How do we think about our business? In this episode Whitney talks with Allissa Haines of Massage Business Blueprint about pertinent business topics such as: What's coming up for the new year? How to get more massage and bodywork clients? How to communicate with your client's healthcare practitioners? And much more.

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The Thinking Practitioner Podcast:
Episode 83: Business, Success, and Change (with Allissa Haines) 

Whitney Lowe:

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Welcome, everyone. This is our first episode of 2023. Til is off this week, but I'm delighted to be joined by my friend Allissa Haines from Massage Business Blueprint, who is here today. Welcome, Allissa, to The Thinking Practitioner.

Allissa Haines:

Welcome. Happy New Year.

Whitney Lowe:

Thank you. Great to have you here. Looking forward to an enlivening and interesting discussion with you today. I want to touch on this theme of the new year of this being our first episode of 2023 and talk about some things related to looking at our overall, what's ahead for us, what are some things that have changed and that kind of thing. So we'll get down to some of those things. But to begin with, for those of our listeners who don't know you yet, tell me a little bit about yourself, about the Massage Business Blueprint, what it's all about and what you're up to with that.

Allissa Haines:

Sure. Me, I am a practicing massage therapist, a small business owner in Massachusetts. And I always start with that because it is the primary thing that I do and hopefully gives me the brain and the credence and the experience to do the next thing I do which is co-run the Massage Business Blueprint. And that is primarily an online learning center that teaches massage therapists marketing and business skills. We've got a podcast available to everyone. We've got a blog available to everyone. We have all kinds of resources and eBooks available to everyone who wants to learn how to run their massage business, every business marketing networking aspect you can think of. And we also have a private community for people who want to really dive in and get a lot of peer mentorship action. And it's all at massagebusinessblueprint.com.

Whitney Lowe:

And I will say personally I think it's a wonderful resource. And how long have you guys been doing this now? It's been a while as ...

Allissa Haines:

We're coming up on eight years.

Whitney Lowe:

Yeah, really? Wow.

Allissa Haines:

with me and my partner Michael Reynolds, partnering together. And it was, I think, I had four or five years prior to that with the earlier iteration of what would become the Blueprint.

Whitney Lowe:

Yeah. Great. Tell me a little bit historically because I'm always curious to hear some of the origin stories, how did you and Michael kind of connect on this and decide that you are the right thing? Because it's hard to find the right perfect partner, that's a great complement for you and I think you all do a wonderful job of being that for each other.

Allissa Haines:

Yeah. Michael and I met through our AMTA volunteering years and years back and he was the president of the Indiana Chapter. I was running education for the Massachusetts Chapter. And his marketing company, because he had two lives at the time, his marketing company was doing websites for state chapters. And we met because the very first time I published my very first blog post on this website intended to help teach marketing and business skills, I wrote a blog post and it went out to my email feed, which he happened to be on or he happened to get it passed along to him from some mutual AMTA friend. And the very first interaction I had with Michael was an email that included my blog post and said, "You're brilliant."

Whitney Lowe:

I like that.

Allissa Haines:

And I thought ... Right? How can you not become best friends with someone who does that?

Whitney Lowe:

That's right.

Allissa Haines:

So we-

Whitney Lowe:

And he's not even a relative or anything like that.

Allissa Haines:

No. Just-

Whitney Lowe:

Unsolicited from the public.

Allissa Haines:

Absolutely found my kindred spirit and borderline twins, our birthdays are within a couple of weeks of each other and we became friends. I learned a lot about marketing and networking from him and we fill in each other's gaps very well. So after three or four years of me just messing around and blogging and starting to teach CEO all over the country and then starting to realize I did not want to travel and teach CEO all over the country, he said, "Hey, do you finally want to turn this into a real thing that makes us actual money?" And I was like, "Yeah, I would love it if the me became an us," because I did not have the wherewithal to structure it well and that is where Michael shines.

So that was back in the days where you just wanted to monetize every hobby you had and that's how we ended up getting organized and partnering up and becoming The Blueprint.

Whitney Lowe:

Yeah. Well, it has become, I think, an outstanding resource. I point people to it all the time just because there's not a lot in that space about growing your business, becoming successful in your business that does anything nearly as thoroughly as you two do it, first of all, but also with really super high quality, and in a way that, I think, just when you look at the stats of why people leave this profession, inability to really succeed from a business standpoint is high on that list frequently. And yet, it's one of those things that people don't necessarily want to ... They're not excited. A lot of people are not excited about learning about business. How have you all found working with that mindset about it's something everybody knows they need to do, but they're just not really that excited about it and doing it?

