accomplished, and what they did for those of us who are currently therapists.

Even those whose information we used to take as gospel from, but new research has changed our thinking on what they published don’t want the profession to sit idle.

I can promise that none of those early researchers and writers want our profession to just rely on the old laurel’s that got us to this point.

We need to move forward, we need change, we need more control.

Photo by: geralt

Photo by: geralt

Progress As Manual Therapists

In the past five years our profession has seen major change.

There has been constant motion in moving the profession forward and challenging our old beliefs.

I don’t think any of us just do “massage therapy” anymore. We are constantly looking for new information, learning, changing, adapting.

The majority of our treatments are not like the massage therapy sessions of old. We incorporate therapeutic exercise, movement therapy, research, we communicate differently with our patients than we used to. I’m willing to bet for the most part, the actual massage is only a part of the treatment and part of our approach.

Even our continuing education has changed.

We are moving past just having modality classes and reaching deeper to get an understanding of pain science, biopsychosocial models, movement therapies and behavioural understanding.

There are entire conferences dedicated to pain science.

The most recent massage therapy conference I went to was even called aManual Therapy Conference.

There were topics covered that don’t even resemble that massage therapy of old. Things like:

  • The Importance of Modern Psychology to Manual Therapy
  • Understanding and the application of the Placebo Effect in Manual Therapy
  • Pelvic Pain Disorder in Women and Men
  • A Process Approach in Manual Therapy, Beyond the Structural Approach

These are just to name a few, but the point is we have moved past being just a massage therapist. The work we are doing has become more encompassing than just simply providing swedish massage and remembering to go distal to proximal.

As our communication techniques have gotten better with our patients there are some words that we should also stop using. The people who come to see us are not “clients” or “customers”, they are our patients.

Let’s also stop using the word “release” and I know this will be a tough one as there are some continuing ed courses with release in the name and we even loosely use the term to say we have released a muscle.

And it’s not a massage therapy “session” it is a treatment. These words are considered code words in the parlour industry, so let’s just take them out of our vernacular.

Collectively working together with our associations there is consistent improvements to our profession as we try to become regulated nationally. We are seeking out more education, more opportunity for specializations and setting up Professional Practice Groups all in an effort to move our profession forward. While we can’t turn our backs on the past and those who fought to get us where we are now, we do have a responsibility to continually move forward. Granted if we changed our name to Manual Therapists, it will still take time to educate the public and shake off what remains of being associated with “massage parlors”, however for the next generation of therapists it would make a massive difference when this is their profession. Except now I guess I’ll have to change the name of this blog. Although “Manual Therapist Development Centre” does have a nice ring to it.

A Dangerous Client Fantasy

It was roughly midnight and for some reason I was still up.

Sitting at my kitchen bar trying to catch-up on emails and social media that I’d not had time for.

It was TGIW for me.  “Thank Goodness It’s Wednesday”.

I pile 15-17 clients in on Monday through Wednesday and have the rest of the week to work on my online business academy.  Needless to say, I was somewhat blurry-eyed.

My phone buzzed from a text message.  

Ugh, I didn’t have the patience to thwart another “I want you to rub my groin pull” moron.  It wasn’t a creepo.

It was one of my best friends and colleagues, Michelle.  I knew this midnight text had to be an emergency phone call because she’s deaf and totally aware that I go to bed early.

I was about to get crushing news.

In The Shadow Of A Famous ‘Madame’

Up until about two years ago, my fellow Massage Therapist and I would get one or two calls for sexual massage per year in our county of 100K residence.

Then it became an everyday occurrence right after two hush-hush-windows-blacked-out massage places opened up.  Apparently whatever they were doing had put Bowling Green, Kentucky on the map for “massage parlors” once again.

My little area of Kentucky is not only famous as the home of the Corvette, the largest cave on the planet and being the home of Bluegrass and Newgrass music; It is infamous as having been the home of the longest-running house of prostitution in America.

For 30+ years, Miss Pauline’s upscale brothel was a top must-do for businessmen, prominent politicians, military men and college students coming from all up and down what we call the ‘I-65 corridor’.

Not surprising since 80% of the US lives within 300 miles of it.

Due to our downtown’s redevelopment project, the house was torn down and individual bricks were sold off with plaques commemorating the establishment for $2,000 a piece.  Miss Pauline was known for paying her girls high wages, free medical/dental care and helping them get college degrees.  Once she retired, she picked up a different kind of hoe to become the first (non-Amish/Mennonite) organic farmer in Bowling Green.

Please don’t think that I’m trying to glorify Miss Pauline’s selective-exploitation.  I’m not and I don’t believe that the creepos calling today even know this bit of history.

Be that as it may, somehow they now believe sex can be had at any massage establishment in Bowling Green; just like when Miss Pauline would set her milk can out on her front porch to let men know she was “open for business”.  

Back to the midnight text

Did I Just Open A Massage Parlor?

Michelle’s text: I hope you’re sitting down.

