An earlier version of this article appeared in the October 2016 issue of Chiropractic Economics, the largest trade publication in the Chiropractic profession.
Ten years ago, Geoff Ricchio, DC, published a controversial article titled “Creating a Profitable Massage Therapy Program.” The advice it contained infuriated many massage therapists, and for good reason. The article included “Ricchio’s Rules” for implementing massage therapy in a Chiropractic practice. The first three rules especially caused quite a stir in the massage therapy community; here are all six rules again for your consideration:
Ricchio’s (Outdated) Rules
Rule 1. Massage therapists are difficult employees. Make no mistake about it, LMTs are at times scary to deal with. All my problems with workers in my office have always been with massage therapists. They have a hard time adhering to normal office hours and office protocol.
Rule 2. Never overpay a massage therapist. When these people get out of school, they seem to think they deserve $60 per hour! Yet, I’ve found that LMTs will work harder for you at $20 per hour than $60. It’s important that you set up a payment schedule that not only rewards them for good work but more work as well.
Rule 3. Only hire female therapists. I know this is wrong to do, but it only takes one male massage therapist to touch a woman inappropriately and you’re sued and shut down by the sheriff’s department.
Rule 4. Create a low-cost massage program for the general public so that they can use your office for affordable massage therapy. I have a system for chiropractors that enables them to create a profit center that pays them a regular income month after month. My massage program paid my office $24,500 every month for years. Not bad for a wellness program.
Rule 5. Have your massage program available for the business community. Many businesses around your office would love to set up a massage wellness program for their employees. You can do this for them and make an incredible amount of monthly income. This is a terrific way to increase your new patient base.
Rule 6. Do massage seven days per week. Your office could be generating income for you even on Saturdays and Sundays. I found that Sundays have been an incredible addition to my office. People love to come in on the weekend because they are free. We’ve even done massage until 10 in the evening.
The attitude Dr. Ricchio displayed toward LMTs in his first three rules generated a powerful backlash from the massage therapy profession. However, in the past 10 years, I have seen little reaction from the Chiropractic profession to this article. As a Doctor of Chiropractic who has employed massage therapists in my private practice for 14 years, allow me to offer some alternative rules for integrating massage therapy into a Chiropractic office.
Rule 1. Doctors of Chiropractic must respect massage therapists as licensed healthcare providers, and as colleagues, not just employees. Massage therapists have state licenses, pay annual license renewal fees, and have annual continuing education requirements, just like any other licensed healthcare provider. My massage therapists’ diplomas are professionally framed and hanging in my office, just like my Chiropractic diploma. Treat massage therapists as a fellow healthcare providers, because that is what they are.
Rule 2. DCs must hire the right massage therapist. Some massage therapists are not great employees and some massage therapists are difficult to deal with. Some massage therapists do have a difficult time adhering to office hours and office protocol. Solution: Don’t hire those massage therapists. There are LMTs who are excellent employees; interview until you find one.
Rule 3. DCs should hire massage therapists who are specifically trained in myofascial release and other soft tissue techniques that will complement Chiropractic care. Massage therapy (CPT code 97124) and myofascial release (CPT code 97140) are billable services under many insurance policies. Massage therapists who do only energy work may not be a good fit.
Rule 4. DCs should hire LMTs as employees, and pay them $30 per 60-minute massage therapy session. The office can offer an introductory massage therapy special of a 60-minute session for $40. If the patient is happy with the massage therapist, they will come back and pay the regular price. Most massage therapists will be happy with $30 per 60-minute massage therapy session as an employee.
Rule 5. If you decide to hire a male massage therapist, hire the right one. Some male massage therapists have touched women inappropriately. Solution: Don’t hire those massage therapists. I have employed several male massage therapists with no problems. There are responsible, professional male LMTs; interview until you find one.
Rule 6. Allow your massage therapists to accept tips by cash, check or credit card. Some massage therapists feel that tipping is inappropriate in a healthcare office setting. I disagree. Your massage therapists will be happier, long-term employees with the additional income from tips. It makes no sense not to allow tipping.
The bottom line is to treat massage therapists with respect, as fellow healthcare professionals. The benefits for the Chiropractic profession and the massage therapy profession can be profound when the right practitioners work together.