Survive & Thrive

Fortify Your Practice

By Robert Chute

When times are tough, you may be the first expense your clients cut. While it’s important to teach them about the long-lasting health benefits of massage and bodywork, you can also bolster your appointment book with some tried and true business practices. Each bullet in the 10 categories that follow is an action item to stop loss and make gains. Apply what you can today and you’ll be able to help people for years to come.


1. Perfect the Fundamentals

When evaluating the health of your practice, it’s important to start with the fundamentals. First, get the basics right so people feel good about purchasing your services. Don’t groan that this is going to be a lot of work, because this is stuff you should be doing anyway. Talk less, listen to your clients more, handle with care, dump excuses at the door, and consider these steps.

• Stay on schedule. When you give clients extra time in their session, you aren’t being generous with your time. You’re being generous with their time. Stay on track, and you might have another slot to fill in a day. One slot a day makes a big difference to your bottom line. Time is money. Don’t waste it.

• Go through your files and update your mailing list. You’re going to boost your retention rate by reactivating clients you’ve let slip away. When clients don’t come back, it’s not necessarily a dire judgment of your clinical skills. They just haven’t gotten around to it and a simple reminder is all they need to return.

• Remind clients they are overdue for a massage. Phone calls are going to feel pushy for them and awkward for you. Depending on how long your mailing list is and how much time and money you want to spend, send them a postcard or a note. No one gets letters anymore so a personalized note from you is very effective. If you’re determined to spend no money at all on this project, e-mail. (You do collect e-mails on your health history, don’t you? If not, it’s time to develop your mailing list further.)

• In order to spend more time working on clients, spend more time marketing. Therapists who devote one work day a week aren’t losing a day of work. They’re growing their practices because they know that if it’s not growing, it’s dying. Here’s a key roadblock to your success you’re going to have to get over: even brilliant therapists need to market their skills. There are plenty of less-than-brilliant therapists who are very successful. Depending on where you feel you fall on that continuum, this is either depressing or sensational news.

• When those reactivated clients start coming in, they should have an improved experience. If you’ve got an oil-dotted wall, it’s past time to repaint. If your sheets are see-through, replace them. Clean the algae out of the aquarium. Dust and sweep and vacuum and get rid of that spot in the carpet. You need to evaluate your clients’ massage experience as if you are the client. Go a step beyond your clients’ expectations.

• Tighten up your paperwork. Are you in a rush to just get clients on the table? Can’t remember the last postural analysis or treatment plan you did? If you don’t keep your files up to date, you’re sending a dangerous signal. You’re telling them this isn’t important. Record pain, stress, and energy levels. Without measurement, you can’t demonstrate how you’ve helped them when they start thinking massage is a frill they should delete from their family budget.

• Therapists who approach client treatment with a lax approach (and I’ve been guilty of this, too) often think they are showing they care more. Wrong. Treatment plans show you care about their health and that we are caring and careful practitioners. Demonstrate that and they’ll be back on a regular basis.

• At the end of each appointment, ask when they want to schedule the next session. It is staggering how many therapists fail to ask even the keenest clients about rescheduling. The client goes home, means to make an appointment, and never gets around to it.

• When you do schedule them, don’t just think in terms of the next session. Lots of appointments are coming your way. For clients to get the times they want, suggest they schedule several appointments at a time. Even better, establish a regular appointment time. Now you’re making progress.

• You’re wondering by now why I haven’t mentioned upgrading your dazzling therapeutic skills. I won’t. Most therapists feel their technical training was excellent. They can’t remember what mitochondria do, but their hands-on skills are solid.

• There is a common denominator I have noticed among successful therapists—they are confident, solid communicators dedicated to problem solving. Their clinical skills aren’t necessarily any better than those of less successful practitioners.

2. Better Your Business Practices

Many practitioners, especially those working solo, often don’t follow good rules of business, yet this is a critical component of your economic health.

• If you’re working out of your wallet instead of a cashbox, at least fold up the money you take in. Deposit the folded money at the bank, or it will be spent on pizza.

• Every lost or ignored receipt is money thrown away. Keep better track of your receipts. Get 12 envelopes, label them from January to December and put every receipt related to your business in the envelope. (That includes your laundry expenses, toilet paper for the spa, and your subscription to Massage & Bodywork!) Track your business-related mileage, too. It adds up.

• Bonus: if you do all the recording and organizing as you go, your accountant should be charging you less at tax time.

3. Find New Income Streams

Don’t sit waiting for something to happen. Get out and make it happen.

• Cross-promote your practice with on-site work. I started out as a new graduate in a new city with no contacts. I didn’t have a mailing list, and my clinic wasn’t in the best location, either. I had to get the word out to people to get them to come to me.

• Find some target markets. I reserved one day a week for on-site massage in a group home for people with cerebral palsy and I did house calls for clients with multiple sclerosis (MS). This paid the rent when my clinical practice wasn’t yet up to speed. It was very rewarding work, but it was also marketing for my clinic. Soon staff members from the group home and the MS Society were coming to me and it grew from there.

• Think about how you could leverage your experience to market your individual skills further. Most spas sell products to complement their services. Many therapists teach to supplement their income. What other income stream could you develop?

• Reevaluate your policy on dealing with insurance. Many therapists avoid taking insurance cases. However, many therapists build successful practices by billing third-party payers. Is there more time, energy, and stress involved? Sure. Therapists who choose to be stress resistant are snapping up work other therapists are turning away from. They are also often satisfying a need for folks in pain who might otherwise not receive treatment. If you have philosophical objections to doing insurance work, fine. If you’re uncomfortable filling out some paperwork, however, you need to reconsider. Is remaining aloof to that income stream a luxury you can still afford? People who are willing to do what others won’t will always succeed, no matter what the economy is doing. For example, if you think plumbers are overpaid, how much money would it take for you to go fix a stranger’s toilet?          