Don’t freak just click this link http://www.rubmaps.com/bowling-green-massage-parlors-ky  I’m here if you need to talk.

I clicked the link.

I was suddenly bombarded by an old familiar stomach-churning, black-out rage so intense that I couldn’t breath, scream or cry.

It felt as though every cell in my body turned from its position to flee in a lateral path out of me.  I’m describing the quiet PTSD-bomb that goes off when you’ve been utterly violated by a monstrously exploitive excuse of a human being.

I had just been listed as a “massage parlor” and I had a “review” that identified me as a prostitute.

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You’ll have to go to the link for yourself and click through to read the review from CalebIV on me.  Yes, I pretty much figured out who he was just from doing a little detective work.  Idiot! And just to set the record straight, His little fantasy description at the bottom is pure fiction.  In order to read the other reviews, you have to pay.

So let me explain this new world of evil to you.

This website, as you can explore, is for the express purpose of training American men in the art of mongering”.

It was originally called rubhub.com and based out of Sri Lanka for the US market.  Men sign up for this site and learn a particular game called ‘mongering’,  that will hopefully get them a variety of sexual acts performed by you, the Massage Therapist.

They have a lexicon, training classes and a forum hosted by “Mongo”.

Each individual man decides how long he will stalk a specific Massage Therapist and the tactics he will use.  He then reports each session back to the forum and receives encouragement and advice on how to proceed for successfully procuring the desired sex act.

Some of these guys will play for up to 12 months to conquer one Massage Therapist.

Once they succeed, they’re done with you and move on to the next challenge (therapist).  If a Massage Therapist is difficult to lead down the proverbial primrose path, that therapist then becomes a hot-ticket challenge for other misogynistic chest-beaters to go after.

Lucky me!  My business, has gotten “mongered’ seven times.

Make no mistake, these men seem super legit.

They are seasoned clients who spend big money getting regular massage for their pursuits.  Back when I discovered this, you could read the forum feed and the stories these men would tell as they came back from the battlefield.  

They don’t use coupons and they book regularly. They even talk about their legit Massage Therapists back home whom they, oddly enough, treat with great respect and don’t monger.  One guy said something about “not s****** where you eat?

…ahhhhh such valor

They decide on the number of massage’s they will get prior to their first attempt to coerce you.

Some of these guys will wait months before propositioning you.  Their most popular way is to get you to feel sorry for them due to some life or relationship tragedy they’ve had and it really helps if they know you’ve had a similar one.  They will loan you books or get you tickets to concerts, etc.

They become your big brother or fun friend.  

They might even send you flowers on your birthday.  Their complements are profuse as they slowly gain a sense of your moral compass.  These men are truly skilled predators; no better or worse than men with lolly-pops and puppies at a park.

The Milk Can Is Back On The Porch

After enjoying nearly half a century without Miss Pauline’s entrepreneurial perfume clinging to my town, it had become painfully obvious that the milk can was back on the porch.

Given the two new massage parlors and being targeted by mongers, I decided to do something about it.

I formed a group of Massage Therapists.  We all shared our strikingly similar stories and decided to do a little detective work to see if we could rid our town of the massage parlors.

Our hope was if they left, so would the creeps.

We gathered enough evidence to present to our chief-of-police and he then convinced our county prosecutor to do a sting operation on them.  Unfortunately, just like in Miss Pauline’s day when the cops showed up, all the girls were just sitting around knitting.

Well, in this case, just nowhere to be seen and the sign that had read, “Ask us about Tantric Massage” was gone.  They had protection, just like Miss Pauline and it didn’t take but about six months of them being in town. So sad.

We’ve accepted that there is not much we can do about the sex trade in our town.  We now are focusing our efforts on self protection and better client screening skills.  One of our members is talking to our state legislators in hopes of changing how we post our licenses.

Currently we don’t have to do that.  She is hoping to get them to force us to have to post our licenses with a current photo.  Then there would need to be public education to make consumers aware that if they didn’t see this upon entrance, to steer clear.

That helps protect the public but what about us?  

Recently, I’ve seen a lot of buzz on social media as to whether or not Massage Therapists should have protection such as pepper spray, body alarms and firearms.

I totally respect everyone’s choices in self protection.  I would say most therapists in my town are protected in one way or another.  However, I’ve determined that never letting the creeps in your front door in the first place (creepo abstinence) works best.

In most places total client confidentiality is non-negotiable but if they’ve never been a client and have just let their lascivious intentions be known in a phone call, they are fair game for exposure.  The therapists in our group have a communication chain where we share the details of any sexual massage requests from non-clients with each other.  We find that if they call one of us, they call all of us.  It’s awesome when we talk and find out that they got rejected over and over.  These guys will often change their name but the phone number is the same.  If they block their number, we just don’t answer, forcing them to leave a message if they dare.  Occasionally they are bold enough to give their names, phone numbers and specific sexual request and ask us for a price…gotta love these guys.  In these cases, I promptly call our local police force and give them the detail.  After all, solicitation for prostitution is a crime.