Tracy Walton & Associates

Caring for clients with Cancer

Are There Jobs in Oncology Massage Therapy?

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Good question. We get this question a lot.

It comes to us from massage therapists who are curious about oncology massage therapy (OMT). It comes from established MTs considering a new direction, and from new MTs who might want to specialize.

Some MTs ask us this because they are deciding whether to invest in an oncology massage therapy course. They wonder whether training is a worthwhile investment, and whether there are opportunities to earn good income. They want to know who is hiring.

Their question, “Are there jobs in oncology massage therapy?” is an honest question.

Actually, there are two honest questions.

1. Are there jobs in oncology massage therapy?

2. Is there work in oncology massage therapy?

Two questions, with two landscapes to consider. Let’s look at each one.

1. Jobs in Oncology Massage Therapy

https://www.tracywalton.com/wp-content/uploads/2015/04/md-cancer-center.jpg
Curtiss Beinhorn works at MD Anderson Cancer Center in Houston, Texas.

Yes, there are jobs in oncology massage therapy.

How do I know this?

Not because we have a central source of data about jobs in this specialty. I know of no specific job board. OMT stats are not tracked by professional massage therapy associations.

However, a quick look at job sites (Hello, Indeed.com!) answers this question. The jobs listed there reflect the growing popularity of oncology massage therapy.

Every month I hear from oncology massage therapists about their involvement in exciting jobs and programs. From what I hear in this office alone, demand for this specialty is increasing.

With a job in oncology massage therapy, you might work in a cancer institute or hospital. Cancer care might be the sole or primary focus of the job.

Employers typically require continuing education in OMT, extensive hands-on experience with this population, or both. In addition to coursework, there are hoops, hurdles, and credentials involved in these positions.

2. Work in Oncology Massage Therapy

The future of OMT jobs is promising, but I want to focus on a different question:

“Is there work in oncology massage therapy?”

This question is even more significant for the profession. It affects all of us, not just MTs looking for certain jobs.

Work in oncology massage therapy is plentiful, even if you’re not seeking specialization or employment in cancer care.

It’s easier to find work than to find a job.

The work of oncology massage therapy in front of us, and all around us. The work is finding its way to our tables.

Here is how I know:

For the year 2020, the National Center for Health Statistics projects more than 1.9 million cancer cases in the US. That’s up from 1.5 million a few years ago. Right now in the US alone, there are over 15 million people living with cancer histories. That number is expected to increase to over 20 million by 2026.

Oncology massage therapy isn’t just for people in cancer treatment; it is for people with cancer histories, as well. Some of our practices are in force  long after treatment is complete–months, years, or even decades. This means we serve a significant population.

Put together the increasing numbers of people with the increasing popularity of massage therapy, and demand for OMT should increase.

Where do people look for OMT?

During cancer treatment and post-treatment, people seek massage therapy in all of these settings:

  • Spas and franchises
  • Private practice
  • Their own homes
  • Massage schools
  • Clinics, hospitals, and hospices
  • Community organizations
  • Corporate settings, “pop-up” events, athletic fundraisers

If you work in any of these settings, you encounter clients with cancer and cancer histories. If you haven’t yet, you will. In passing, even some franchises and spas mention that oncology training is a plus in their hiring.

The public is asking for oncology massage therapy.

Oncology Massage Therapists work with “Living Proof” riders at the largest athletic fundraiser in the US, the Pan-Mass Challenge.

Non-drug approaches to pain and other symptoms have grown in acceptance. In particular, the Joint Commission recently added a standard in non-pharmacologic approaches to pain relief, and specifically mentioned massage therapy. As the certifying and accrediting body for hospitals, clinics, and programs in the US, the Joint Commission has wide reach and influence.

More and, patients seek non-pharmacologic relief in cancer care.

Here are some of the reasons they seek OMT:

  • Clients with cancer seek relief from pain, anxiety, fatigue, nausea, and even depression. They ask for massage therapy to help them cope.
  • They need stress relief post-treatment, when they are expected to resume normal life, but they encounter a “new normal” with persistent stress.
  • People need massage therapy during the process of diagnosis, or re-diagnosis.
  • Massage therapy support can ease people’s experiences at end of life.
  • At the very least, clients tell us that massage helps them sleep. During treatment, they need to sleep better.

As massage therapists, we are motivated by the rewards of helping people. The need is great in cancer care, and the rewards are heightened.

Yet some people are sent home.

Despite this documented need, some people with cancer are still being sent home without massage. Massage therapists do not always feel comfortable or prepared to see them. A failed encounter like that can leave both client and massage therapist demoralized. Proof: I receive distressed phone calls and emails. Regularly.

What do clients need from us instead?

They need therapists to understand their needs. Instead of being sent home, clients need to be welcomed by skilled therapists who are ready to provide support and symptom relief.

They need to be asked thoughtful questions, and they need their own questions answered. Clients need a sensitive intake experience–beyond the rote questions off of a stock client health form. They need massage therapists to ask them the correct questions about their health and treatment–not too many stray questions, and not too few.

Clients need a conversation about their condition and their treatment. They need clear communication about how massage therapy will be customized for them.

They need lifelong modifications in the years ahead. Post-cancer-treatment, clients need practitioners who know that some massage precautions are lifelong, in force for decades after cancer treatment ends, and that others become less relevant, the further away someone gets from their treatment. They need this explained to them, competently and compassionately.

These needs can be overwhelming to massage therapists who haven’t been taught how to provide for them. But with preparation, meeting these needs is pretty straightforward. The best form of preparation is foundational training.

Who attends a foundational oncology massage therapy course, and why?

Some MTs want to specialize.

For some, oncology massage therapy is a career-defining choice. It is a specialty, a focus on a certain client population. For some, it’s why they went into massage therapy in the first place. Perhaps they have experienced cancer themselves, and massage made a difference. Perhaps they enrolled in massage school after wanting to bring relief to someone dear to them, but they did not know how to do it safely.

Oncology massage therapy can be a specialty private practice. (Photo (c) www.tracywalton.com.)

Now, they want to help others. For them, OMT training helps them grow a specialized practice on their own, or position themselves for certain jobs or programs. Or, there’s no such job or program in the moment, but they want to be ready when opportunity appears.

If you decide to specialize, oncology massage therapy is a good niche. It can be a powerful way to distinguish yourself in the massage therapy market. It commands attention and respect.

But not everyone specializes.

Some MTs see a mix of clients.

Other therapists say that OMT chose them, rather than the other way around. They were puttering along in employment or private practice, seeing a mix of clients. Eventually more and more people appeared, wanting massage during cancer treatment, or beyond.

Way back when, 25+ years ago, this is how I came to the work. It came to me.

Faced with clients wanting this kind of care, these massage therapists realize they need help. Most entry-level massage training doesn’t prepare them for the work. Therapists know that real help is more than a list of tips, more than a chatter of conflicting advice from a Facebook group.

