You may be aware that Warrior Massage has a policy covering what happens if you cancel your scheduled appointment. If you aren't aware, then you can find the policy here. I'll also recap it below:
Though there is a wide degree of variation from business to business in how strongly it is enforced, the above is a fairly standard cancellation policy for the massage industry. If you are a regular consumer of massage you are probably aware of this, but you may not be aware of the reasons behind these policies, so I'll answer a few frequently-asked questions about it here:
Why is there a charge?
While you are not receiving the service you reserved, the time has still been set aside for you, and without advanced notice it is very difficult, if not impossible (depending on how much notice, if any, you do give), to find someone else to sell that time to. Because massage is a low-volume business (we only see ONE client at a time, for an entire hour or more), every cancellation not only leaves a significant hole in our schedule, but also represents a significant loss of income. The cancellation fee mitigates the loss for the practitioner.
Is the fee punitive? Don't you make exceptions?
Because the fee is not punitive, the only exceptions made are if the spot gets filled by someone else. Though we certainly sympathize with those who are unable to make the appointment due to circumstances beyond their control, we are not in the business of judging whether someone's excuse is 1) truthful or 2) "good enough" to warrant a waiver. And no matter how good the reason for missing an appointment is, the financial loss suffered by the practitioner is no different. There is no malice or spite towards those who miss appointments; it is simply a matter of recuperating the cost for lost time.
How do you determine the amount charged?
Some massage businesses charge the full amount for a missed appointment, however Warrior Massage only charges half. This is because, as stated above, we sympathize with those who miss an appointment due to situations beyond their control... and for those who miss an appointment because you just forgot, we appreciate your honesty. Either way you'll only be charged half of the regular rate for the appointment.
Does charging a fee really reduce missed appointments?
Yes. Practitioners who do not charge a cancellation fee have many more missed appointments and no-shows than those who do. Ultimately, the decision of whether or not to go through with an appointment is entirely in the hands of the client, not the practitioner. Yet the cost of missing the appointment is, without a fee, paid mostly by the practitioner. Passing on some of that cost to the person making the decision means that people are a) more likely to take seriously the responsibility to remember appointments and b) less likely to schedule appointments for times when they might not be able to make it.
Hopefully this will help you understand massage appointment cancellation fees, and alleviate some concerns regarding them. See you at your next appointment!
Running a business is difficult work, with lots of risks and challenges. Running a massage business is no exception. Doing massage is the easy part. The hard part? Selling massage. Getting people in the door and getting them to spend their money on your business is difficult to do and challenging to do well. However it is the key to running a successful business, so people have come up with plenty of tricks to get it done.
You've probably experienced many of these tactics, as a consumer, but may not have given them much thought. Whether they work or not is not the topic of this blog entry. I mean to speak of the reasons NOT to use some of the most common sales tactics in the massage industry - and more specifically, why you can expect to be free of these tactics when you deal with Warrior Massage.
1. The Odd-Number Price
Have you ever noticed that nothing every costs $50 or $100? It's always $49 or $99, or worse: $99.99? That 1% (or 0.01%) price drop is not because merchants have found a way to fine-tune prices to the exact price point where your WTP (Willingness to Pay) meets their WTS (Willingness to Sell). It is there because merchants think they can trick you (or at least part of you) into thinking you are paying less than you actually are. Because when you pay $49.99 for something, you are ACTUALLY paying $50 but somewhere in the stupid part of your brain which controls basic survival instincts like resource rationing, you think you're paying "$40-something."
Essentially, the merchant is LYING to you about the price. And they're not even being honest about lying, because they're lying to a part of your brain that doesn't understand deception.
Also, it makes book-keeping all that more difficult.
2. The Must-Act-Now Deal
The more time you have to think about a purchase, the less likely you are to spend your money. Or so the thinking goes, except maybe when it is something essential like a new water heater, or heart surgery.
The trick to get around this is to offer you a good deal but make it contingent upon deciding right away: walk out that door (or take time to think about it) and the offer goes away. You may be familiar with this trick from car salesmen. It uses fear to manipulate you into making a hasty decision.