Allissa Haines:

Well, what's nice about running something extra, "I'm not within a massage program," right? Because when people are in massage school, they are not prepared to even think about the business aspect. You're already trying to absorb all your origins and insertions and your boundaries and how you're going to deal with working on your grandmother and all of this stuff. You don't know what you need to know yet in regards to business. And I've found that any education, any business education people get in massage school goes in one ear and out the other because it's just not the best time to learn that. And that's why all of this education stuff regarding business isn't really needed.

And I also want to note it's really needed and it's needed to be taught by people who currently have a hands-on practice and/or have had a hands-on practice recently. When we started doing this, the bulk of the people teaching business hadn't put their hands on a body or run a business in 15 years. And the economy is very different and business and marketing skills are very different. Even a couple years out of massage school, so we're talking like 2008, '09, '10, I took a business class where they were still teaching written ledgers and such and I was like, "No, there's software for that now." And so-

Whitney Lowe:

That come from the days when our business teacher was telling us to go put business cards up in the health food store.

Allissa Haines:

Right? "You should make a flyer and put it at the health food store," definitely. And so there was a real need for people who were actively running practices like massage businesses to share what they were learning as all of this business and marketing stuff evolved. And that's how we filled that void and I forgot the original question that you asked already.

Whitney Lowe: Well, no, let me take it ... Yeah, you nailed the original question, but let me take that also to another place, because when you speak about business education in massage schools, trying to train practitioners for the future, this is one of those places where it changes so damn fast in terms of things like social media, how to get things out there. And like you said, many of the teachers and people who have been charged with teaching in these places may not be up on how to do this kind of stuff. And it is one of those things that you all do exceptionally well because you stay current with these things.

But I'm wondering, what's your thought on, is this essential or necessary to try to get these people to be staying more current or is this something that, for example, might be better served by you doing what you're doing when people actually get out and start working? Because it's one of those things that situational learning here, I think, is so relevant of people learning this stuff while they're in the midst of really practicing as opposed to saying, "Oh I just have to learn this to pass my licensure test," or whatever. And like you said, it's not top of mind when they're in school at that point.

Allissa Haines:

Yeah. And I remembered your original question, which was, "How do you deal with massage therapists who have this resistance and don't really want to learn this stuff?" And the nice part of starting this endeavor is that people who don't want to learn this stuff don't come to me. So we're really self-filtering. So anyone who comes to the Blueprint via our podcast or just emails me a question or joins our community, they are ready to dive in. So I don't have to convince anybody that they should want to learn this because they're here because they want to learn. So that is one. Working with people who actually want to work with you is super nice.

But yeah, there is a lot of... Here's the thing, this is my whole marketing shtick in one sentence. There isn't really anything new foundationally, right? There's just all these new tools to do the things. So 50 years ago, you were going to create relationships with other small business owners, maybe by being part of your neighborhood business association or a chamber or whatever your little town or big city had, you were just going to in-person connect with other small business owners, right? Awesome. We still need to do that. The bottom line of all business and marketing is it's about relationships, but the tools we use to build those relationships are very different and they evolve.

So you went from having personal one-on-ones with people and small neighborhood business associations and your little address book and that evolved into actually having printed business cards that you could give everybody and then you had a business card file and folder. And then people started storing contact information in their phones and you started having people ... Phone service got better. You weren't sharing a phone line with three other families or two other businesses. Like back in the day, people had to share phone lines and that's how you would talk to people, but now it's via email.

And so the bottom line, the foundational parts of running a business and building a business are not new. It is simply learning a new tool, "You can use a screwdriver, you can use a drill, that's it." It's just an evolution of tools. So I do think that, in massage school, there should be a foundation. We should be told that we need to ... "It is extremely helpful to track your income and track your expenses in a very structured clear way." We should be told that, "Your first year out, you might need to pay some quarterly estimated taxes." We need to be told that. We do not need a deep dive into QuickBooks when we're in massage school.

Whitney Lowe:

Yeah, for sure.

Allissa Haines: 

That's business. That's business skills. That's business practices, right? And then you've got networking and marketing. We need to be told that other small business owners can be a great resource for us. We need to be told that, "You should look for a networking group, maybe one that even has an offshoot for health and wellness," but we don't necessarily need to be told to go visit 10 BNI chapters. So the foundation is always the same, but the tools are going to constantly evolve.

Whitney Lowe:

One of the things that I hear from people all the time, and I know I have said this myself as well, and I wonder if you have a pearl of wisdom for people when they get in this place of saying, "I just want to do this work. I don't want to be salesy and I'm not a seller. I don't sell things well." Do you have one kernel of wisdom or the go-to statement for people that say that?

Allissa Haines:

Yeah, you can't serve anybody if they don't know you exist.

Whitney Lowe:

Yeah, there you go.

