Saturday, July 30, 2016


According to the AMTA the average, massage therapist worked 25.3 hours per week in 2015 and was paid for 19.7 of the 25.3 average hours.  Also indicated in the report massage therapists provided massage for an average of 45 clients a month or between 11 and 12 clients a week. Only about 50% of those surveyed by AMTA indicated that they wanted to work more hours. (AMTA-- The 2016 Massage Profession Research Report). 

Well, that is interesting.

Also according to the AMTA 2016 Massage Profession Research Report, gross income ( I assume that means prior to income taxes and after overhead is deducted if self-employed)  was$24,132  in  2014 and $24,519 in 2015. That sounds terrible until you realize that is PART TIME and about 62% of the typical forty hour work week. 38% of the reported income of $24,519 is about $9500.  Therefore , factored out to full time,  this means that full time earning for a massage therapist (prior to income tax) is about $ 34,500 per year.

This is a good income for a diploma based education of 625-750 hours and in the vocational sector of health professions.

So why are massage therapists working part time?  About 50% are happy with part time. So what about the other half?  Why are massage therapist only providing 45 sessions a month—part time instead of  90 massage sessions? This is between 20 and 25 client sessions a week or 5 sessions a day.
Two reasons come to mind. Ergonomics/bodymechanics and lack of client volume.  I have been pleading for an independent ergonomics and biomechanical analysis for massage therapy for YEARS.   The massage therapy leadership organizations NEED to fund a “for real” independent analysis by objective experts outside the massage profession to get an unbiased perspective and useable recommendations.  I do not care who you are or how long you have been doing massage or teaching (including me), all of us are guessing.  We do not know for sure and it is time to know!

Client volume is an issue as well.  So what are the obstacles preventing more people from receiving massage?  Again, according to the AMTA 2016 Massage Profession Research Report, Females without children in the home with incomes over $50,000 are the main massage consumer and 1/3 of all massage consumers had a household income of $100,000 or more in 2015.  Only ¼   of those with a household income between $75,000 and $100,000 received a massage in 2015. Seventeen percent of those with incomes between $35,000 and $50,000 got a massage in 2015, down from 22 percent in 2014. And only 7%  of those with an income of less than $35,000 got a massage in 2015, down from 8 percent in 2014.

There is a huge potential to increase clients since only a small percentage of people actually receive massage.  The largest group of people are those making less than $50,000 a year.  Price point of a typical 60 minute massage session will need to be between $40 and $50 for these individuals
How often clients receive a massage is also an issue.  Many who get massage only schedule once a month. Research has shown multiple times that that frequency is not enough to generate and sustain benefit.   Weekly massage sessions are idea but realistic scheduling for clients is a massage every other week.  Increasing the frequency of massage for current clients would double the session hours worked. What are the obstacles for receiving more massage sessions in a month?  Cost and time with cost being the biggest deterrent.  If the average fee for massage is $ 65  the monthly cost for a client receiving a massage every other week is  $1625 a year or $135 per month.   For those with incomes less than $40,000 a year that is a real chunk of money.  For those with yearly incomes of $ 75,000 or more that is 2% of income but for those making $35,000 a year it is 5% of income.  Those earning $35,000 -$40,000   only have $700 (2% of income) to potentially spend on massage.  The most they could spend is $30 a massage session if they received  2 massage sessions a month.

I just had this conversation with my students as we were discussing how to provided massage therapy to first responders such as EMT, fire fighters and police.

This is the reality we face right now.  People know massage has value and many more people would become clients if they could.  If more people could receive massage then more massage therapist could work full time if they want.  This is a tricky economic line to walk.  As massage therapists we need to make an income sufficient to meet our needs and at full time, like so many, that is $30,000-$35,000 a year and this is the income of the group of people that can be helped so much by massage therapy on a regular basis.

I certainly do not have all the answers but I sure am thinking about it. 

Monday, July 25, 2016


The employee based massage business model is about the same regardless if a single owner independent massage clinic with 2 or 3 employees or an owner of multiple franchise/chains locations. Some have higher services fees for the massage or maybe other services such as skin care or yoga and some a bit lower.  A middle range initial investment of the owner is about $200,000 plus a year of operating costs. The initial investment in a facility and equipment is expensive and advertising is a huge cost especially in the beginning.  $300,000 as a commitment is reasonable.  Before that  owner makes any money, the business must earn back $300,000.  Let’s also use an average of $50 as the amount paid for each unit of service—a massage.  The business must sell over 5000 massage sessions. –That is a lot.  Full time massage practice for an individual massage therapist ranges from between 1000-1200 massage sessions a year and MANY massage therapist only want to work part time.   

At the same time and for ever after, the business must generate enough gross income to pay all expenses including wages BEFORE the owners get any profits. This amount can range from 
$ 150,000 a year to $350,000 a year—about 4000 service units ($50 massage sessions).
As an employee, if the cost of each massage is $50 you have to provide a minimum of 650 massage sessions per year just so the employer can pay your wages. In addition, all the other overhead operating expenses must be paid. There are not just massage therapists to pay, but also receptionists and housekeeping, management, repairs and maintenance staff. This is another 250 massage sessions at $50 each. So when working as a full time massage therapist employee  you have to do 900 massage sessions in the year before the owner makes ANY money off of you IF you want to earn $30,000 a year.