I believe that all relationships built on fear are unhealthy for everyone involved.
3. The Add-On
At many spas and massage businesses, it is common to offer "add-ons" to your massage: a foot-bath, steam towels, aromatherapy, et cetera. These can be nice if luxuriation is what you're in for, but as far as value they are designed to get you to pay more for the same amount of service: usually, they don't add time to your session, so you are actually paying MORE for LESS massage, because every minute your therapist is spending preparing a foot bath or steam towel is a minute she's not spending massaging you.
4. The "Massage-Drunk"
It's well-known amongst massage therapists and massage enthusiasts that, immediately following a massage, people often have a feeling of relaxed euphoria, probably due to the flood of oxytocin, dopamine, serotonin, and other happy hormones and neurotransmitters unleashed during a massage. This state is colloquially known as "Massage drunkenness," and it's commonly accepted amongst massage therapists that this is the best time to press a client to sign up for another massage, or buy a package or membership.
While I certainly don't turn away someone who immediately wants to book another massage after their massage, I prefer not to apply too much pressure to someone (especially to commit to a large purchase like a package or membership), because it feels like taking advantage of someone, and I don't want any customers to regret having made the decision to pay for my services.
If it wasn't clear, I don't approve of any of these sales tactics, so I strive to not let them creep into the business plan at Warrior Massage. However I do not condemn everybody who uses them because, like most consumers, it's likely that most business owners don't really give any thought to the tactics they use. They were probably taken in by some shyster who used unscrupulous techniques to sell them on the idea.
"Hey, how are you?"
"I'm good, how are you?"
You've probably had the above exchange innumerable times. It is a standard greeting etiquette, and yet it is rife with dishonesty: often the person asking does not really have any interest in how you are doing, or even if they do, they likely do not have the time to listen to an honest answer. Likewise, the person responding is often not good or fine, but will answer in such a way because they understand that the question is a matter of formality and a pleasantry, rather than an actual inquiry into your well-being.
As massage therapists we are no less guilty than others of using this worn-out small-talk. When you come for your appointment, however, and we ask you "How are you doing?" it is anything but a formality. We genuinely want to know, at least physically, how you are doing as knowing will help us assess your condition, the appropriate treatment to provide, and the progress of any ongoing issues you are being treated for. Typically, the response we get is of the formality type - even if our patient is not doing fine, they'll say they are. We do know this, however it is still easier to ask one question hoping to solicit any relevant feedback, rather than using your time to ask any number of more specific questions to hunt for the relevant feedback which may not exist. When your therapist asks "How are you doing?" we are really asking:
"How are you feeling?"
"How did you feel following your last massage?"
"Have you had any changes in your health since last time I saw you?"
"Has there been any improvement of your injury/condition?"
"Is there anything new that you'd like me to work on today?"
We really do want the answers to these questions, even if we encapsulate them in a simple "How are you?" which in other situations is just a formality. And if you want to complain about things we can't help you with, like your mean boss or misbehaving children, we've got time to listen to that too. Approximately 60 minutes.
Since many of my new customers come to me through Living Social, Groupon, or Amazon Local, there is a fairly good chance that if you are reading this, you are familiar with how those sites (called daily deals or voucher deals) work - from the client side. I am often asked by clients (especially those who are themselves entrepreneurs) about how successful the daily deal campaigns are, and how they work from the merchant side.
How Does It Work?
You are probably familiar with daily deal sites, but if you aren't, here's how it works: merchants (that's me) offer their product or service at a reduced rate, to be marketed and sold by the intermediary (that's Living Social/Groupon/etc), to you. What you actually receive is a voucher or coupon which the merchant is obliged by their contract with the intermediary to accept in exchange for the goods or services described on the voucher. The terms of the voucher - such as the price point, any restrictions on use, and how many will be available - are worked out beforehand between the merchant and the intermediary. The intermediary pays all the costs associated with marketing the deal and getting you to purchase it, and in exchange keeps a portion of the proceeds.