Allissa Haines:

And I had a classmate in massage school who, in a very self-effacing way, would go, "I have these hands and they're great, but I have nothing else." I'm like, "Okay." And the good part is you can learn and I tell people all the time, "Your first effleurage was terrible. It was terrible. Your first effleurage on an arm, you were too hard over the elbow. You probably put your hand into the armpit. You didn't go all the way around the shoulder and you didn't think to come all the way down and make it full by ending at the fingertips. You were terrible." Your first networking experience will likely be awful. And epically, I'm going to give this example, I have a friend who bought a bakery about five years ago and it is the only nut-free bakery in Rhode Island. Huge, really big for people with allergies.

And she got this beautiful placement spot on a TV show, a local, whatever, statewide TV show newsy thing and she demonstrated really quick how to decorate a cake really well. And it was a three-minute spot and that was it. And she called me afterwards and said, "Never mentioned it was a nut-free bakery." I was like, "Yeah, but it was the first time you were on that show. Everything else was fine. Don't worry about it." And she's been on that show five more times and is the biggest nut-free bakery in Rhode Island. So anyhow, you're going to screw up like that. You're going to stumble in a networking experience. You're going to not know the terms of the business certificate you need to get from the town hall. You're going to get better at it.

Whitney Lowe:

Yeah. And what you said at the very outset too, I just want people to hear that again because that's so important, which is that you're not going to help people if people don't know you exist. And it is one of those things that I think we just have to grin and bear that it's a part of what we do to be able to do what we do. And most people that I talk to are in this because they really have a mission or desire to want to do something significant with their work and that's how that's going to be relevant and possible for them to do that. So one other thing I want to touch on here with the community, with the Blueprint community, I think community building and community resourcing is so valuable for learning this kind of stuff, people who've done something that you're trying to get into doing, somebody knows something about databases and you have no clue or something, somebody knows something about accounting or whatever.

How has that been for your community members in terms of a resource? I think that's a really valuable part of what you're doing and you find the same that people are really learning and using a lot of that community resource.

Allissa Haines:

Yeah, it's awesome because we've got core resources. We've got these tutorials and worksheets and anything you could ever want to learn about any aspect of running your business, but sometimes you need someone's personal experience. So I don't do the formal networking that a lot of massage therapists do. Now Michael's really good at it, but he's never done that level of networking as a massage therapist. So someone will come in and ask, by come in, I mean log into our community and ask in the forum, "I'm going to visit three BNI, which is Business Networking International, meetings, as a guest and it's a super hyper structured networking group and I'm going to go visit as a guest. What do I need to know and can I run my elevator pitch by somebody?"

And it's so good because we'll have a bunch of members who have done that kind of structured networking with that exact group because it's this massive international group and they'll say, "Okay, here's how most meetings go. There's going to be this kind of an opening, there's going to be an intro. Everybody's going to go around the room and have 60 seconds to give their shtick. There's going to be a longer presentation like five, 10 minutes by a member who's chosen for that week to give some kind of presentation and dot, dot, dot. And here's how it works with tracking your referrals in that group." And it's something, I don't know. I know if you'd be on it, but I'm not really good at that, but in our group of 200+ massage therapists, we've got a handful of people who nail it and know everything you need to know.

There's a lot of ... I live in a suburb and I know the foundational aspects of marketing, right? But it's different if you're in a huge city. It's different if you're in a very, very small town. It's different if you're in a suburb that is only 10 miles from massage school and your whole area is just saturated with massage therapists. So the foundations are always the same, but there's always these little adaptations for geography or specialty or even the gender of the massage therapist or the circumstances of a massage therapist, a single parent who has no childcare, so this is how they have to work. So in our community, there's usually someone who can answer a question. It is very rare for any question to go unanswered.

And typically, when that happens, a few of us can jump in and say, "I don't have an answer, but let's work through that together," and then we'll do that. We have live office hours which are just Zoom meetings where any member can pop in and out and people can peer mentor and also just hang out. Because being a massage therapist can be very lonely and it's better now because we have the internet. But when I started, that wasn't a big thing, so you would just spend like 20, 30 hours alone in a dark room with a client every week and it was very isolating and there weren't a lot of massage therapists around

Allissa Haines:

Thank you.

Whitney Lowe:

I want to also talk a little bit about the new year, and when the new year comes around, everybody makes their requisite resolutions, which they're going to not fulfill in two weeks, whatever it is, the way that usually goes, but it's always the time for us to talk about change and looking forward and everything. The last few years have been just an absolute whirlwind of change globally for all of us in so many different ways, and of course, a lot to our profession. And I'm asking a lot of different people this question just to hear different perspectives. What have you seen as some of the biggest changes impacting our field and what do you see as you look down the horizon for the next year and the next few years of anything that's going to be different than it was perhaps?