So they seek out a CE course to strengthen their skills and work with confidence. Ultimately they might shift their practice to cancer care. Or they continue in general practice, but with a steady stream of oncology clients. They become known in their communities as practitioners who welcome people with cancer and cancer histories.

Others see only an occasional client with cancer.

Perhaps a friend of a friend wants a massage while on a short break between cancer treatments.

Or a new client comes in, and you learn that she had breast cancer treatment 15 years ago. She doesn’t know the massage precautions needed for her situation.

Another client schedules a session for a parent, who has advanced pancreatic cancer with multiple organ and bone involvement.

Massage therapists tell me that without training, they muddle through these occasional situations. Some just work the way they always do, closing their eyes and hoping their intuition gets them through the session. Some try to play it safe by working lightly the whole time.

They struggle with the before-and-after conversations, too. They aren’t sure what to ask the client about their condition, and how to tell them what might need to be modified in the session. They have a hard time encouraging a client to re-book, when it was a stretch see them in the first place.

Even if these struggles are occasional, they are painful.

So some massage therapists attend a CE course in oncology massage therapy so that they can better serve occasional clients.

And other therapists wonder, “How do I justify a whole CE course for just an occasional client?”

Occasional clients need care, too.

For clients in treatment or post-treatment, good massage care requires more than a sound bite. “Follow your intuition!” doesn’t help a therapist fumbling with interview questions before the session. “Just work lightly!” doesn’t fly with a client who might indeed be able to benefit from firmer work. “Give them whatever they want!” is poor and often dangerous advice in some cases.

Using firm pressure without thinking about it can do real and lasting injury, as in cases of bone involvement or past lymph node removal.

How do you explain–to a client post-treatment–why massage should be gentle here, but could be firmer there? Without practicing that conversation, it can be hard to face down a client who challenges you on it.

These exchanges can be awkward. It serves no one, to push through when we don’t feel confident or professional.

The alternative is no better: It is embarrassing to turn someone away, explaining that you don’t have the skills. Especially if they are sitting expectantly, a few feet away from your table. It’s even worse if they are already on it. In the age of social media and bad press, turning someone away can be hard on a business.

The choices seem limited. Fumble and fall, or invest a lot of time and money in a course?

The question becomes, “Do I have to specialize, just to see an occasional client with cancer?” And, “If I don’t want to specialize in it, why take a CE course in oncology massage therapy?

Fair questions.

Not everyone is a specialist.

Not all of us want to specialize. Not everyone has to specialize. But as massage therapists, most of us end up serving a broad range of people, and that range includes people with cancer.

If we want serve our clients over their lifetimes, no matter what health issues they face, then we need to be ready to work with people with cancer.

If you want to serve that friend of the friend, or the woman with a long-ago breast cancer history, or your client’s parent with pancreatic cancer, a foundation is essential.

Without preparation, even an occasional client presentation can be overwhelming. Cancer is a collection of over 200 different diseases. As common as cancer is, it can look very different in different people.

How OMT training can help

It helps to meet them with some unifying principles. To have some case studies behind you, to have practiced what to say in difficult situations, and to have had supervised hands-on practice. A basic foundational course in oncology massage therapy provides exactly that.

With a foundation, you don’t have to muddle through, or refer out, or suffer the pain or backlash from not being able to serve someone. And there’s a bonus: massage therapists tell us that the skills of OMT transfer really well to serving clients with other complex medical conditions. So a single foundation can go a long way in practice.

Like everything else, OMT competes for limited CE dollars, and CE can be expensive. In the end, however, it is more cost-effective than avoiding an entire population of clients.

Oncology massage therapy should belong to all of us.

It can be argued that oncology massage therapy should be the work of all massage therapists, not just those who specialize.

Although some people call it a modality, OMT is not a distinct set of techniques. At the foundational level, it is an approach to Swedish/classical massage. In this approach, therapists modify massage to benefit people with cancer and cancer histories. They adapt to the effects of cancer and cancer treatment.

Notably, oncology massage therapy is not just a quick list of precautions. Instead, it is a way to sort through complicated health histories and figure out how to work. It is a system for communicating that work with clients receiving it.

Where does this system come from?

The content in foundational oncology massage therapy courses was coded into a set of standards by the Society for Oncology Massage (S4OM). They worked in partnership with nurses, physicians, pharmacists and other cancer care providers to develop standards of practice as well as standards of education.

S4OM screens instructors, who are then called Recognized Educational Providers (REPs). Their courses are listed on the S4OM website. In order to teach, REPs have at least 500 hours of clinical OMT behind them. All of the instructors on our team have met REP requirements, but there are additional, growing numbers of REPs worldwide. All teach foundational courses.

Therapists who specialize in OMT can choose to study beyond this foundational level. They can pursue advanced techniques aimed at lymphedema and scar tissue. They can supplement their learning with mentorship programs or advanced case studies.

But even without advanced coursework, after a single foundational course, you can provide great benefit to your clients.

A foundational course is for everyone.

The foundational OMT course is for any massage therapist who might see an occasional client with cancer or a cancer history. That would be every MT.  Foundational OMT courses teach therapists to use classical massage therapy to benefit clients and keep them safe.

At this time, few entry-level massage therapy programs teach those skills. One day, we hope that these basics will be part of standard massage therapy school curriculum. Then we can all more fully claim oncology massage therapy as our own.

Until then, people with cancer continue to seek us out, and OMT skills enable us to serve them.

The job you already have is an oncology massage therapy job.

Cancer is part of our landscape. It affects our communities, colleagues, and current clients.  It affects the client scheduled to see you next week or next year.

Increasingly, people with cancer and cancer histories turn to massage therapy for support and symptom relief. From there, many first-time clients become lifelong consumers of massage therapy.

So, yes. There are jobs in oncology massage therapy.

But more importantly?

There is work in oncology massage therapy.

With skills to rest on, you have options. You can serve an occasional client, who is likely to be extremely grateful for your care. You can see a few clients in a mixed practice. You can grow a whole specialty practice, or reach for a certain OMT job or program.

No matter how it plays out into your practice–serving many people, or just a few–oncology massage therapy is a welcome service. It is paid, purposeful work.

It is deeply rewarding work, as well.

***

The Society for Oncology Massage (www.s4om.org) lists foundational courses in oncology massage therapy. They set standards of practice and standards of education in OMT.

After completing a foundational course from a S4OM recognized educational provider, you can join S4OM and become listed as a preferred practitioner in their locator service. They hold the Oncology Massage Healing Summit conference every two years.

Cancer statistics from the National Cancer Institute. Accessed April 23, 2019.

Joint Commission advisory on non-pharmacologic and non-opioid solutions for pain management, August 28, 2019. Accessed April 23, 2019.

