The Private Practice Advantage

By: Catherine Ming, NC LMBT #13880 

Wondering what the difference is between the private practitioner massage therapist with his or her own office and the national spa chain franchise at the shopping center, or the multi-therapist practice not owned by the therapists themselves?  Let us examine some of the differences between these options which one may experience.

Unlike national and international chain spa franchises, often found at local shopping centers, a privately practicing Massage Therapist (MT) will not rush you into and out of your therapy session.  Chain franchise owners, who are often not massage therapists themselves, frequently do not allow their employed therapists any time between scheduled appointments with clients.  The therapist in such a setting is pressured to get the client out quickly in order to turn the room for the next client, change the table linens, clean the room and table, restock supplies, make notes in the client's file, and check the next client's file in a matter of a couple of minutes.  How thoroughly can these processes be completed in such a brief timeframe?  A private practitioner, however, schedules enough time between clients to take care of these tasks.  Time will be scheduled to have a detailed conversation both before and after the session about the client's concerns, health, and treatment plan, and to perform any assessments or special testing that may be necessary.  The therapist in private practice will make plenty of time to give the client stretching and self-care homework to empower the client to help themselves, and to (hopefully) allow a longer period of time between sessions, thus saving the client money.

Many chain franchises pressure their customers to purchase a membership to presumably get a cheaper price for their sessions.  These agreements can be difficult or impossible to cancel, locking the client into a membership for a certain length of time regardless of changing circumstances.  Although this may seem like a great way to save money, in the long run it may be more expensive, especially if the client is forced to buy more sessions than they need.  These businesses are usually located in a shopping center for a reason:  they are primarily retail establishments.  A chain spa may charge $50 and up for a 50 minute session, plus the client would tip $15 or more, bringing the total to at least $65 for less than an hour session.  For just a few dollars more, a client can see a privately practicing massage therapist who will spend extra time before and after a full hour of massage to ensure that the client's health and wellness are fully and properly addressed.  Most MTs in private practice do not expect additional tips any more than a physical therapist, psychologist, or dentist would, thus saving the client money.

It can be difficult to schedule with the same MT each visit to a chain spa franchise because of high turnover of employees and scheduling conflicts.  A private practitioner will be the only therapist you see in his or her own office.

Since chain franchise owners are usually not massage therapists themselves, they do not fully understand the anatomy, movement (kinesiology), physiology, contraindications (reasons why massage should not be performed due to a medical condition or medication), or pathologies that may be present.  Unfortunately, it is the experience of many MTs that such business owners' main concern is making money, not the wellness of their clients or therapists.  This can lead to terrible conflicts of interest, such as the owner trying to force the MT to work on a client who has an absolute contraindication because the owner wants the client's money regardless of the danger to their health.  Additionally, it should be noted that just because a client has a doctor's note granting permission to receive massage does NOT mean it is OK to massage.  Most doctors are not massage therapists, and are unaware of the contraindications which may endanger the client.  The MT should have the last word and final say on whether a client may receive massage, NOT the franchise business owner.

Many chain spa owners who are not MTs themselves are unable to discern whether each MT employee they have interviewed and hired is truly a knowledgable, skilled therapist, or just a person with a massage license who gives decent backrubs.  I and many other therapists I know have worked in such places where many MTs were shockingly ignorant of basic massage techniques, anatomy, kinesiology, contraindications, etc.  I have worked with other MTs who worked in such a dark room that they could not see if they were massaging right through a bruised or injured area, an area with varicose veins, or a patch of ringworm.  These situations are dangerous to the client for obvious reasons.

MTs at spa chain franchises or multiple-therapist practices are often poorly paid, thus relying on tips for a significant portion of their income.  The majority of your massage fee at such establishments goes to the business owner and not your therapist.  If the average MT can work 20-25 hours per week without overdoing things and injuring themselves, but are only making $16 per hour plus tips, they will be tempted to work longer hours to make ends meet, risking injury.  One of the top two reasons MTs leave their field is due to injury from seeing too many clients per day.  Particularly common are back injuries, shoulder injuries, and wrist and hand injuries such as carpal tunnel syndrome.  The more clients a MT is forced to see per day to earn a decent living, the more their effectiveness and quality of massage suffers, especially for the clients scheduled later in the day.  A private practitioner MT controls their own schedule so that their fourth massage of the day is just as good as the first.  Of course, if a therapist in a franchise location is not getting enough hours to earn a full-time living, that is yet another problem.  Many locations have too many therapists for the amount of work to go around.  This is the other top reason therapists leave the field:  lack of income.

Privately practicing massage therapists with their own offices have made the commitment to start their own businesses and devote their lives to helping people.  They do not share their income with any other employer, business owner, or entity.  Many MTs have made complete career changes to enter this field to help others. That commitment will be evident in the level of care that is experienced by their clients.

Having said all this, spa chain franchises and the like may be the only option some people may have to experience massage, and it should be noted that not every single chain franchise is a totally bad experience.  There are some good therapists in such locations.  Clients and the general public will hopefully be educated about the options, experience the differences in various bodywork practices, and continue to see the value and advantages that a private massage therapy practice can provide.