Allissa Haines:

Oh, I think long term, in the 17-ish years that I've been doing this, I was thinking about this the other day, it has been a very, very long time since I was asked if I give happy endings. It has been at least a decade and it has been probably just as long, at least a decade or more since a client who was looking for sexual services got past all my screening and it led to an uncomfortable situation in a massage room. It has been years and years and years of that. And part of that is me knowing how to put my practice out there better now, me having better screening techniques and also because it's a much more educated consumer base nowadays.

So there are more and more people who have actually gotten a massage or have actually who know someone who's gotten a massage or have utilized or know someone who has utilized massage in the aspect of rehab or healthcare. And that's really, really big. It used to be, when you said, "I'm a massage therapist," you could see the gears turning in someone's head if they were going to make a joke or not and I haven't ... Frankly, it's been a long time since someone mistook me for a sex worker. That's great, sure, awesome because not that there's anything wrong with sex work. I want to be very clear. It's just not what I do. It's not my specialty.

So it was nice to think about that and be like, "Wow, that's great." There's licensure and regulation in a lot more states. Is that a good thing or a bad thing? It depends on who you ask. Massachusetts is the template of what not to do for state licensure, which it was badly executed and we will pay the price, literally pay the price of lots and lots of licenses and inspections and such for the rest of my career and that's fine. I also think that to see more and more massage therapists specializing is really nice because I think that ... And I don't think that everybody needs to have a hyperspecialized practice. I don't think everybody has to say, "I work on runners," "I work on women athletes," or, "I only work on people with cancer," or, "I only do this particular modality." That's not the right kind of practice for everyone, so I don't want anyone to be like, "Well, I'm running a general practice. None of her advice applies to me."

But I think it's neat to see more and more therapists specializing in oncology work and in manual lymphatic drainage and in very specific techniques, especially techniques that don't require someone to take their clothes off because that allows us to serve more people. And seeing that, seeing more people niche is really, really fun. And-

Whitney Lowe:

So what do you think are those key benefits of that specialization? Is it that more people are able to get their specific needs met that they weren't necessarily through more generalized approaches that were available before?

Allissa Haines:

Yeah, so there's a benefit to a client base, right? Because if I've got TMJD issues and I go to my regular massage therapist who's a very journal practitioner, she's going to do some jaw work and some related neck work and it's probably going to help, but not as much as if I go to someone who specializes in jaw and neck and TMJD stuff who is going to do more specific and thorough work, who is going to be able to maybe do a little bit of assessment and evaluation within the scope of whatever our practice is, apply hands-on work that is informed by that assessment, maybe get better results and probably teach me more specific and effective self-care on my own. So it's good for the client base and that it provides better care for certain issues or it provides better customer satisfaction when they want certain modalities.

I am terrible at hot stone massage, and back when I gave hot stone massage, it was mediocre at best. When I stopped doing it and I sent a few of my clients to my officemate who was very good at it, they were like, "That is a whole other experience." I'm like, "Yeah, I was absolutely underserving you." So even technique-wise or modality-wise, it can be better at delivering the massage that your client wants. So it's good for the client base. And of course what's good for the client base is good for your business because word gets around, but also because massage is more popular, because there's more ...

Franchises weren't a thing when I graduated and when I started my business. That wasn't a thing that I had to worry about competing with, but if you're in a city and there's a spa or a franchise in every third corner and you've got a massage school in your city or nearby, so you've got a very saturated market. If you can specialize in a thing, every person looking for a solution to that problem, so say TMJD work, they're going to be more attracted to you than to a general practitioner. So it is a way of putting yourself outside the crowd of massage therapist, outside the fray and the blurriness and really focusing so that clients who need your specific thing and a client who needs very specific work from a highly specialized practitioner is going to drive a half an hour for that.

They're not going to drive a half an hour for a general relaxation massage. Well, some of mine do because that's part of my specialty, but they're not going to just drive and go through the effort of researching a practitioner to do general stuff. But if you've got that niche and it's a need that needs to be filled in your area, then your schedule will be busier with less effort on your part.

Whitney Lowe:

Yeah, so I want to touch base on that just for a second too, first of all, and also make another plug for a wonderful eBook that you all have on your website about how to find new clients. So I'll also put a link to that in the show notes, so people can find that. So in reference to this, do you have any quick hint suggestions for individuals how they find those niche people when they say like, "Oh, I've identified, this is something I want to really specialize in"? There's not a listing of people necessarily walking around with TMJ disorders, but you want to specialize in that. How do you find those specialized needs people?

Allissa Haines:

Well, you think about where they hang out and you think about the other practitioners that they see and you try to make those connections. That's always like the first go-to. Let's take TMJD, you would go to dentists, dental hygienist. You would try to connect with ... And there's a lot of big dental chains now. They may not be as easy to connect with as a neighborhood independent practice dentist. And again, other business owners. That's the core of what this is, right? So people who serve people with dental pain and also by really refining your elevator pitch, so that everyone knows that's what you do.