Build a Massage Therapy Practice in 13 Months? Really? (Part 2)

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In the Part 1 of this interview, Kate Prouty shared some of her strategies for growing a practice from scratch to a full-time, busy practice. In one year, she implemented a lot of ideas. Some of them landed in the last post, and the rest are featured here.

Here in Part 2, we continue the conversation about Kate’s outreach to local hospitals and medical professionals. She tells us about studying hospital-based massage therapy at the Mayo Clinic, and how she used her studies to grow her practice. Kate shares her practice-building advice for other massage therapists and specifically for oncology massage therapists. She tells us about the materials she created for outreach to physicians’ offices.

Tracy: From what you have said, it seems like you created a real partnership with your clients.

Please tell me about your partnership with hospitals, a work in progress.

An example of Kate Prouty’s “Info Sheets” she uses as graphics for her Facebook business page.

Kate: Well, first I found a nurse navigator at a hospital, while doing research for your mentorship program homework. I put together materials from the mentorship program to bring them, and I gave them a lot. They seemed eager, but in the process of negotiating, they set up terms that weren’t so favorable, given where I would be working.

Then I found a nurse navigator at a second hospital. I also found that there were two oncology social workers on staff there who had received an award. When she mentioned them, I responded,  “Oh, wasn’t that the person who received that award?” She seemed impressed. I asked her to write a quick email saying I would contact them, so she wrote me an intro.

Then I emailed the oncology social workers. I heard back and they invited me for a meeting.

Tracy: What did you bring to that meeting?

Kate: I had learned not to show my whole hand at once. She asked me what I had in mind for their hospital. I said the more important question was, “What do you need?” Tell me and I’ll tell you what I’ve got. I don’t want to present all sorts of stuff your hospital doesn’t need. We went back and forth with meetings and calls and brainstorms, then she invited me to give a couple of presentations. I did one at a breast cancer fitness group luncheon. With the other oncology social worker, I gave a class on self-massage or friend massage, techniques you can use to lower stress levels when anxiety hits.

To that second hospital, I brought the updated research on massage therapy, what you reviewed in the oncology massage therapy mentorship course. And I gave them info on fee-for-service vs. other funding, the different methods I have learned about from other hospitals. I knew I couldn’t scrounge up funding for them, but I was perfectly happy passing along useful information. Now they are working on a grant, using those materials.

And then I told them about wanting to go to the Mayo Clinic course in hospital-based massage therapy. There were other similar courses, but I really wanted the weight of the name “Mayo.”

Tracy: While you were taking the Mayo Clinic Hospital-Based Massage Therapy Course, you blogged about it. I notice you posted on Facebook about the lessons you were learning. How did that help your practice?

Kate: Well, actually, I started the blog so that my parents could see what I was doing!

But also, I had run a “before-and-after” Mayo special. It was two massage sessions for $100. They would receive one massage before I traveled to take the course, and one after. Those clients paid ahead of time so I could pay for my housing at Mayo.

This required seeing new clients—people I’d never seen before. I did specify that this was ideal for someone with a complex condition. Cancer, recent surgery, others. As I promoted it, I said, “If this doesn’t apply to you, please pass along this special to someone you know.” So I got a ton of referrals for that program.

Tracy: How did you work with those clients?

Kate: I did a comparison of my own decision-making processes before and after. I asked the client if they noticed anything. I would ask them in-depth questions. Healthy or with medical conditions. I also asked, “Let me know if the technique feels different now, after the course.”

Offering this special gave me many chances to tell my Mayo Clinic story. I wanted to get the Mayo Clinic  training out there.

I scheduled the first session when I was taking the online portion of the Mayo Cliniccourse. I said, “These are the conditions I’m learning about at Mayo Clinic. The next time you come in I’ll use all the decision-making processes I’m learning there, and I’m going to compare my notes and see who are the clients who got the biggest benefit and how did things change.”

I did about 40 of these sessions, and each time, I got to share a bit of my story of the Mayo course. I got to repeat my story of a practice client at Mayo Clinic, whose post-surgery pain dropped from 8 to 2 after a massage session.

It was a great training, as I describe in my blog. But studying at the Mayo Clinic also lent my practice a certain credibility. It has been fun to spread the news about it in different ways.

Tracy: What advice would you give to other MTs about building a successful practice?

Kate: I would say be careful of how you choose your continuing education. Because you can study and spend a lot, and it may make you feel like you are doing a lot. But you might not be gaining what you can use or gain you credibility. Research who is teaching, and their background.

Also, from my marketing friend: Do everything as cheaply as possible unless you have to spend money. To decorate my office, I grabbed things from my house. It wasn’t the right time to spend money.

I have done all the free advertising I could. I have talked to a lot of people, then I have looked back at what worked.

I loved writing down my marketing efforts every month. With that practice, I made sure I was doing marketing efforts every month! I have a record of what I actually did. It’s garbled and gibberish but I love looking back at it.

Tracy: How about oncology massage therapists? What advice would you give them in building a practice?

Kate: Obviously, take the mentorship program.

But also: Hunt down the queen bees. Find out who is actively serving oncology clients in your area. There are people who are creating fitness programs for breast cancer survivors. Or they have survivors’ meetings. They hold bereavement classes. Connect with them! They are deeply invested in helping their people. They think of them as their people. One person said to me, “I’m very picky about who I introduce to my groups.”

Also remember that people love to be asked for advice. For every contact you make, ask them who else you should be talking to. Humbly request an email introduction.

Be sure to use the word “oncology” and “cancer” in your advertising up front. Not all over the place, but up front. That is all I need sometimes. It catches people’s eye.

And remember: You’re not necessarily marketing your work to the person with cancer. You are also marketing yourself to her 46-year-old daughter, the one in charge of her appointments. I’ve gotten possibly more people from that than anything else. People coming to try me out “before I bring my mom in.” Market to the person who loves the person with cancer.

Use local referral groups. Facebook is your friend. It’s cheap. It’s free.

Tracy: And what about those info sheets? You’ve created an info sheet for each of several medical conditions! Some research about massage therapy benefits, along with your contact information. What do you call those things? Info sheets?

Kate: Informational sheets! They are info sheets I created and I post as graphics on my Facebook page. I don’t have a better name for them. I came up with them in January, when I saw that my schedule was lighter. Out here in Michigan, people go into hiding. I realized, “This is a time for me to go out and talk to doctor’s offices, because I have time.”

I also realized: I can’t go in empty-handed. I can’t afford to bring them lunch.

A SCORE (Service Corps of Retired Executives) counselor (I still keep up with her) suggested this: GIVE THEM DOCUMENTS. Something to read. A single page glossy.

Then hand it to whomever is in charge. Hope that it gets pinned to the break room wall.

Tracy: How did you choose the medical conditions to feature on each info sheet?

Kate: I struggled to figure out what to put on them.