How Much Does the Merchant Make?
Not a whole lot. In order to have a deal listed on one of the daily deal sites, a merchant must typically agree to cut their price at least 50% from their normal rate - this is what entices most people to purchase the deals. Then the intermediary takes a percentage of that, which is negotiated on a case-by-case basis. A large, well-known brand with high pre-existing demand will be able to negotiate a larger cut than a small merchant with an unknown brand. When I first did a daily deal I was paid 47.5% (50% minus credit card fees for each transaction); with higher-than-average reviews from daily deal clients, and making the intermediaries compete for my patronage, I have since negotiated up to 60%. Some math:
My regular rate is $60.
Offering at %50 means daily deal customers pay $30.
The intermediary takes 40% of the $30, which means I get $18.
This is about what a brand new therapist just out of school gets paid at the sweatshop known as Massage Envy (after tips are added). That therapist doesn't have to pay any expenses like rent, or spend any time answering phones, scheduling, marketing, doing laundry, etc, because they are an employee of a business which already covers all those things.
On the plus side, the merchant gets paid whether or not the vouchers are redeemed (as long as they are not refunded). In my experience, approximately 30% of vouchers are never used (that's a lot!). This amounts to about another $6 for each voucher redeemed for a 1-hour massage, or $24 total ($18 for the unredeemed voucher, divided by 3 because there is about 1 unredeemed voucher for every 3 redeemed vouchers). The mean pay for a massage therapist who works as an employee somewhere OTHER than Massage Envy is $30-$35.
Why Would You Offer That?
I hope you don't take the above paragraphs as complaining. It is just an objective picture. The reason we (the merchants) do it is because it brings new clients in the door. As I said in the beginning, the majority of my regular clients started as daily deal customers, or as referrals from those who did. That being said, it is an awful lot of work. The "conversion rate" (how many daily deal customers actually return and pay full price at least once) has been somewhere between 10% and 25% for my business. I consider the time I put into these low-paying massages to be a marketing expense. 10% or even 25% seems like a very low number, but I have poured lots of money into more traditional forms of advertising (including conventional internet ads and SEO), and was never able to attribute a single new customer to those marketing methods. I can't compare the conversion rates because you can't divide 0. So it seems like a pretty solid marketing plan in comparison.
It is also worth noting that, despite being a merchant, I also know what it is like being a customer - I still am one, regularly, of merchants other than myself. I know how it is to be wary of spending a lot of money trying out a new service, or a new provider, that you are not familiar with. I respect the risk you are taking by trying me out. Offering the reduced rate for new customers reduces that risk (because, if you don't like it, at least you spent only $30 and not $60, right?), which I hope encourages more people to give it a try than otherwise would.
How Do You Get Paid?
The exact terms are determined by each merchant-intermediary agreement, but typically the merchant receives a check by mail or direct deposit 2-4 weeks after the end of the sale period, for 60-80% of their share of all vouchers sold. The merchant receives another check for the remainder of their share (minus deductions for any vouchers that were refunded) 2-4 weeks after the vouchers have expired. In the case of ongoing deals or more lengthy sale periods, checks are received twice a month for the same respective shares of any vouchers which were purchased or expired during the previous two weeks.
What is it?
Intraoral Massage is massage of the muscles and soft tissue structures in and around the mouth and jaw. In the state of Washington, massage therapists' scope of practice does not include massage of any body orifices. The one exception is the mouth, but additional training and certification (called the Intraoral Endorsement) is required. Fortunately, I (Jesse) am fully certified for intraoral massage.
Why would I want massage inside my mouth?
The most common reason for intraoral massage is for treating injury or dysfunction of the temporal-mandibular joint (TMJ) - that's the hinge part that flaps your jaw up and down when you chew or talk. TMJD: Temporal-Mandiublar Joint Dysfunction, is usually experienced as pain, restricted movement, or clicking in the jaw when chewing.
Some other conditions treated with intraoral massage include:
Is it safe?
