Medical Massage Therapy

Marketing a Successful Cash Practice (Part I)

Gregory T. Lawton, D.C.

Inherent within the practice of medical massage therapy is the medical massage economic and financial model of office management. This practice management model is based on the medical practice model of treating patients according to their chief complaint, which is usually pain related, using a therapy plan that is specifically designed to treat the patients problems, and using therapeutic modalities along with manual therapy. The medical massage therapist who uses the medical massage model will treat more than one patient per hour. This practice model is effective in either a cash practice, with insurance billing, or a mixed cash and insurance practice.

The medical massage therapist who treats more than one patient per hour can charge less per patient visit than the therapist who provides 60 to 90 minute massage sessions. Medical massage therapists routinely charge between 15 and 25 dollars per 30 minute office visit as compared to therapeutic massage therapists who may charge from 45 to 100 dollars per hour. In most market areas there are far more patients who can afford to access massage therapy treatments when they are affordable. This is especially true for the patient whose condition requires two or three treatments per week. To the medical massage therapist, whose mission is to provide health care and not recreational massage, an affordable fee schedule is an important aspect of patient retention and practice building. If the incredibly high professional attrition and turnover rates for therapeutic massage therapists are any indicator, the therapeutic massage model based on the 60 or 90 minute massage session with higher per visits rates is simply not working for the majority of new therapists entering the massage field. Another reported element of attrition in the massage field is due to “burn out”, which may be related to the fact that many, if not most, massage therapists provide essentially the same massage session to every client that they see. The medical massage therapist who treats patients according to the patients presenting symptoms will provide a wide variety of treatments, techniques, and procedures that varies from patient to patient.

Within the health care community there is an ongoing debate regarding the merits of a cash or insurance based practice, the answer is probably to do both, but in some states, especially where there is no state licensure, the ability to bill insurance may be a rare event. A medical massage therapist who treats 10 patients per day on a half hour schedule and with an average fee of 20 dollars per patient will gross 200 dollars per day, 1000 dollars per week, 4000 dollars per month, and 48,000 dollars per year. Medical massage therapists who treat specific patient conditions with localized therapy as opposed to a “full body massage”, can easily see 45 to 50 plus patients per week.

Two of the well hidden secrets to successful practice building are:

1. Building a practice is like priming a pump, the more patients that you see the more patients you will get.
2. The main element in practice building is patient referral of new patients.

Many relaxation massage therapists attempt to build their practices with “high” fees and will often have a very small caseload of only two or three dozen patients. This is an “unhealthy practice”, in that this practice has too few patients overall and contributes to therapist burnout if from nothing else the boredom of seeing the same few patients over and over again. The therapist in this example has collected a small number of patients who will not take responsibility for their own healing process, but rather depend upon the therapist for continual maintenance care. This type of practice usually hovers around 16 to 24 patient visits per week and until the practice begins to suffer an inevitable slow down the therapist may think that they are doing well. These therapists have poor practice building skills and are seduced by the short-term income that they achieve with fewer patients and higher rates. Often these therapists are simply part time dabblers in massage therapy and it is in this group that the higher levels of attrition and drop out are seen. The healthy and growing massage practice will maintain a fairly constant level of 300 or more active patients that are in various stages of treatment from acute care to occasional maintenance treatment.

The professional medical massage therapist with a large successful cash practice will have a patient management plan that will include these actions:

• Will maintain a professional and efficient telephone answering and patient scheduling plan.
• Will thoroughly educate patients while they are in the office and on the treatment table.
• Will take control of the patient visit and develop a management plan for each patient.
• Will schedule the patient while they are on the treatment table and will direct the patient regarding when and how often they will return for treatment.
• Will handle patient objections by explaining the treatment, fees and total cost of care, and length of time of care before the patient even asks.
• Will schedule multiple visits for care on the patient’s first visit to the office.
• Will use patient education methods to get patient referrals.
• Will provide each patient with a simple drawing and notes that explains the patient’s condition and problem on the first visit.
• Will maintain a results oriented practice that achieves a clinical response during each patient visit.
• Will have efficient collection of treatment fees at the end of each visit.

Visit the article gallery again soon and read Part II of Marketing a Successful Cash Practice.