I googled the most common causes of doctor’s appointments and chose from that list.

For topics so far, I’ve chosen fibromyalgia. Low-back pain. Migraines. Anxiety. Cancer gets several different ones, each with a different focus. And another, very different info sheet that describes how my practice grew!

Tracy: What is the format? Where can people find them?

Kate: It became so much easier once I developed the format. I finally made a template. A couple of text boxes. Some graphics. For each one, a single citation. All citations come from medical journals, non-massage sources. I know a physician is more likely to respect a clinical trial of massage published in these sources. I know their time is important and tight. So for these info sheets, I do the work and research and get the citation and make it easier for them to have a reason to recommend massage therapy.

(I learned something about making flyers. Don’t ask everyone for advice. I got too much conflicting advice. Fewer fonts. More fonts. Don’t ask everyone to evaluate everything you print. At some point you have to just print it.)

Look on my Facebook page, “Patient Relaxation LLC.” You can find examples there.

Tracy: That reminds me: How did you choose your business name, “Patient Relaxation LLC?”

Kate: I chose “Patient Relaxation” very carefully.

First, the idea of patience. No rush. That kind of patience.

But when I was coming up with the name, I knew that eventually I wanted to be working in hospitals or at least coordinating with medical practices. I wanted the patients to know I was focused on them. That I wasn’t just looking for “people off the street,” but that I was specializing in people who were medical patients.

I didn’t call it “Patient Relaxation Massage Therapy” because I may someday incorporate other modalities into my business. In my area, there was recently a research study done on the effects of reflexology and cancer patients. That was a huge success and spread information about reflexology to the community and created a market for it. While I personally do not do reflexology, and I don’t plan on it, I might hire a reflexology provider someday to work in the hospitals. I didn’t want to limit my growth by including “massage therapy” in my name, once I’d established it.

Tracy: How long have you been a massage therapist, and how did you get into it?

Kate: I’ve been a MT for … hmm. 5 years? 5.5. I went to Lansing Community College, where I now teach. I went there — honestly– because I was intellectually frustrated after being a professional musician for 25+ years (orchestras, teaching privately and in colleges, judging, etc).

I literally googled “Return on investment careers” and it was either massage therapy or radiology support.

Tracy: No WAY. You didn’t! You did NOT just google “Return on investment careers.”

Kate: Seriously, I did. I wanted financial independence and schedule independence. Massage therapy is growing, especially in my area. I looked at the department of labor statistics, and decided it was the best choice. I could do massage school while still teaching and playing, and in 1 year I could be working.

But it took some serious thinking, and asking actual experts for help, to make the music-to-massage-therapy transition.

Tracy: After you graduated, did you ever start a serious private practice before this past year? Or did you go straight into working for others?

Kate: Just employment. I tried one time, for a few months, to be both employed and have a private practice, but back then I knew nothing about how to market massage. I was so hopeful, but also so … directionless. I didn’t know my niche. I didn’t know how to get anyone’s attention. So I had my 11 faithful followers, but that was it.

Tracy: How much music are you playing and teaching these days?

Kate: I have cut down my music teaching to almost nothing. But I am playing more. Not necessarily to make money. I’m saying yes to things that I want to do.

Tracy: What drew you to study oncology massage therapy, then our mentorship program, back in 2017?

Kate: Well, I researched who Tracy Walton was. Your education, background, writings, associations, and colleagues. I wanted to make sure your training was credible, fact-based, well-trained in science, well-regarded by physicians, oncologists, and scholars.  I felt sure that you and these courses were the very best I could do. Now that I have the two courses under my belt, I am confident that the information I have gained is true, factual, and well-reasoned.

It was delightful to find that in addition to all of this science and reason, there was as beautiful heart, a sweet soul, and an inspiring fire. I personally have struggled with the dichotomy of science vs intuition and heart, and it was nicely embodied in you and your teaching.

Tracy: Thanks for that. Kind words, for sure! Yet I see that combination of qualities in your work, your marketing materials, your social media presence. Also, in the trajectory of your practice. Many congratulations for your success! Thank you for sharing everything you’ve shared with us.

Kate: Thank you!

Build a Full MT Practice in 13 Months? Really? (Interview, Part 1)

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A year ago she started her private practice from nearly nothing. Now Kate Prouty sees anywhere from 15-30 clients each week. Her practice focuses on oncology massage therapy and massage for people with medically complex conditions.

In this interview she shares some excellent marketing tips and other tools she used to build her practice, Patient Relaxation, LLC, in Lansing, Michigan.

I met Kate in 2017, when she completed our 4-Day Oncology Massage Therapy foundational course. She followed it with our 40-CE hour online Oncology Massage Therapy Advanced Mentorship course, where we focused about half of our work on marketing. She completed that in December 2017.

I was interested to hear how intensely she focused on practice-building, and what worked for her.

Kate Prouty Built Her Massage Therapy Practice, Patient Relaxation, LLC, in 13 Months.

Tracy: You’ve had a busy year! What does your practice look like now, compared to a year ago?

Kate: I work full time. I see about 18 people/week average, sometimes 25 or 30. Minimum is 15. About half have complex medical conditions. About half those are people with cancer. I am on my way to seeing about 8 people per week with cancer or cancer histories.

Thirteen months ago, in late 2017 when I finished the mentorship course, I was afraid. I was working at a spa. I wanted my own practice. I thought there was no way I can make this happen. I was starting from zero.

In September 2017 I almost felt reckless when I signed up for your online mentorship program, literally the day before it started. However, it was the right decision. I threw it onto a credit card, closed my eyes and hit “purchase.” I knew that I needed a leg up in order to gain both confidence and credibility, so that I could establish a private practice (either my own or within a hospital or cancer center). I chose carefully, actually.

Tracy: How did you grow it from 11 sometime clients to 390 people on your email list, and 15-30 sessions per week?

Kate: There were a lot of steps.

First was goal setting. I wrote down goals—stretch goals, and reasonable goals—in a little notebook. Personal goals relating to the business, like I want to be able to walk into my building and smile. I want to be able to sleep at night because I’m not panicked about money.

Then I broke it down into steps. What do I need to do to get to this goal, for real? How much money do I actually need as a bare minimum, and how much each week? By getting really concrete, I realized as long as I was making as much as I had been making at the spa per week, I would be okay. Because I’d been okay, working at the spa.

I got help from a number of places. The oncology massage mentorship course, of course! I’ll tell you about the networking in a bit. In the first month when I started, a woman came to me who was an amazing marketing specialist. She had a background marketing credit cards, and she offered a trade. 30% off sessions if we can do a marketing meeting for a half hour every week. I took it.