Chances are, you have had what you might refer to as a "knot" in one of your muscles at some point. Perhaps you tell your massage therapist where your knots are every time you come in for an appointment. Maybe you've heard other people complaining of knots, and wondered if that pain you've got is caused by knots. Just what is a "knot," anyway?
What it isn't
Clearly, when we talk about "knots" as a source of aches and pains, we are not talking about measuring nautical speed. More importantly, do not imagine that your muscles are actually tied in a knot like the loose ends of your shoelaces. In order for this to be the case, your muscles would first need to detach themselves from your bone (or tear apart somewhere in the middle). If that happened you wouldn't be asking "why is my back so achy?" you would be asking "why am I a screaming puddle of suffering on the floor?"
In all seriousness, you should not be overly concerned if you have a "knot" in your muscles. They are common, usually easy to treat, and not necessarily indicative of injury or dysfunction. Think of them as normal wear and tear on your body.
"Knot" is also not a terribly specific medical term. It can refer to a number of different physiological phenomena, owing to the similar way they feel when you experience them. To an experienced therapist, however, they feel different to touch, and each has its own indication for how treatment should be approached.
Hypertonicity means that the resting tone or tautness of a muscle is higher than it should be for ideal, efficient function. A number of things can cause hypertonicity - postural strain, repetitive/overuse, stress, etc. It normally affects a whole muscle, making that muscle feel "tight," and often causing soreness at the muscle's attachment points or in adjoining muscles and tissues. Techniques used to address hypertonicity include many variations of stretching, direct pressure, and tissue mobilization.
Adhesion means that muscles or other tissues are adhered (stuck) to other tissues in ways that are not ideal. One of the causes of adhesion is the healing process: as muscle and other tissues are stitched back together after being torn, things sometimes get stuck where it's not necessarily good for them to get stuck. In the case of major injury, adhesion is obvious and long-lasting, and we call it scar tissue. But it can occur more subtly, building up a little at a time from the micro-trauma caused by hard labor or working out.
A trigger point is a local contraction in a limited number of fibers of a muscle. This is the closest thing to a "true" knot. It usually appears as a small nodule in a highly taut band of muscle, and feels like a very tender spot that, when pressed, causes pain to a broader area (this is called referred pain). It may even refer pain to an area distant from the trigger point itself. A number of factors can cause trigger points, but often they are a result of physical trauma or muscle overload.
So... do you have knots? The answer is that you probably do have knots of some variant, to some degree of severity. You should get a massage.
If you have never had a massage before, you may not know what you should wear to your massage appointment. Or perhaps you have had a massage at a spa, and aren't sure how massage etiquette differs for a massage at a clinic. Or perhaps you have been getting massage every week for a decade, but your therapist is too polite to tell you that you've been committing a massage faux pas for ten years. Hopefully you will find the following wardrobe tips helpful for your next massage appointment.
1. Less is More: generally speaking you don't have to undress completely if that makes you uncomfortable. However, when receiving Swedish massage or any therapy rooted in Swedish massage (most Western massage therapists practice a system based in, or influenced by, Swedish massage), your massage will be better with less clothing on. This is because many techniques used in Swedish and other systems are intended to be used on bare skin, and work best that way. Since wearing clothing limits your therapist's ability to utilize these techniques, the less clothing you wear, the more variety of technique your therapist is able to employ.
2. If you don't want it pressed into your flesh, don't wear it: if you are not comfortable undressing for your massage, that's OK, but it's best if you wear light clothing with no extraneous buttons and bobs attached. Things that are a bad idea:
4. Spa Day: Speaking of staining sheets; if you are planning to have your nails freshly painted or your hair freshly dyed/tinted/highlighted, please schedule that appointment AFTER your massage, not before.
5. For Sports Massage: if you are getting a massage for sports conditioning purposes, your therapist will likely employ stretching and movement techniques that may compromise the conventional draping. For this reason, it is best to wear some light, comfortable, and form-fitting undergarments (such as boxer briefs), lycra biking shorts, or the like.