So if you're at a networking meeting or a chamber event, or you're meeting other people who perhaps could send clients to you one day and you say, "I'm a massage therapist. I specialize in people with jaw pain," the next time they meet someone who has jaw pain, you're going to come up in their head versus, "I'm a massage therapist. I help people relax." Also useful, not as specific. So it plants a seed in people's heads. So that is part of getting the word out, but also having a really specialized website that makes it very clear what you do, lots of helpful information for people with jaw pain, maybe some videos for self-care, and then oftentimes, some really well-placed Google Ads. And it doesn't have to be a huge spend. You can run a Google ad for a dollar a day.

And so that people who are searching for like, "Jaw pain therapy Boston," my website's going to come up a little higher on that search than other websites. So there's that.

Whitney Lowe:

Yeah. So there are tactics and ways to get there for people and these are some of the things too that people could learn through what you all are doing with your Blueprint community and the resources and things that you have about how to use some of those specialized tactics to find people.

Allissa Haines:

Yup, absolutely.

Whitney Lowe:

Yeah. So another thing I want to ask about here, this is something I see on social media a good bit, that there's a lot of topic or a lot of discussions in various different groups about business and economic survival and finding equitable pay rates for the things that we're doing. This has been a topic a lot with the franchise models and things like that. Since you've got a community built around these business issues, I'm curious to know, do you hear this talked about a lot? What are some of your thoughts on these current issues with pay and equitable compensation for people?

Allissa Haines:

It is so hard. It's just so hard. So many of us come into this because, one, we are caregivers, but also we want to be self-employed, we want to have autonomy, we want to be financially self-supporting. And you can't do that if your primary mission is also to provide hyper affordable massage. To build a sustainable business, you have to pay yourself enough, so that you can live and not get burnt out and not feel resentful about your work every day. And I don't have any fantastic answers and I have less answers now than I did three years ago because this pandemic has just been a nightmare for small business and for our kind of work.

And I think what'll ... My specialty here is people who are running their own one-person business, right? So I don't want to speak too much to big employee-based shops. I will say that for someone to run a business with lots of massage therapists, there's a lot of overhead, here's always training, but yeah, massage therapists have very much been taken advantage of. And there's all these weird pay models where you can do better if you take a commission versus an hourly wage, but at the end of the week, if your commission isn't this much, you get whatever. It's like a minimum-maximum, "If your commission doesn't make enough, we have to pay you hourly, which will get you this, whatever's more, whatever's less."

And it gets so confusing that employees don't know what they're walking into until three paycheck cycles there and then it's like, "Great, now I got to start again somewhere else," and they just say because now they're three months in and maybe in three more months, they're eligible for a raise. So there's a lot of confusion in hiring about what they're going to get as an employee and I think that part of that leads that they get overpromised, "Everybody tips 20 bucks." No, not everybody tips 20 bucks. So there's a lot of smoke and mirrors in the hiring process.

I will say that I think the push towards unionization is really fascinating to watch and I know that there is one franchise location in Colorado that has applied with the big labor organization to get the help to start unionizing. I think they've even had their first run of votes and I love to see it. I think that in many, many, many trades right now and what we're seeing with unionization is going to probably save. I actually think it's going to save the franchises in some way because there's so many that can't get enough massage therapists to work. They don't have enough open massage spots to serve all of their members and that's becoming a huge issue on a lot of the franchises. I think that unionization and just forcing them to be better employers might actually save those larger businesses. That's my shtick on that.

Whitney Lowe:

Do you think there's likely to be some fallout from that and that the lesser quality owners/franchise locations maybe won't make it but the better ones would ...

Allissa Haines:

Yeah, absolutely.

Whitney Lowe:

... with certain resources available to them, that sort of thing?

Allissa Haines:

I think that there are ... People like to apply very blanket thoughts to chains, but when you have a good owner, when you have a good franchise owner, especially when you have a massage therapist franchise owner, it's a very different ballgame. So I do think that those lesser quality owners will get pushed out because they can't survive treating employees well. So there you go.

Whitney Lowe:

Yeah. I also want to make a plug to something I heard you say on a recent podcast too and just have you reiterate that point that sometimes there is a perception within our profession that you are a less-than therapist if you work for somebody, let's say you work for a franchise, a chain or something like that as opposed to being a solo practitioner. But as you noted, when I was listening to you talk about this, some people just find that's not their shtick to be the solopreneur business owner who's doing all that stuff and they like being an employee. But there does still seem to be, I'm not going to say a stigma maybe, but just a perception of like, "Well, I'm not quite as good because I work at a franchise or a chain," or something like that.