The marketing specialist said, “I will give you an assignment every week. We did that for about 10 months. Every week. I followed her advice: Get a notebook, and fill out one page for each month, 12 in a row. As you go through every month, jot down EVERYthing you do for marketing purposes. Every single Facebook post, every article, every presentation. Keep track of the research you did or what you worked on. Did you make phone calls? Write every little bit down, then don’t think about it. Then go to the next month. But if you notice a sudden uptick in business, look back and see if you can correlate.

Tracy: Then what?

Kate: The marketing specialist advised, “After a year, sit down on January 1st. Block off the whole day. Look over with colored markers and mark the ones that seemed to have the most impact and the ones that were a waste. Now you’ve created your framework for the next year.” She also told me not to dismiss the ones that didn’t seem to make a difference, it may take longer for those to come around.

Then she told me write them in the NEW year’s notebook and you have half of your marketing plan. I look back at it and it’s pretty darn impressive! It’s clear which ones worked.

Here is an example: in June I wrote down: Ran a senior citizen special, an ad for cancer survivors, and I taught a class on self-massage for people with cancer. I emailed an MLD specialist for some information.

Fourth, I did a Groupon. I talked to Groupon and bargained. I told them, I’m just a little person. I work with people with cancer. It turned out I made more on a Groupon massage, even with the low percentage, than I had done at the spa. I was doing better than at the spa. Because Groupon is a wide net, I saw lots of different people. I got to practice setting up a practice.

Also, I tapped into local referral groups. Angie’s List for my town. On Facebook I found “Not Your Mother’s Networking Group.” It is only in this area. It’s a curated group. You have to answer questions to get in. It’s got 17,000 women in it. They post everything. Anything from, “Does anyone know a plumber?” to “My kid has these red patches on their back. What is it?” It has been a source of lots of new clients. At least 50 people came from there.

Tracy: Tell me about your networking.

Kate: I saw that the self-massage class I taught, while it didn’t yield any direct clients from the class, did give me credibility in the eyes of a doctor. Here is how: I went early to the hospital to do the presentation in a conference room. Being who I am, I introduced myself to everyone on the floor. “By the way this is who I am, if anyone asks where this class is, it is happening down the hall. Here’s my card if you need to text me that someone is lost.”

One person I told this to was an oncologist.

Sometime later, when I returned to the hospital to ask if we could bring in OMT in that part of the hospital the oncologist recognized me. “Aren’t you that person…?” I was!

In the oncology massage advanced mentorship program, it helped that we had to CREATE the marketing materials, not just do the research. We had to actually create letters. And documents. And the website. (I have had so many compliments on my website!) Writing the emails to talk to oncology social workers. Wow, did that help. That’s how I found people! I talked to nurse navigators, but Oncology social workers were the ones who knew where things were, they knew everyone I should talk to.

Tracy: How did those meetings go?

Kate: At the end of every single contact I made, I asked, “Who else should I be talking to?” People love to be asked for advice. Ask them who else I should be talking to. Who are the leading practitioners? Who are the leading referrers? If you ask that question frequently enough the same names will pop up and you see who is making the world go around.

There might be oncology social workers at one hospital who aren’t nearly as influential as the ones at another hospital. In your course, I had to collect all that contact info and run it by you.

Pretty soon I had a whole bunch of contact info that was redundant. I realized, “AHA.” This person is THE person. Then I spoke to her and asked her who else I should talk to? She said, “This other person, but let me call her first.” So then I got an introduction.

Tracy: Let’s talk about your radical fee increases. You started low, then moved your fees up quickly over the year.
How did that work?

Kate: Remember, I was starting from nothing. I needed to make what I had made at the spa. That was low.

At the beginning, my weeks were pretty empty. I would post on “Not Your Mother’s Networking Group.” I would offer $30 massage that week. I did 30 massages that week. The next week, all $40 massage. Then I did $49.

In the beginning, I told every client, “It’s a new practice. Can you please go back into the “Not Your Mother’s…” FB group and write that you liked it, so people trust me? Before the end of that week I had 20 recommendations.

Every time I would fill up the week, I’d say, “I’m full Thursday but there are six openings on Saturday. Which bumped up the post, my clients saw it, they would comment, “Kate is awesome.” That momentum would barrel me into the next week.

Sunday night, a post again, when people are looking, filled up with more. All of this in the first few weeks.

I offered $49 massage for a couple of weeks. My marketing friend said that was a distinct breaking point. She said “You can’t keep going at $49 because you train people that your work is too cheap.” One goal was more emails for my list. I had wanted 100 people on my list in 8 weeks. Well, I was there. I got it.

Tracy: How did you break the $49 barrier?

Kate: So then I bumped up a bit. I sold packages at $150 for 3. Lots of the $49 people bought 3. Then I had 200 people on my list. Then they were referring people to me. But I had to get a critical mass up.

Kate Prouty’s Massage Therapy Space in Lansing, Michigan.

My fee at end of 2018 was $80, but not everyone was paying that. I was still running a lot of specials, or leftover packages at the lower rates.

At the New Year, 2019, I moved into a more affluent area. I brought my fees up to $95. BUT, I gave all of my existing clients either 1 or 4 massages at last year’s $80 rate.

If they had one massage last year, they get one in 2019 at the old rate. If they had 4 or more last year, they can get 4 at the old rate.

I call these my “Startup Support Specials.” I make a big fuss over them. I tell them, “You were here in my first year, you helped me do this.” I sent out an email to them that said, “Look what you helped me do!”

Tracy: Your private practice sounds like a real partnership between you and your clients!

In Part 2 of this interview, to post next week, Kate will answer more questions, starting with her partnerships with hospitals, a work in progress. She will talk about her study of hospital-based massage therapy at the Mayo Clinic. She’ll share some more outreach tips. Finally, she will offer advice to other MTs and OMTs about practice-building.

See Kate’s business Facebook page, Patient Relaxation LLC, here.
Check out her website, here.

Ethics (Mine), Massage Therapy, and Cancer Spread

by 32 Comments

A debate was recently revived around the possibility of massage therapy spreading cancer. I encourage all oncology massage therapists, massage therapy instructors, and interested parties to catch up on that conversation. Links are at the bottom of this post.

The conversation recently took a disagreeable turn when my judgment and professional ethics were challenged. It’s a serious accusation, deserving a serious response. This post is my serious response.

For those who have missed it, our dispute has focused on the role of a single massage study. We disagree about how to use it, and I’ve been faulted for questioning it. Here is an open letter to the two authors who cited the research, then used that research to mount a challenge to the practice of oncology massage therapy.

***

Dr. Turchaninov and Dr. Cullers, the foundation of your argument is that I am attacking a “bulletproof” study from a respected group of oncologists, and in doing so I’ve succumbed to personal opinion and bias.

And yet…

The quality of the Wang et al. (2014) study on massage in bone cancer is not, in and of itself, the foundation of my position.

(I do think it is far from “bulletproof,” and I don’t think the investigators’ credentials carry your argument for you when they have left out so much critical information, but I already stated that and I’ll just leave that there.)