4. Beware False Economies

Work within your field to develop your clientele. On an hourly basis, it’s hard to find part-time jobs that outperform our fees.

• Don’t take an unrelated, low-paying, part-time job without strict analysis of the reward. Working behind a retail counter won’t pay if you’re going up into the next tax bracket and you splurge with your low hourly wage on an employee discount. That kind of pay costs you.

• Evaluate value over cost. One $300 pair of glasses lasted me years. My $60 frames fell apart in a month. Poor quality items cost more when they have to be replaced quickly—especially when you skimp on the quality of your professional supplies. Sheets with low thread counts cost you less but will devalue your clients’ experience. Is the table Uncle Jack pounded together really as comfortable and reliable as a professionally-made massage table?

• When clients say they have to cut massage because they can’t afford an hour of treatment, don’t automatically rush to discount your services. How will you get out of that discount hole when things improve? You don’t want to communicate to your clients that you aren’t worth your hourly rate. Instead, try offering them less time and charge that rate, or stay with the hour and cut down on frequency if that’s appropriate. Now you have time freed up in your schedule for more clients.

• Don’t be afraid to think outside the hourly-rate box. In fact, some therapists make this approach the strength of their practices. They work in shorter blocks and—charging more than half their hourly rate—make more in one hour than most therapists charge by the hour. The pace is faster. The case focus tends to be weighted toward more therapeutic than relaxation goals (though not necessarily) and makes for a varied, dynamic practice.

5. Control the Outgo

Look around to see where you can cut back. When you control the outgo, you may be surprised to find you don’t need more income.

• Leave your credit card at home, locked up, preferably with your spouse holding the key (and pay down that expensive interest-spawning debt!).

• When you go grocery shopping, leave the kids at home. You’ll save 35 percent on the bill.

• When you’re shopping, evaluate if you really need something more to dust and consider online services like for buying locally at flea market prices.

• There are many books to help you simplify your life. Borrow them from the library, don’t buy them.    

6. Reevaluate Your Relationship to Stuff

Find other ways to save your hard-earned dollars and enjoy the “experience” more than the stuff.

• There’s no shame in choosing to work from home to slash overhead. If you have a grand clinic, good for you, but don’t look down on spa therapists paid on an hourly rate. Chances are excellent you’re both working for the same money and each client base values the services provided.

• Our lives don’t have to be shrines to conspicuous consumption. Entitlement and overspending got us into this global economic crisis. If your clients are evaluating your success based on what kind of car you drive, that says nothing about you and more about them. Don’t get sucked into that mind-set.

• Some of us are going to have a lean Christmas. You’ll choose presents more carefully this year. The kids will actually play with all the stuff you do give them and there will be more time for tobogganing Christmas day.

7. Free Up Energy

If all economists were piled end to end, they’d still never reach a conclusion. Many of the so-called experts you see on TV are the same people who scolded us for not spending, except for when they were scolding us for not saving. People are panic-selling stocks and, ironically, the people buying up the stocks think they are making an equally sound economic decision.

• Turn off the TV and focus on being better and doing better. Otherwise, you might catch fear-induced paralysis by analysis and that doesn’t help you move forward. Don’t feed anxiety. When you stoke those fires, you’re fueling the recession rather than the recovery.

• Keep in mind that, despite the panic in the air, many people will not be affected at all by this downturn in the economy. People still need care and treatment, so you are in an excellent position to weather this storm.

8. Downsize

Amanda Harper, owner of Living Well LLC in Mobile, Alabama, is a real-world example. She loved her big clinic space with three other therapists, a psychologist, and a homeopath for pets. However, when the stock market dropped precipitously, Harper knew she had to move into a smaller space with just one other therapist. “The easiest thing for me to do would have been to close up,” she says. “For a while, I thought moving back into the smaller suite was failure but it took a lot of strength. All around us there are spas closing. I get calls every day from therapists who are looking to work. I personally wasn’t feeling the crunch but … I spent a lot of my own money on marketing [the clinic]. I realized I had to act quickly and resolve the situation.”

Harper arranged with her landlord to move back into a 580-square-foot space—down from 1,600 square feet. She dumped an expensive website, opting for a cheaper one, and she cut down to one phone line from three. The new website gets more traffic than the expensive one. “Sometimes people think they can just go with the flow. I’m a more ‘go out and get it and make it’ type of person. I do something as soon as my mind is made up.”

Most people will feel uncomfortable with this downsizing strategy and lay down until the urge to take action passes. Do what you know you must.

9. Measure and Track

Success that is not measured can’t be repeated easily. Unmeasured failure will be repeated.

• Watch where the money goes. I lost four regular clients when a local industrial plant closed. They will continue to see me, but far less frequently. I bartered a massage for a tutorial on spreadsheets. It was an eye-opener as to where the money is going. The math came to an annual loss of  $3,000. That’s when I opened my schedule to new clients again.

• Watch where the money goes at home. This is a family project, too.             

10. Ask for Help

This is the hardest one. Nobody wants to admit they need help, but everybody needs it sometime.

• Prepare an envelope with three business cards. When your clients are on their way out, ask. “You know three people who’ve been thinking about coming in for at least a year. I need your help. Would you give them my business card and ask them to give me a call so I can help them? That would really help me. Thank you.”

Few clients will refuse to help you. Your clients want you to succeed so you’ll be able to continue to help them.

Insulate yourself from financial heat. Stay cool. You could earn even more income than before the sub-primed bottom fell out.


  Robert Chute, RMT, is a regular contributor to Massage & Bodywork magazine. Contact him at