6. Medical Equipment: if you wear a device or garment that is medically necessary, by all means wear it to your appointment; we can work around it. This includes any medical braces, external defibrillators/tensers/medication delivery devices, incontinence wear, and others. Especially incontinence wear.
If you are new to massage, you may be wondering what is the etiquette regarding talking during a massage. Are you supposed to lie there quietly during your massage? Is it rude to chat with your therapist? Is my therapist going to chat at ME during my massage?
In the industry refer to this as "table talk," because it is the act of talking while you are on the massage table. Whether your therapist is asking questions about your injury or condition, educating you about what it is they are doing or about what it is you are feeling, or if you are just chatting, it's all table talk.
There is some variation depending on setting, type of massage, and therapist preferences that can determine how much table talk is appropriate. In most cases, a minimal amount of table talk is completely necessary: your therapist may ask questions about where and when you feel pain or other symptoms, about the kind and frequency of activities that may aggravate or relieve your symptoms, or about physical signs they notice that may impact how they will proceed with treatment. If you are at a spa getting a relaxation session, you are less likely to get a lot of these questions than if you are at a clinic getting treatment for an injury. Whether or not you are feeling chatty it is important to answer these questions fully in order to give your therapist the insights they will need to give you the best massage possible.
Beyond medical necessity, however, the decision whether or not to talk during your massage is up to you as the client. You are, after all, paying for the session. There are some therapists who believe that it is important for the patient to remain quiet and focused on their body, while other therapists believe that it can be therapeutic for a patient to feel comfortable talking freely. In my opinion, both can be true. For some clients, the most therapeutic thing is to have a whole hour with no talking. For others, perhaps having someone finally listen to THEM for a change is the most therapeutic. Sometimes, the same client may have different needs depending on the week. In any case, at Warrior Massage your therapist will follow your lead: if you don't want to talk, you will only be asked the questions most pertinent to your care. If you do wish to talk, your therapist is more than happy to oblige - just don't feel too jilted if you're doing most of the talking: we're probably just focused on our work, but we ARE listening!
In my last installment of this particular topic, I discussed the types of insurance that cover massage. Now, I'd like to explain some of the reasons I do not accept insurance at Warrior Massage:
Billing insurance isn't as simple as just sending off a bill. There are benefit verifications, pre-authorization requests, claim forms... and that's just the beginning. Every insurer the provider contracts with has different rules, different points of contact, and different processes to follow. The more forms of insurance a provider accepts, the more difficult it becomes to manage them all. With so many moving parts, billing insurance is rarely a simple affair. It demands more of the therapist's time, which means we have to charge more to make it worthwhile.
2) Client Accountability
I strive to make myself and my business accountable to the people that matter: my clients. Their well-being is, after all, the mission. I feel the relationship between the client and the provider needs to be the entire focus of a business. At Warrior Massage, my clients pay for my services and support my business. I am invested in and accountable only to the client. In an insurance-based practice, the client is not the one paying for the services, which shifts the focus away from the client and onto the insurer. Instead of thinking "what can I do to make this client's visit as awesome as possible so they'll keep coming back?" the provider is thinking "what can I do to make sure the insurance company keeps paying for this claim?"
While the insurance company creates rules to ensure medical necessity, improve client outcomes, and prevent fraud, these rules can get in the way of what a client actually wants or needs. This can be as simple as the inconvenience of delaying treatment while waiting to find out if it will be paid for. It can also mean modifying one's treatment to suit an insurer's protocol for how a patient should be treated.
3) Loss of Flexibility & Control
With every insurer comes a contract of some kind which proscribes the manner in which a provider can manage patient interaction. For instance, some contracts may prevent a provider from charging missed appointment fees; others require that the provider give their members a favored rate, effectively eliminating the provider's ability to provide discounts and special offers to their other clients.
In most provider-insurer relationships, the insurer holds all the cards. An insurer often doesn't pay for up to 90 days (there is a lot of processing on their end), with no penalty, and can deny payment for a number of reasons. Providers sometimes find out a claim is being denied only after they have been treating the patient for some time. And with the high number of claims being processed, not every one is fully vetted before it is approved. Claims can be audited years after payment is made, and a provider can then be told to return the money if the insurer decides to retroactively deny the claim.