My position: You have misinterpreted the study findings.

You are trying to take a study of a certain time point (massage given pre-cancer-diagnosis, nothing known about cancer) and apply it to a different time point (massage post-cancer-diagnosis, lots known about cancer). You are using this to justify your guideline, that all massage therapy should be stopped after diagnosis, then resumed after cancer treatment starts, in order to avoid spreading cancer during that window.

One medical director has already looked at Wang’s work and the  poor cancer outcomes following pre-diagnosis manipulative therapy. That physician observed that it is entirely different from the work of oncology massage therapists, post-diagnosis.

The difference?

Pre-diagnosis, MTs are pressing away, with various levels of skill, trying to relieve pain that does not have a cause that they can relieve.

Post-diagnosis, oncology massage therapists (OMTs) swing into action with specific interview and hands-on skills that avoid direct pressure on tumor sites. They have the benefit of images and other test results that pinpoint location of masses, symptoms, and complications. Pre-diagnosis, no information. Post-diagnosis, rafts of information. We use that information to work with them safely.

This difference is significant, and you haven’t addressed it.

Moreover, you extrapolate from that osteosarcoma study, saying your prohibition must also apply to all other cancers. Many other primary tumors are deeper and much less accessible to our hands. It is problematic to apply this clinical scenario across the board to all cancer cases.

Your misinterpretation of the study is a serious concern, and it’s been echoed by others.

As of this writing, you have not responded to this concern.

(For those of you just tuning in, a full account of the conversation is available from the links at the end of this post. Here, I highlight a few points.)

The Wang et al. (2014) study, the center of this conversation, has two parts.

In the mouse study, they point to direct pressure at a tumor site being a harmful thing. I agree. I have never advocated for that kind of focused pressure on a tumor site.

The second part is the human study of cancer outcomes. They looked at people who received massage before they knew they had osteosarcoma. In this, the Wang et al. study may have implications for better basic massage therapy education, including referral skills and interviewing clients about pain before working with them. I already noted that, too.

But to withhold oncology massage therapy entirely? Based on this two-part study? That is overreach.

Here is an analogy.

It is not perfect, but it helps illustrate what is going on here:

Within days of receiving her new bunk bed, my child tumbled off the top bunk and broke her arm. It healed quickly, but of course we reinforced a rule: no standing or playing on the top bunk. We enforce the rule with all visitors playing in her room. This is a measured, appropriate guideline for a bunk bed.

An overreach would be to ban standing on or playing on all beds: single beds, trundles, with and without box springs or frames, and even mattresses on the floor.

These overbearing solutions are sometimes tempting, but they do not necessarily make a safer or livable world. No standing on the mattress on the floor. Or avoid a whole city because of a single dangerous traffic circle. These are extreme measures.

You are suggesting something just as extreme.

Using the Wang study—which is aimed at pre-diagnosis—to forbid all massage therapy for people who are between diagnosis and the beginning of treatment is an excessive guideline.

Despite what you imply about it, the Wang et al. study never reports anything about the post-diagnosis period; they do not state a guideline for post-diagnosis. They talk about direct massage of tumor sites in mice. And although it is not easy to tell from their human reporting, a quick look at previous research suggests they are talking about clumsy attempts at manipulative therapy for pain relief, right on the areas of pain, swelling, and tumor. The study subjects were human patients whose real problem was undiagnosed bone cancer, not excess muscle tension.

If there is a real link between manipulative therapy and later cancer outcomes, then it remains a massage therapy problem—how to address pain, how to ask about it, when excess muscle tension contributes to it, looking at the cause, ferreting out the possibility of bone cancer, and referring clients appropriately instead of treating them inappropriately. Massage therapy educators: Standards for handling this should be addressed in basic massage therapy education.

This is not an oncology massage therapy problem.

This point is really important. You are arguing about a problem in the field of massage therapy, not a problem in oncology massage therapy.

Moreover, your misinterpretation and misapplication of this study has been pointed out numerous times, here, here, and here.

Yet you have offered only a few leaps of logic in trying to make the Wang study fit an entirely different clinical situation than the one it describes. To the problems raised by Wang, you propose an overzealous fix. Your solution has been challenged because it affects large swaths of people, not just those in the window between diagnosis and treatment.

When pressed on your logic, you merely double down on the Wang study, claiming it as a “proof” and “scientifically a done deal.” You throw shade on the ethics of one daring to question it.

That would be me.

Wang et al. is not the focus of my challenge. Instead: your use of Wang et al. is a serious problem, and as of this writing, you have not addressed that. You continue to throw out obstructions and distortions. You continue to insist that I produce a counter-study, when you haven’t even adequately defended yours or its poor reporting. You try to shift the burden onto me to provide research to counter your misinterpretation.

Then you change the subject. You focus outrage at my ethics and professional judgment and it sounds impressive and righteous.  You repost this repeatedly, where your followers can also question my judgment, my ego, and the motives of “people like me.” Perhaps I’m just trying too hard to sell courses. It clouds the judgment, right?

After all, this is social media in the year 2018. Everyone has a sound bite and a snap judgment. We don’t need anything more to form an opinion of character, nor do we have to consider each point carefully ourselves before we pile on.

But at the end of the day?

While you and I argue, lymph moves. Blood flows. Quietly, all day long, it moves in everyone, diagnosed or not. And yet you continue to harp on some pivotal role in cancer spread, as though we should slow it down somehow and order every patient to lie quietly on the couch until their cancer treatment starts. With that reasoning, we should probably disallow blood pressure readings, saunas, scary movies, body lotion applications, and position changes, as well. Wait until treatment starts. Only then will it be safe to to move, and to move fluid again.

Your inordinate focus on lymph and blood flow as the prime contributors in cancer spread returns us to the dark ages when we didn’t have a clue about how metastasis actually worked. As Gayle MacDonald has aptly and repeatedly pointed out, we didn’t understand how a complex set of circumstances including genetics, tissue affinity, and microenvironment had to line up in order for cancer to metastasize.

Those dark ages prevented people from getting massage therapy when they really could have used it.

People need MT while they’re waiting for cancer treatment

This is an enormously stressful time for patients. It is not a good time to withhold massage therapy, waiting until cancer treatment starts.

To support your point, you cite a case where Cullers did just that, turned away a very sick patient, in a story that is supposed to sound principled.

I believe your good intentions at the time, yet the growing number of oncology massage therapists worldwide have already figured out how to support that patient with thoughtful, careful massage therapy. They’ve collaborated with nurses and physicians because they agree that symptom relief is possible and that metastasis is more complex than simple fluid flow. They know that the patient’s blood and lymph are already moving, and that their own role in that is minuscule.

And although you’ve vilified it, we offer up again our “exercise argument” to your concern: If blood and lymph movement were primary factors in cancer spread, oncologists would prohibit exercise in people diagnosed with cancer. They would send people to bed, not to the gym. They would limit the actions of skeletal muscle on vessels.

