Massage Therapy Career Options: Private Practice vs. Employment

At some point in their careers, most massage practitioners work alone, whether in a private office, home or outcall practice. Some, however, choose to kick-start their careers by working as an employee at a spa, massage franchise or clinic. Others take part-time jobs to augment their private practices, and still others prefer to work for others exclusively and long term.

Running a private massage practice is different from working as an employee. And yet in either arrangement, you still have to perform basic practice-management activities, though in a different manner.

Private practice
A private practice provides freedom and flexibility (e.g., you choose the attire, clients, environment, music, modalities, fees and scheduling), and you can essentially do anything you want as long as it’s legal, ethical and moral. In addition to general practice-management activities, the sole practitioner must manage other aspects of practice:

Autonomy
Along with the freedom of being on your own is the potential for loneliness and isolation. You are the one responsible for making certain everything is done, which often means you get to do it all-until you can afford to hire an assistant.

Finances
When you are the only source of revenue in your business, you may not have the cash flow to purchase items when you want them. Often you need to delay financial expenditures, such as expensive equipment like an office copier, computer or hydraulic table.

Marketing
When you are in private practice, you are responsible for all aspects of marketing to attract new clients and retain your current clients.

Safety
Safety is a concern for any business owner, but even more so for the person in private practice. You don’t always know who the clients are the first time they come to your office, or the neighborhood you’ll be entering if you do outcalls or on-site services.

Benefits
The only employment benefits you receive are the ones you pay for yourself–which rather defeats the whole concept of perks. As a sole practitioner, there are no true paid vacations, holidays or sick days.

Employment
Working as an employee provides many benefits, such as the possibility of walking into a full practice with little marketing; the ability to provide a larger scope of services for your clients’ well-being; starting out with a ready-made professional image; being part of a team with clear and established boundaries; reduced paperwork (there’s usually an office manager); the ability to focus on hands-on work; access to better and more varied equipment and supplies; an excellent built-in referral base; and support staff to handle the scheduling, appointment confirmations and financial transactions.

Spas are the number-one employers of massage therapists, followed by clinics. Working in these settings requires conforming to a set image, policies and procedures. Here are the aspects of practice an employee must manage:

Client contact
You may be required to alter your treatments in terms of style, modalities and length. In a clinic setting, the time you spend with clients and the actual work you do may be determined by the lead primary care provider. The most often-cited complaint from spa therapists is the lack of control over scheduling, such as being required to work several 50-minute sessions without a break. Another concern is receptionists booking a specific service even if it isn’t clear the practitioner on duty is proficient in that technique or if contraindications are present.

You rarely get to choose your clients. In spas, there is little chance to mark progress or make lasting connections because clients don’t return very often. Some spas also require massage therapists to perform other services when not doing their primary service. They often expect practitioners to promote services and products to their clients regardless of whether the practitioners like them.

Finances
Some spas hire therapists as employees and others as independent contractors. Compensation varies greatly. If the spa isn’t well known with a high guest count, there might not be a lot of work available for practitioners-meaning your shift would not be filled. Spas often base salaries and preferential scheduling on seniority.

Working in these settings does avail certain perquisites. You can receive discounts on services and products. If you work at a spa, you usually can use the facilities and get free or low-cost meals. When hired as an employee, benefits can include health insurance, paid vacations, paid sick days, pension plans, profit sharing and reimbursement for continuing education.

Logistics
Most spas have staff for the day-to-day activities of running the business (e.g., preparing the office for clients, stocking supplies, cleaning), but in some spas (and many clinics) these activities are shared by everyone. You need to know what’s expected of you when you’re not directly working with clients (e.g., paperwork, janitorial chores, clerical duties, assisting the other practitioners, providing treatments for staff and marketing). Whether you are paid for these activities depends upon your employment status.
You usually have to share the treatment room with other practitioners. This can be challenging if the layout doesn’t suit you well. The rooms may not be adequately sized or insulated, and the equipment may vary from room to room.

Marketing
In a destination spa, you don’t have to do the marketing or scheduling of clients, but there is no guarantee your work hours will be filled. Successful spa therapists excel at marketing to current guests for repeat sessions. Many practitioners (particularly in clinics and day spas) discover to their dismay that to increase their client flow, they need to market their services actively.

About the Author

Cherie Sohnen-Moe is an author, business coach and international workshop leader. She has been in business since 1978. She was in private practice for many years as a massage and holistic health practitioner before shifting her focus to education and coaching. In her coaching/consulting practice, she has worked with individual therapists to small wellness centers to day spas that have multiple locations. She has served as a faculty member at the Desert Institute of Healing Arts and the Arizona School of Acupuncture and Oriental Medicine, and is an adjunct professor at Clayton College of Natural Health. She has written more than 100 articles that have been published in more than 15 national and international magazines. She is the author of the book, Business Mastery, which is in its fourth edition, has sold more than 325,000 copies to date with 650-plus schools requiring it as a text. She is also the author of Present Yourself Powerfully and The Art of Teaching. She is co-author of The Ethics of Touch, with more than 300 schools requiring it as a text. She is also a contributing author of Teaching Massage: Fundamental Principles in Adult Education for Massage Program Instructors, and was interviewed for a chapter of SAND TO SKY: Conversations with Teachers of Asian Medicine. Sohnen-Moe is a firm believer in education and as such serves on the exam committee of the Federation of State Massage Therapy Boards (FSMTB) and is a founding member of the Alliance for Massage Therapy Education (AFMTE). She can be contacted through her website, sohnen-moe.com.