4) Legal & Ethical Issues
Besides the specific contracts that come with each insurer, there is a whole minefield of legal and ethical pitfalls that a provider billing insurance must navigate. Simple things that are common practice in everyday business become unethical or even illegal when a third party (insurer) is paying the bill. A keen example is referral rewards: it is a common, accepted, and even lauded practice to give some kind of reward as an incentive to those who refer new patients. However, when those patients are insurance claimants, it is called a "kickback" and it is illegal.
While the above does not include every reason not to accept payment by insurance (I could go on, but who really wants that?), it should shed light on why I (and other providers) might "turn down money."
I also hope that it does not come off as condemnation of insurance entirely. As a therapist I have worked (and continue to work) as an insurance provider, but not at Warrior Massage. It can be a great thing, allowing patients who may not otherwise be able to afford the cost get treatment that can vastly improve their health and quality of life. Most clinics and insurance providers hire professionals with specialized training whose job it is to navigate the process of insurance billing, making it a much more viable business choice. If Warrior Massage ever grows enough to make such a thing a possibility, insurance may be integrated into the practice. But until then, keeping the practice "cash only" keeps business simple, honest, and affordable.
It takes a lot to give a great massage, and your therapist at Warrior Massage will always do everything in our power to make your experience a great one. But there are also some things you can do to make sure you get the most out of your massage. Whether you are a massage veteran or are nervous about your very first massage, you may find the following tips helpful when you go in for your next massage therapy session.
Before Your Massage
1) Arrive early. Especially for your first visit, there will probably be some intake paperwork for you to fill out (just like when you see your doctor or any other medical provider). Even when you have no paperwork, it is good to arrive with enough time to catch your breath, so you are not still tense from your commute when you get on the table.
2) Use the restroom. Few things disrupt a massage more than this pressing need. It can be hard to relax when you really need to go. Do yourself a favor and go before your massage starts, even if you don't think you have to. Also, this is another reason to arrive early!
3) Schedule a time buffer. If you have somewhere very important to be ten minutes after your massage, chances are you will be too worried about that to be present and body-aware.
4) Ask questions. If there is anything you are unfamiliar or nervous about, ask! We love to answer questions.
During Your Massage
1) RELAX! We work on your muscles and other soft tissues, and the less active tension in your muscles, the better work we can do.
2) If you have any questions, ask them! We are happy to answer them. If you have any feedback, tell us! Sometimes we know when something is a tender spot, but often it is impossible to know unless you tell us. If you are cold, we can help by turning on the table warmer or giving you another blanket, but we won't know unless you tell us.
3) Do not attempt to "help" your massage therapist. Unless your therapist specifically requests that you lift an arm, bend a knee, or perform some other motion, chances are that we want your muscles completely relaxed. Though we know you're trying to make our job easier by helping us move your limbs, it is actually making it more difficult by increasing muscle tone while we are trying to decrease it.
After Your Massage
1) Drink plenty of water. If you've had lots of massage, you've probably been told it has something to do with flushing toxins out of your muscles. There's actually very little, if any, evidence that this is true. But it's still a good idea. Being well-hydrated is good for your health in general, and good for the health of your soft tissues specifically.
2) Pay attention to how you feel not just right after your massage, but in the days/weeks following your massage. Then the next time you have an appointment you can let your therapist know if something we did made you sore, or if you had particular lasting effects. This way we can adjust our treatment appropriately and help you get the most out of it.
3) Schedule your next appointment! Getting massage therapy regularly is a great way to increase wellness and quality of life, and will have much better effect than just trying to squeeze in an appointment when you are in pain. No matter what frequency works for your body, lifestyle, and budget, if you always know when your next appointment will be, you won't find yourself suddenly realizing you haven't had a massage in years.
This area of the blog is for discussion on topics specific to massage, wellness, and the massage industry. If there is a topic you'd like to see discussed here, please ask!