This is emphatically not the case.

Exercise and movement typically are encouraged in cancer care.

In response to my line of reasoning here, you venture out onto the fringe even more. You question whether oncologists the world over should be recommending pre-treatment exercise. You take on the common, growing practice of “prehabilitation,” exercise programs to strengthen patients for treatment.

This is important. You act as though the question of whether movement and exercise will spread cancer is still an open question. You act as though you alone have information that thousands of oncologists, PTs, nurses, OTs, and exercise scientists have somehow missed.

I don’t think you intend to sound arrogant there? But it sounds that way, for sure.

You even misinterpret an opinion paper I offered on exercise and cancer by Koelwyn et al. In that paper, the authors’  overwhelming emphasis is on understanding the tumor-suppressing effects of exercise. Yet you picked out a couple of tiny, more circumspect sentences about the need to better understand effects of exercise on different patients. You used them to support your own position, that exercise/fluid flow could contribute to cancer spread. You cast aside the thrust of the Koelwyn article in the other direction, and amplified only a single sentence, then somehow accused me of cherry-picking information.

Listen to the data, don’t sensationalize it

People with cancer will be better served when you stop fitting evidence and ideas to your worldview. Science works the other way around, to shake our beliefs and help us formulate a more accurate worldview. Let the data speak and really listen. Mind the gaps. I have joined you in this inquiry, but you have gone in a different direction with the answers.

Your academic and clinical credentials have been pointed out by followers, but the way you have conducted yourselves so far flouts some of the basic standards of academic debate.

Instead, when your data are challenged, you become more shrill. You continue to pummel me with exclamation points and all-caps and the Wang et al. study. You continue to recycle arguments, then copy/paste them into social media group after social media group. You are trying to prevail with volume rather than substance. Now you’re questioning my character. That always gets people’s attention.

To the untrained eye, your arguments seem more scientific than they are.

You point to a research paper. You use the word, “proof.” These all appear under the umbrella of your Journal, and readers might not recognize that self-publishing your views in your own journal does not subject them to the same rigor as submitting them to another journal and a blind peer review by other scholars. Self-publishing shifts the review process from a formal pre-publication review by other experts, to informal post-publication on social media, for all of us to feed on. There, readers may or may not notice the missing pieces, or the logic leaps that don’t add up.

As a result, some readers may actually come to believe oncology massage therapy (and, by extension, exercise therapy), is endangering patients the world over, cancer center by cancer center, hospital after hospital, hundreds and hundreds of thousands of patients served.

By reviving the old massage-spreads-cancer debate, you’ve created undue alarm. Following your reasoning, massage therapists could be deterred, not only from massage during a specific window, but also from working with wider swaths of the population. As Gayle MacDonald points out, this has broad implications.

We’re not making up standards on our own

You have singled me out because of my writing, but your argument is with the entire workforce in oncology massage therapy. Oncology massage therapists have already taken care of your safety concerns. Not by dreaming them up in isolation, but by partnering with countless nurses, physicians, and legal departments at hospitals to develop protocols. We have had their supervision, standards, and input in place for more than 20 years. We have taken great care to develop tools. We have lines of interview questions, assessment skills, referral skills, and hands-on modifications.

We have done so for clients who are post-diagnosis, in treatment, post-treatment, and beyond. In partnership with hospital staff around the world, we’ve made sure the care is cautious and compassionate.

We’ve done that so that we can help more people, and not have to turn people away.

Unfortunately your analysis would turn back the clock, and turn people away.

Calling all cancer centers

You have pledged to contact cancer centers one by one to “correct” their oncology massage therapy practice. On this crusade, you will likely be dismissed more often than not. Not because we have already brainwashed hospital administrators about oncology massage therapy. (In fact, massage therapists do not have a super-successful record of brainwashing hospital administrators.)

Instead, your points will be dismissed because all your audience has to do is take a quick look at the research, and at Wang’s previous research, to see immediately how you are using a scant amount of data in error.

I know you want your alarm to help, not to hurt, but it backfires. As MacDonald points out, you cast doubt on the safety of massage therapy for many different populations. You’re compounding fear about massage therapy. There is already enough nervousness about working with clients with cancer.

Ethics and Argument

You’ve lobbed serious accusations my way, and you probably need to revisit your language there. You’ve tried to paint my opposition as a self-interest problem. An ethics problem.

More generally, your views are compromised by a bombastic approach. At times you are strident and impatient. This does a disservice to the many thoughtful teachings and writing you offer. You lose people when you depart from civil, scientific discourse.

Alarmism can be damaging.

Who does it hurt the most?

Not me.

I am confident my ethics are sturdy, so I’m not concerned about that.

I’m  concerned about the patients turned away under your rigid rule.

Patients are hurt the most. Newly diagnosed patients, especially: They often feel isolated during a frightening time. They need all the symptom relief and stress relief that we can humbly offer.

They have a right to receive our care.

***

Readers:

If you have read this far, I hope you will take a look back at the various installments in this conversation. Listen and come to your own conclusions. Contribute to the conversation on blog posts and on social media.

We’ve had 20+ years of active oncology massage. Now, the fear that massage could spread cancer has re-emerged, fanned by Turchaninov and Cullers.

We need to air any concerns and put them to rest again, once and for all.

Please read, share, and participate.

Here are the articles, columns, and pivotal posts so far:

  • Turchaninov & Cullers initial articles, raising their concern about massage post-cancer-diagnosis and pre-treatment, and citing Wang et al. article (2014), focused on massage prior to cancer diagnosis:

Turchaninov and Cullers Part 1

Turchaninov and Cullers Part 2

 

On Not “Charging What You’re Worth” in Oncology Massage Therapy

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Recently, in a group of oncology massage therapists, I started a discussion about setting fees for massage therapy.

In this particular group, we were all in private practice. They were all participants in my oncology massage therapy mentorship program, and we were talking about money and pricing.

It is a charged topic, this question of what to charge. Massage therapists in private practice are the deciders, but those decisions can be fraught with pressure and confusion.

Our conversation went in several directions and plunged through several layers. How high, how low, whether to discount, how to raise fees when it is time.

But by the time we brought the discussion to a rest, we had focused heavily on one topic:

The Tangible Value of Oncology Massage Therapy

This might not seem like a new or particularly earth-shattering topic. But it is worth revisiting with care. Here is why:

As we talked, we shifted our conversation away from the therapist and toward the therapy.  Eventually we did one better and shifted it toward the therapeutic outcomes.

By focusing on outcomes rather than our service, or ourselves, we achieve an important separation. Setting fees requires that we separate ourselves from our work. Even though who we are is a part of what we bring to the session, it is liberating to see our service as separate from ourselves.

Why?