Allissa Haines:

Yeah, there is that thought in the back of the head that if they were any good, they'd be working for themselves, right?

Whitney Lowe:

Yeah.

Allissa Haines:

And I absolutely used to think that. And after this many years of running my own business, I absolutely see why someone would not want to own their ... I am exhausted sometimes and I'm in a good place with my business where it mostly runs itself, but a couple years ago, I shut down my large practice where I rented to a lot of people and I reopened in a new space. And having to do all of the startup stuff that I hadn't done in 15 years was a lot. And as I trudged through it and reminded myself, "Okay, you only have to do this thing once. You only have to renew this license every two years. You only have to, blah, blah, blah, blah, blah," it was a lot of work.

And if you have not yet sought out the education so that you have the skills to make your business mostly run itself, it's hard. And especially in that first year or two when you're really trying to get new clients in just so you can survive, it's a lot. And it's not something people can do even when they have another income coming into their household or they are financially stable outside of needing to get money in for a massage. To be a single solo business owner when you have children is really, really hard. So really, really hard, or hello, sandwich generation, when you are trying to deal with your parents who are 80, and again, we're caregivers and we're like 80 something percent women, so hey, Gen X and the older Millennials, we're here trying to care for our parents who are breaking hips left and our kids and for some of us are grandchildren, it's a lot.

So I feel like ... I was talking to somebody today. For me, full-time massage was about 20 to 22 massages a week, which was about 35 hours at the office. And for the most part, that include all the admin work. Didn't include also doing laundry, but about 35 hours of work a week. That was full time for me as a massage therapist. But to fit that in when you're also the primary caregiver for kids or even just an equal caregiver to your kids, it's hard and it also took me a lot of years to get to the point where I could fit it all into about 35 hours. If you are struggling to learn your bookkeeping ... There's so many factors, there's so many things that takes a long time to have it happen smooth or you're really having to go big with marketing and networking to get more clients in.

Client recruitment can be tough. Client retention is much easier. So once you get an almost full schedule, it's easier to keep it going, but those first couple of years, I wouldn't want to do it. I wouldn't think I would do it again, essentially what I'm saying. I would much rather have a set schedule at a place where I can walk in and greet my client and bring them to the massage room and put my laundry in a hamper and not see it again until it's clean. That'd be pretty sweet.

Whitney Lowe:

Yeah. So there's a lot of hidden things in there of pros and cons about that. And the point I think that you were making to is people need to really figure out who they are, what they resonate with and what's their real pain points in places that really feel more or less comfortable for them.

Allissa Haines:

Yeah, and I don't think that your skillset is defined by the environment in which you're working and vice versa. There are phenomenal therapists working in all places and there are terrible therapists working in all places.

Whitney Lowe:

Yeah, right. I want to touch base on another issue related to another eBook that you all have on your website available to you about communicating with your healthcare team. And I heard you and Ruth talked about this some and she collaborated with you on this particular project. In particular, addressing this question that so many people hear about like, "Oh, if you have so-and-so type of thing, tell your

person to ask their doctor or whatever. Tell this therapist to go ask that person's doctor if it's okay to work on them," and you brought up the fact that that's really a lot of problems with that whole process or idea. I was wondering if you could talk about that a little bit.

Allissa Haines:

Yeah, so this whole thing came about ... I'm so excited to ask me about this because it all just launched in the last couple of weeks. This came about because I took a class in May for manual lymphatic drainage and we're in the class and the instructor said something like, "If they have this or this, you need to get a doctor's note." And I was like, "What do I need the doctor's note to say exactly? How do I need to ... What do I need the doctor to know if they can approve," I'm air quoting this, "the massage?" And she was like, "Well, you just want to know that they know it's safe." And I'm like, "How does the doctor know what kind of," and I'm totally ... You do not want me in your classes because I am so obnoxious about this kind of stuff.

And so it turned into this whole conversation about, "Yeah, I'd love to communicate with doctors more, but it's really, really hard, right?" You can't email doctors because email's not HIPAA-compliant. Patients email doctors within a special portal. You can call a doctor's office, but you are not getting past the front desk. They may pass a message on, but you're not going to get a callback. Offices are just a mess. So this whole conversation started about how my approach and I don't need to get doctors info all that much anymore. I don't need to communicate with them much anymore, although I'm going to start doing more manual emphatic drainage, so I will. I empower ... I don't even try to call doctors' offices anymore. I empower the client to do it. I give the client a script and I say, "You should maybe email this to your doctor within that portal if that's the best way that you communicate with them or print this out and bring it to your next office visit or call and ask to speak with the doctor because I'm not going to be able to get through," and I give the client what they need.