REALITY CHECK--- And this is based off of $50 per massage. Most unit sales will be less than the $50 because of member discounts, coupons, specials, etc.

If massage therapists were paid a flat $15 per hour for a 40 hour work week performing 25 -30 massage hour during the 40 hours on the job, the yearly income is $30,600 which costs the employer $40,600 in payroll and another $12,000 in operating costs. So the business owner has to cover about $53,000 of expenses if they pay $15.00 an hour for every hour at the job regardless if you perform a massage or not.  That is 1375 hours of massage per year working 40 hour work weeks and based on figures of actual massage hours of  BUT you are getting paid for 2040 hours a year.

Soooo-the profit to the owner on this model of employment is based on 25 units of service at $50 or $1250 a year.  If that owner has 15 massage therapists working full time, yearly profit margin is about $20.000 and that is less than what each massage therapist makes.  I wouldn't take all the risk for this type of profit. Would you? So why do people become business owners?  Well, that is a good question. 

Quite a different picture isn’t it. These figures are within a realistic range and based on maximum schedule.  What happens when there are no shows or a bad weather day?

This is a tough cookie to eat.  A lot of people have their fascia in a twist.  The employee model is miss understood in the massage community. This is unfortunate.

What are the solutions? Paying employees less for sitting around when not doing a massage and charging more for the services hoping there is enough volume. The massage franchise membership model was originally based on affordable massage for the masses. The average yearly income in the US is around $35,000 per year. The most a massage can cost to serve this majority of the population is $50 with the tip.  That means the price point cannot be much more than $45 per massage and that only buys one massage a month which in really not enough to gain the health benefits massage can provide.  Volume will likely decrease as the cost of a massage exceeds $50. $40 per massage is a better price point for client retention, multiple massage session and volume.   So much for raising the price of services.  Over time owners often do better than the $20,000 profit mentioned earlier but the first 5 years is really hard. There are product sales and add on services.  Paying the low rate for sitting helps the profit margin.  And if the massage therapists are fully booked everybody does better.

 Still being a massage business owner is not the huge money maker many would think and the intent is not to work massage therapists to the bone and treat then badly. 

Often it is to keep the doors open.

Wednesday, July 20, 2016


I just now figured out how to get back into my blog.  It has been a year! No excuse.  Not all my fault. Blogger settings were changed.

I have been thinking  a lot about the current state of the massage therapy community.  Over all I think we are moving in the right direction. Here are some events that I support with --of course-- editorial comment. Also some needed areas for improvement.

I support The 6th edition of Fundamentals of Therapeutic Massage and the 5th edition of Essential Sciences came out this May.

  I was meticulous to make sure ELAP curriculum recommendations are covered. The more I work with the ELAP documents I am confident that the content should be the platform for ALL entry level education for massage therapy.

I also support COMTA's curriculum endorsement program.
Students and schools can now look for a “seal-of-approval” to symbolize excellence: COMTA-Endorsed Curriculum. This innovative new status can stand on its own or be a pathway toward accreditation. Students get peace of mind knowing their program fulfills national competencies, while schools show their professionalism in voluntarily earning this meaningful designation. Better education will make for better graduates–leaving our profession in good hands for the future.

I support the Massage Therapy Foundation, the Samueli Institute and AMTA and the initiative taken to reach out to experts and complete a high quality Meta Analysis and Systematic Review of massage therapy  and pain.
I also support ANN BLAIR KENNEDY  and the work she has done with the best practises data.

I support the Alliance for Massage Therapy Education

Join us for the 2017 Biennial Educational Congress

hosted by The Alliance for Massage Therapy Education

The 2017 theme is “Elevating Standards of Excellence.” The second Educational Congress will take place over five days at the end of July 2017 in Tucson, Arizona. In addition to the pre- and post-conference events, the exhibit hall, keynote, and general and breakout sessions are scheduled for July 27, 28, and 29.


I support the current direction of the NCBTMB including Board Certification partnerships for college credit for associates and bachelor's degrees
and development of specialty certificates.
I strongly encourage NCBTMB to maintain tight control over the specialty certificate educational partners continuing the process of working with organizations instead of individual educators  while at the same time carefully expanding access to course availability.  

The AMTA and any other organizations that provide statistics about massage therapy income need to change how they report. AMTA is especially confusing in how it reports income data.  Graduates and current massage therapists as well as employers cannot accurate use the data to be informed about income.  Currently via AMTA reports income yearly is around $25,000. 

Same for employers especially the Franchises-- it is ethically responsible to report average income not only the highest possible income. 

It is time to STOP bashing the Franchise system of massage delivery and all work together for improvement. The massage community is shifting to employment versus self employment and these are two very different  career pathways. 

Massage Therapy delivered in the medical setting is not more valid than massage delivered in the wellness setting.  

Massage therapy is a built on a platform of health care-- especially is terms of quality of life and well being.  The delivery of massage therapy for this major sector is outside of the medical setting.  Massage in the medical setting is not more valuable nor does it increase the validity of massage therapy. It is one emerging setting. The major care process in a medical setting such as a  hospital is palliative care for a short duration since people do not stay in the hospital for long periods. This offering of massage is important however the medical setting does not lend itself to  health maintenance especially condition management of chronic conditions.

I continue to plead for an independent ergonomics and bio mechanical analysis for massage therapy practise. 

Of course there is more but this is enough for now.