Tracy Walton & Associates

Caring for clients with Cancer

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

March 8, 2018 by Tracy Walton 12 Comments

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.

Filed Under: Oncology Massage, The Business of Massage

Comments

  1. MK Brennan says

    March 12, 2018 at 9:15 pm

    Thank you for this discussion. Wonderful comments for everyone to ponder. Geographical location is also a significant consideration for fees, I think. Cost of living varies so widely across the US and into other nations that there isn’t a way to “set” a fee for all.

    Reply
    • Tracy Walton says

      March 12, 2018 at 9:42 pm

      Yup, I agree. I’m not “worth more” when I work/live in area A than when I work/live in area B. I saw that this came up in the FB discussion I mentioned, as well.

      Reply
  2. Destiny says

    March 13, 2018 at 4:16 am

    Excellent article!

    Lots to think about, such an interesting way to look at our “value”. This is truly ‘eye-opening’!!

    Thank you Tracy!

    Reply
  3. Carmela says

    March 13, 2018 at 5:29 am

    As one who practices relaxation massage, I no longer try to sell myself to the average person looking for “deep tissue” massage.
    Thank you for all you do Tracy.
    Carmela

    Reply
  4. Sandy Fritz says

    March 13, 2018 at 10:08 am

    Yes.

    Reply
  5. Irene Diamond~High Revenue/Time Freedom Mentor says

    March 15, 2018 at 12:49 pm

    Agreed, Tracy!

    When setting fees — I think the concept of “worth’ is misleading and interpreted as ‘self worth’.

    I teach practitioners and clinics to set their fees based on the VALUE of the outcome’s worth. Set it at whatever amount you feel is appropriate based on the clinical outcome your clients get from your therapeutic services …

    And remember, that VALUE is ultimately subjectively validated by the consumer, not the practitioner because it is up to the clients to decide if your rate is worth it to them in exchange for the outcome they get.

    When you have clients happily singing your praises AND you feel you’re being compensated generously, you’ve found your sweet spot!

    Reply
    • Tracy Walton says

      March 19, 2018 at 9:43 am

      Yes! Outcomes, problems solved. Focusing on this, more than the therapist experience, can help in pricing. And yes, going for the sweet spot.

      Reply
  6. Pam Soule LMT says

    March 18, 2018 at 4:15 pm

    Tracy!

    As always, you make such a difference in the way to think about an issue.
    Thank you, Thank you, Thank you!

    Reply
  7. David Bailey says

    April 22, 2018 at 7:22 pm

    Which inevitably brings you to the question of volunteering – https://www.oncologymassagetraining.com.au/userfiles/Guidelines%20-%20Volunteering%20as%20an%20Oncology%20Massage%20Therapist%20v2.pdf

    Reply
    • Tracy Walton says

      August 24, 2018 at 10:50 am

      David, somehow I missed replying to this. Thank you. “Volunteering should not be exploited for profit” is a clear boundary. I appreciate your sharing this.

      Reply
  8. Carmel Andrews says

    September 2, 2018 at 4:50 pm

    Important conversation. I however, have always used the statement “value yourself” to convey this idea…and not because its tied to personal self worth, as Sandy described here….but because more often we are all very likely to be sole proprietors in our career at one point or another. Meaning that if we don’t give permission to ourselves to maintain a market standard for our service, because we may be frightened of making enough money or getting enough clients, we are doing ourselves a disservice and also a disservice to.our colleagues in the field. I think the wording has become such, “know your worth”, because we are usually speaking to the individual and not the professional consensus of a team or group of employees. But the meaning is the same, honor the competitive rate so that we are not devalued and undercut.

    Reply
  9. Kay says

    April 24, 2019 at 6:34 pm

    I have also found that the issue of pricing gets caught up in the issue of self-worth. You did a great job of disentangling it, in a beautiful, non-snarky way. THANK YOU! I seriously breathed a big sigh of relief reading this post. no matter which side of the “pricing debate” you’re on, it’s hard not to be defensive, and you’ve neatly sidestepped it.

    Kay Warren

    Reply

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What’s New

Why take a course in oncology massage therapy?

There are so many good reasons. Here are a few:

Service. During cancer treatment and beyond, people need support. They need symptom relief. They need sleep. Oncology massage therapy (OMT) can help people cope during cancer treatment, at end of life, post-treatment, and during diagnosis.
Practice building. With the right skills, you can meet growing client demand and build your practice. You can be part of cancer care. It is better for your business to be able to work with people right then, right where they are, than to refer them out or send them home.
Career satisfaction and longevity. OMT is immensely satisfying work. Your steady presence and your hands can make a huge difference in someone's day or week. You might even find our approach to be easier on your hands and alignment. We offer new ways to provide comfort without effort and "deep tissue" work.

To practice OMT, massage therapists need to know what to ask clients before the massage, and how to use the client's answers. They need to know how to think through what to do, and how to communicate with clients in difficult circumstances. They need confidence, sensitivity, strong interview and table-side instruction. They need to learn from actual case studies and real-world exercises, and good chances to practice.

We provide these learning experiences in our 4-Day Intensive, Oncology Massage Therapy: Caring for Clients with Cancer.

Learn more...

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