And so the MLD instructor, a week after the class, was like, "Can you share that template with me?" And I was like, "Sure." And I was like, "Ruth, can you look at this template for me before I give it to somebody because I use it, but do I sound smart enough? Is it good enough to give to somebody else to share with other massage therapists?" And that's how this whole thing evolved, right? And people need templates. We need more guidance on what to say when we're communicating and what tools we need to give a client to empower them to handle that interaction.

And I don't need a doctor to say, "Yes, it's safe to massage." I need a doctor to say, "The client's cardiovascular system is compromised in this way. I understand the amount of pressure you will be applying and I believe, I agree with you that that is equivalent to your customers or your client taking a brief walk around the block and that's not too challenging to their system, so I agree with you that massage is probably safe with these accommodations." I want to converse with the doctor to make sure I understand the limits and the limitations in regards to how the client's body is going to receive the massage and I want them to know what I'm actually doing.

Because if the only massage experience that doctor had was on a cruise 20 years ago when somebody really did deep tissue work, they're going to say, "No, don't touch that client. Absolutely do not give a massage." And-

Whitney Lowe:

Yeah, I don't think that's ... Yeah, that's ... Sorry to interrupt, but I want you to drill down on this a little bit because I think you all talked about this. I can't remember what it was a podcast that I heard both of you talking about this on or something like that, but this very issue of many physicians and other healthcare providers just really have no idea what we do. So it's difficult for them to say, "Yeah, it's okay for you to do this," when they really don't understand massage and a lot of what we're doing, I think, in many of these instances.

Allissa Haines:

Yeah, and unless you're dealing with a doctor who's also an osteopath, they're not going to know. And I had this exact conversation with my primary care practitioner last year because I was having tension headaches and she actually palpated my neck and I was like, "Hey, you're good at that. You could be a massage therapist." And she was like, "Actually, I was an occupational therapist. That's how I put myself through med school and that's why I'm a doctor of osteopathy and not an MD." She goes, "All of the training is identical up to a certain point." She's like, "We didn't actually palpate or touch people until I was into my osteopath training." She's like, "We would learn palpation for organ dysfunction and things like that, but they didn't teach us, in the primary medical training, they don't teach that kind of palpation for pain and muscle tension and stuff."

And so doctors may not have that hands-on experience with the kind of tissue in the way that we do, nor have they gotten a massage from me. So they don't know what massage is. And in massage, we can't even agree on a glossary of terms. So I certainly wouldn't expect a doctor to know what my light effleurage is, which is why it's really important that we use things like the Walton Pressure Scale, which very clearly lays out five levels of pressure in regards to what you can feel and what you can see and what parts you're moving in a patient's body.

Whitney Lowe:

Yeah, that's particular, and I want to just put a shout out to Tracy Walton and the Walton Pressure Scale. We will put a link too to that in the show notes as well. That's, I think, a very helpful resource for some people who may not be terribly familiar with things and where pressure levels are a big deal in terms of what they might be doing. That's a great way to try to share some of that information. So one of the other things that I run into all the time is people come in with unrecognized musculoskeletal disorders and this thing where they're often told, "If you're uncertain about what's happening here, send that person back to the doctor. Find out if it's okay, the doctor says it's okay to do massage."

And many people not realizing, especially with general practitioners, their education in musculoskeletal pain conditions is in many instances very inadequate in medical school training. That's been acknowledged a lot in many of the research studies about the medical school curriculum that have come out. So it is a conundrum for us oftentimes to try to just assume that just because somebody has DR after their name that they are an expert in all kinds of things related to musculoskeletal health, things that we work with all the time. So some big challenges there.

Allissa Haines:

And I think that in relation to how we interact with healthcare providers, and for me, it's how I empower my client to interact with our healthcare provider, one of the most important things that we do and can do that we don't discuss nor are we trained about is how do we teach our clients to advocate for themselves in that doctor's office or in their provider's room because it's hard. A client will come to me and they'll say, "I'm so tired. My shoulder hurts. I keep waking up when I roll over on it." And I drill down, "Is it sharp? Is it stabby? Where's it radiating to? Does it feel this way? Does it feel this way? Does it this, this, this?" I don't do a lot of this work, so I'm probably saying all the things wrong, but they don't always say those things in the doctor's office or the doctor will take off with the first thing they say and they don't get to the rest. 

So I try really hard to teach clients how to advocate for themselves to the point where sometimes you're writing some bullet points down together before they leave the office to say, "Okay, here's what I think is important. Maybe remind your practitioner that this has been going on for more than three months, that you're not sleeping because of it and that's starting to infect your daily life and that you did in fact try six weeks of PT and you didn't notice any difference." Because the doctor's not always going to see that in their chart. They're just going to see that they're coming in for pain again.

