Nurture Professional Networks

By Terrie Yardley-Nohr
[Ethics and Etiquette]

Throughout your career as a massage therapist, you work with a variety of individuals, both inside and outside the profession. It is important to understand the complexities of these relationships and how working with others affects your own success. Although you usually work one-on-one with clients, other professionals can help your own growth and contribute to your success as a practitioner.

From the time you enrolled in massage school, you began to build a crucial network of business contacts. Whether you work on your own or become an employee in a spa or franchise setting, it is important to realize the value of continuing to develop relationships throughout your career. If you are a student, you are wise to tell your friends, doctors, family members, and local business people that you are in school learning bodywork. These people may be instrumental in helping you find work once you graduate or at other points during your career.

Professional relationships should be handled with the utmost of care. You never know where an opportunity may be waiting for you. Think of each person you meet as a potential client or connection to a great job opportunity. You will also begin to deliberately develop peer relationships. For example, if you like the chiropractic office where you have been a patient and would like to build your practice in this type of setting, you can begin to develop a good relationship with the doctor and his staff.

Build A Network

As your practice grows, you’ll need professional alliances—health care providers with whom you can network, refer, and consult during your career. Begin by looking to people you already know (such as your doctor or physical therapist) and branch out to include qualified allied practitioners in your area. Options include crisis centers and support groups, physical and occupational therapists, psychologists and counselors, and other massage therapists with different specialties.

There will be instances where you refer a client to someone else and once they finish the referred treatment, they will return to you. If you refer a client to another health care provider, there is a possibility the client may not return. It is important to do what is best for the client. Clients have the right to choose their treatment and they should never be put in an uncomfortable situation between two providers. Keeping alliances professional and strong between referring parties can help eliminate potential conflicts.

Ethical Behavior

Once you realize the potential for developing professional relationships, you have a heightened sensitivity to the importance of ethical behavior in everything you do. You have the potential to make a good impression—or a bad one. For example, if you talk about other professionals in a negative manner while you are with a client, the focus of the session is elsewhere. Personal opinions are best kept to yourself.

Clients will ask your opinion about a variety of subjects beyond the realm of bodywork including nutrition, medications, a medical diagnosis, or your thoughts about other health care providers. Consider the following before answering clients’ questions:

What relationship do you have with the other individual who is being discussed?

Is it within your scope of practice to advise the client on this subject?

Could this client be harmed if you do not answer the question?

What harm could come to you if you give advice?

Is the information you have to share objective? If it’s subjective, should you emphasize to the client that it is subjective?

For instance, it can be difficult if a client tells you about a type of therapy he received that did not work. Of course, it is unethical to talk negatively about the therapy. It’s best for a therapist to remain neutral and avoid offering opinions on other therapists or their work. You may want to explain that not every type of therapy works for everyone. There are many options available and a client may need some help finding the appropriate one for their situation. Perhaps the therapy just wasn’t suitable for that client. Also, it’s not unusual for clients to try a number of therapies to find one that works for them. Therapists should think of this trial-and-error process as a potential pathway to their door. If a specific therapy doesn’t work, clients may seek out alternatives that may include the type of work you do.

Although clients may want to discuss the failure of other therapies, don’t let them dwell on the topic. Simply tell the client you are sorry the therapy was not effective and offer another type of therapy. Asking the client why they felt another therapy did not work may provide useful information when revising the treatment plan. This redirection helps the client focus on the present and the positive aspects of bodywork, and eliminates discussing other therapies or providers.

Referrals Build Business

A professional always keeps the client’s best interests in mind. If you have been working with a client for a number of sessions and he or she shows little or no improvement, it is appropriate to refer this person to someone who may be able to obtain better results. The referral could be to another MT or to someone with an entirely different—yet appropriate— scope of practice. The client will appreciate your concern and honesty. You would expect the same courtesy if you were being treated by someone.

Doctors, psychologists, and other health care providers often refer clients for massage when they think it will be beneficial for the client’s health and wellbeing.  Referrals are a good source of new clients and it is important to follow a few guidelines.

Always acknowledge the referring party.

Know the expectations of the referring party.

If the referred client asks for a change in treatment, confirm the change with the referring party.

Know the referral may be temporary. Be prepared to return the client when the therapy is done.

Keep in contact with the referring party when requested.


 Knowing everyone’s expectations is an important aspect of the referral. A doctor may write a referral asking for a certain type of massage or for a specific area to be addressed. It is important to follow these directions and if you think a change would benefit the client, talk with the doctor first. A doctor may not know about a modality that would help; as a therapist, you can explain what you can possibly accomplish for the client. Once the therapy is complete, follow up with a final thank you note and a report of what you and the client accomplished during the sessions. This level of communication shows other health care providers the quality of your work you and it showcases your professionalism. It also provides the referring therapist or doctor with a more complete record of the client’s treatment. Customer service and superb work will likely lead to other referrals.


We all have times when we need the advice of other professionals to help us with our clients or businesses. A consultation is a great way of obtaining information from an expert about a subject that’s not your specialty. During the consultation, you will receive advice regarding your business, techniques, treatments, or conditions that may help you in a variety of ways. Consultations simply give you more information to consider before you proceed, but it’s important to remember that there are no guarantees that the consultant’s information is correct or that someone else knows the right way to treat your client. In any case, it is important to respect your consultant and thank him or her for taking the time to speak with you. And there may be a time when you can help that individual in return. Perhaps it’s appropriate to compensate the consulting party or offer to barter services in the future. 

Working with others is an important component of any massage therapy practice. Obtaining information, referring clients, and working with other therapists require that you treat others professionally and ethically at all times. Your clients will see that your practice is focused on their best interests. Treating your clients and others ethically and with respect serves your clients, your community, and your profession. 


Terrie Yardley-Nohr, LMT, has been a massage therapist for 18 years, working both in private practice and medical settings. She began teaching massage techniques and ethics 12 years ago and became program manager at Allied College in St. Louis, Missouri, nine years ago. She is the author of Ethics for Massage Therapists (Lippincott Williams & Wilkins, 2006). Contact her at