“I Should Charge What I’m Worth**” Can Be a Trap

It’s too easy to fall into the trap of “I should charge what I am worth.” I’ve even encountered MTs who ask each client to pay what the client feels the therapist is worth. Deferring to the client for the final word can be problematic, to say the least.

But equally troubling is the notion that we charge based on what we are worth.

When we do, a simple fee for a simple service becomes gnarled up in self-worth. Add in all the emotional energetics of money and self-esteem, along with the gender wage gap and other social forces, “charging what I’m worth,” is a prescription for confusion. Pile on the intimacy of massage therapy and the therapeutic relationship, and it could take decades to disentangle it all.

Here is an important nugget that can clear things up in a hurry:

The Intrinsic Value of a Human Being is not up for Sale.

It never was. Each person is perfect and sacred, beyond the language of “value.” Not a single person’s worth is affected by their choice of pricing. Not one person’s worth can ever be captured in a $50 or $80 or $150 hourly fee.

No, you’re not for sale.

Even the value of your time is not up for debate. So what are you selling?

Your solutions are for sale.

It’s useful to remember that we work in a service industry. In service industries, we solve problems. We bring expertise and energy to problems that are hard or impossible for people to solve by themselves.

I do not know how to shingle a roof or fix blown plumbing. I cannot cut hair well enough for school picture day. When I hire the roofer, the plumber, or the hair stylist, I pay them for their service. Not because they are “worth” something, but because it is worth something to me have those problems solved. Especially the night before picture day.

The Industry of Solutions

In massage therapy, we would do well to remember our membership in the service industry. It is important to focus on the problems we are known to solve, and those we have the potential to solve.

In oncology massage therapy, that list of problems is compelling. People in cancer treatment and post-treatment deal with pain, nausea, fatigue, stress, trauma, insomnia, isolation, poor body image, stigma, anxiety, and depression.

That’s the short list.

Does Research Back up These “Solved Problems?”

Research on oncology massage therapy is still in a tender place, but there is growing research on massage therapy helping the “Big 5” symptoms in cancer care: pain, nausea, fatigue, anxiety, and depression. From that body of research, the strongest support seems to be for pain relief and easing anxiety.

More generally (across multiple populations, not just oncology), there is compelling evidence that massage therapy is as helpful as psychotherapy for the problems of anxiety and depression.*** That  alone is worth celebrating.

We can make clear and accurate claims about massage as follows: “Research suggests massage therapy can help people with cancer and cancer histories with the following: pain, anxiety, fatigue, depression, and nausea,” or, “There is strong research showing massage therapy is as effective as psychotherapy for anxiety and depression.”

Neither of these claims over-promises or overstates what we know. (For a list of claims to avoid because they do overstate and over-promise, download my free e-book, “5 Myths and Truths about Massage Therapy: Letting Go without Losing Heart.”)

Clients Tell Us We Solve Problems

Research aside, we have other reasons to promote our work to oncology clients. These reasons come from the clients themselves.

Over many years, my clients have told me tangible, intangible, and sometimes surprising benefits that they attribute to massage therapy: That massage helps them sleep. With massage therapy they feel less isolated and stigmatized. Massage helps them feel feel cared for and appreciated. They look forward to pleasurable sensations from massage, after months of needle sticks and scans. They tell me that when they receive regular massage therapy, they feel better able to cope.

These benefits are worth money.

Our clients’ observations count for a lot. They are telling us why massage matters to them, with or without rafts of research behind them.

We Solve Other People’s Problems, Too

In addition to the client with cancer, there are others in the circle of care who are helped by our services. Nurses tell us that that massage therapy eases the nursing workload. They notice that when MTs are working with inpatients, the nurses themselves do not have to respond to so many call buttons. This is worth money.

Other people’s burdens are also eased by oncology massage therapy: The out-of-state uncle or daughter who purchases a session for a family member. A group of co-workers who finds a meaningful gift in a package of sessions. An exhausted caregiver who gets an hour off while the MT sees their loved one in the home. The cancer rehab PT who works more effectively when a patient’s muscles are already relaxed.

These things are worth money.

Our clients, client communities, and health care providers tell us that massage is solving problems. With or without research, theirs is an honest truth.

Charge for Solving Problems

Oncology massage therapy has enough of a track record to be well-compensated. We can charge accordingly, without getting ourselves or our self-worth mixed up in it. Oncology massage therapy is well-received. It feels really good.

That sigh of contentment once we’ve bolstered and positioned a client–even that is worth something. (So often, after I’ve set up my client for the session, she’ll sigh and begin to relax deeply. When I suggest I just excuse myself for an hour while she rests on my warm table, she nods…”Whatever.”)

Relaxation is part of the solution. Sometimes it is the entire solution.

“Massage Therapists: The People who Practice Massage Best.”

Zoom out. Look at the field of massage therapy, not just oncology massage therapy. Even massage therapists do not always appreciate the value of basic relaxation massage therapy. Sometimes we search for more powerful techniques, forgetting how highly effective our Swedish massage foundation is.

Years ago, I attended a workshop on breathing problems with Leon Chaitow. He presented the osteopathic view and the PT view and an intricate account of the problems to address with precise manipulations. Then he said something like, “But massage. Don’t forget massage! It’s really helpful.” Gesturing to the crowd, he continued: “And you’re the only ones who can really do it. Or, at least, you are the best at it. Remember to massage!”

It was amusing to have to be reminded of this, but I loved the simplicity of his endorsement. We’re good at massage. Unadorned, un-fancy, effective massage.

When questions of worth enter in, they can confuse matters. Yet all by itself, massage therapy is a compelling service. Our skills are badly needed.

Those Skills are Worth Something

We live in a market economy, where services are exchanged for money to solve problems. Our services should be no exception. We can exchange skilled touch for money, because skilled touch solves problems.

I have more to say about pricing, and our tendencies to over- and undercharge in some cases. There are sometimes special circumstances in force, or a client’s financial need to consider in pricing. I’ll share those thoughts soon.

Meanwhile, remember this important starting point: Pricing does not have to be so personal.

Pricing Does Not Have to be Personal

It is not so much about the problem-solver, or what you, as a therapist or a person are worth. It is more about the results.

Disentangling the self from the service can be freeing. A focus on the service can reveal a much clearer perspective, one where difficult problems demand good solutions.

With that perspective, we are uniquely equipped to provide good solutions.

We can and should be well-compensated for them.

**********

*After I wrote this post, I noticed a Facebook discussion about “charging what you’re worth.” I did not have time to incorporate that discussion here, but if you follow Irene Diamond or Sandy Fritz on Facebook, they tackled this as well. I highly recommend taking a look.

** Do not get me started on the fuzziness of the term, “deep tissue.” That’s a topic for another post.

***Moyer CA. Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull. 2004 Jan;130(1):3-18. Every MT should read it.

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