And so sometimes I think the best thing we can do for a client is lay our hands on them and calm their nervous system down and then give them some vocabulary to get better results in the very limited time that they have with their primary care practitioner.

Whitney Lowe:

Yeah, yeah. Some wonderful ideas there. One more thing I want to ask you here too as we look at their turnout into 2023, lots of things have changed, lots of things or challenges that people are facing, but I'm asking a lot of people this as they come on the show here too, what do you see as some of our biggest challenges ahead in the next year, maybe five years also as a profession? I know we got a lot of big things that we're grappling with. What comes onto your list as some of the biggest things that we're grappling with?

Allissa Haines:

Public health in general. I think that we're starting year three of a global health crisis that is not going to end anytime soon that puts us in immediate danger in our massage rooms. So being a COVID conscious and just infectious disease conscious now because flu and RSV and pneumonia and all of these things, being conscious of protection, protecting ourselves from disease, infection and exposure, really protecting us from exposure and protecting our clients from exposure that could happen within ... We work in small massage rooms. And I think primarily continuing to keep ourselves safe is going to be an issue and continuing to keep our clients safe in our massage room is an issue, but I also think that it's going to be very easy for a lot of us to burn out.

This virus is disabling 5 to 20% of the people it infects for some period of time. Some people, it takes them a week to get over COVID. Some people it takes them a month and there are people who are having long COVID. So we're looking at people whose body, they're not functioning the way it used to for six to 12 months. We are looking at greater numbers of diabetes. We're looking at a five times greater risk of cardiovascular events in the 12 months after you have COVID, even in mild cases and even in vaccinated people. So sorry, this wasn't intended to be a big lecture about COVID, but what all of this is, it is leading to a much greater proportion of our population being sick, long-term sick, disabled, connective tissue, just in general immune system like autoimmune stuff.

So I think that for those of us who are lucky enough to remain well and remain working, we need to not burn ourselves out taking care of everyone else because there's going to be, I think, a much greater call for massage because it's a pretty gentle intervention even with a lot of these conditions that we're going to be facing that are just going to increase and increase in our population. And I think we can be very busy. And if we're not real careful, we're going to burn ourselves a lot quickly, a lot more quickly in the next decade than we have in the previous just because of what is going on in health and what I think is going to occur in public health over the next 10 years as we start to really face the ramifications of what this virus can do to bodies.

And I think that the second part of that is that we don't have as many massage schools as we used to. We're not turning out as many massage therapists as we used to. So it's good. It's great for me that again, it's also going to be exhausting and I don't know how that's going to turn out. So that was a very long winded, I apologize, but I think that-

Whitney Lowe:

Well, no, it sounds like self-care is the theme that that really comes out of that, is paying attention too, yeah.

Allissa Haines:

I don't even call it self-care, I call it boundaries. Like boundaries on how much you work, the times of day that you work, what you charge for your work and all of the boundaries around a sustainable business. And yeah, part of that's caring for yourself, but all of the boundaries you build so that you can keep doing the work you do for as long as you want to.

Whitney Lowe:

Yeah. Wonderful. Well, thank you so much again for joining me today to look down the road for what's coming up in the future and what's happening for us in 2023. And again, if you will put a plug in, let people know how can they find out more about you and Massage Business Blueprint, remind us again where that's located.

Allissa Haines:

Yeah, massagebusinessblueprint.com. Super easy. Everything is there. The podcast, the blog, all the free eBooks, all of that stuff is at massagebusinessblueprint.com.

Whitney Lowe:

That sounds great. Allissa, again, thank you so much. It's been a delight talking with you here today.

Allissa Haines:

Thanks, Whitney.

Whitney Lowe:

All right. So keep in mind, everyone, the Thinking Practitioner Podcast is supported by ABMP, the Associated Body Work and Massage Professionals. ABMP membership gives professional practitioners like you a package including individual liability insurance, free continuing education and quick reference apps, online scheduling and payments with PocketSuite and much more. ABMP's CE Courses, podcast and Massage & Body Work Magazine always feature expert voices like Allissa and new perspectives in the profession including those from Till and myself, Whitney. Thinking Practitioner listeners can save on joining ABMP at abmp.com/thinking.

So thank you to all of our sponsors and thank you especially to you, the listeners, for hanging out with us here today. You can stop by our sites for show notes, transcripts and any extras. You can find that over on my site at academyofclinicalmassage.com and also over on Til's site at advanced-trainings.com. If you have any questions or things you'd like to hear us talk about, please email us at info@thethinkingpractitioner or look for us on social media under our names. Til Can be found under his name, Til Luchau, and mine over at Whitney Lowe also on social media and various different channels. You can rate us on Apple Podcast as it does help other people help find the show and you can hear us on

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