Category Archives: Practice Strategies and Advice

Business Plan Creation Guide for RMTs

business plan for massage therapists

One of the most important decisions you will have to make as an RMT is whether you want to start your own business, or work for someone else. There are pros and cons to both situations, and not everyone is suited to running their own business. There are many misconceptions about the amount of work required to run a clinic, as well as what clinic owners are likely to earn from their business. If you’re considering starting your own business, it’s imperative that you make sure you have a firm understanding of everything that’s involved. The best way to do this is to create a comprehensive business plan.

What is a business plan?

Business plans are documents, usually 20 or more pages long, which describe in detail various important bits of research about a potential business’ likely success or failure. It looks at factors like the location of the business, potential customers (clients), the costs of running the business, what the competition is like, and potential income from the business.

Business plans are traditionally required when you’re applying for a business loan or some other form of external funding. However, creating a business plan even if you don’t plan to apply for a loan is hugely beneficial as a potential business owner. Gathering and organizing the information required for a business plan helps you to make educated choices about your business, and to avoid a lot of the common missteps that new business owners encounter.

There are several components to a business plan. We’ll break each one down, and give you some direction for what to include with each component.

Executive Summary

The Executive Summary is a short form of the entire business plan, including the most important elements of each section. It’s usually only a couple pages long at most. It’s purpose is to provide a concise “short form” of the business plan for someone to review quickly, so they get a good summary of what’s contained in the more detailed plan. It should be included at the beginning of your business plan, but it’s also a good idea to have independent, stand-alone copies ready too. Because the Executive Summary contains information from all the other sections, it’s better to leave this create this section last.

Business Overview

The Business Overview includes general information about the business.

You’ll want to include the proposed structure of the business. The three common types are sole proprietorship, partnership, or incorporation incorporation. If you’re not sure what the difference is, you can read more about business structures here.

You’ll also what to include information about the history of the business (what lead you to creating the proposed business), the type of business (a massage therapy clinic, multi-disciplinary practice, mobile practice, etc.), and the location.

The Business Overview isn’t long, but it should give the reader a clear idea of what sort of practice you will have.

Operations Plan

The Operations Plan is a description of the day to day activities of the business. In the case of a massage therapy clinic, you would describe the different types of tasks completed at the business, such as booking appointments, maintaining and storing client records, treating clients, and so on. This section is also where you describe the layout of the business – how many rooms will the clinic have, and what purpose will each of them have? What types of employees / contractors will work at the location, and what are their general duties?

Assume the reader has never been to a massage therapy clinic before. After reading the Operations Plan, the reader should have a clear understanding of your business’ daily operations.

Market Analysis

You will want to show that there is demand for massage therapy in the region you plan to operate your business. The Market Analysis section is where you describe the demographics of the area (population, age, average income level, etc). You can find this information in the Census Program data from Stats Can. You start by searching for the city where you want to pull data from, and go from there. The most recent data as of the time of this writing is from the 2011 census, but the 2016 data should be released soon.

You’ll want to identify your target market(s) in this section. Target markets are subsets of the general population that you believe your services will appeal to the most. Although it can be tempting to say “I want to target everyone!”, it’s usually better to focus on a particular niche of the population and focus on your attention on them. Obviously you can still treat people outside of your target demographic, but narrowing your focus to a niche allows you to create more effective marketing, build your client’s reputation within that community more quickly, and differentiate yourself from competitors. Examples of target markets include “new moms”, “youth”, and “athletes” (ideally specific types of athletes, such as “runners” or “group sports players”). You should pick a target demographic that you are already very familiar with; usually a niche that you actively belong to yourself.

Once you have a target market figured out, you can use the demographic data to see if the population of the area you selected is likely to support your business. For instance, if you’re planning on opening a clinic which focused on “new moms” in an area which is predominantly elderly, you will struggle to find clientele.

You’ll also want to find census information specific to health conditions and healthcare in the area. Stats Can has information on this topic as recent as 2013 as of the time of this writing. Identifying common health concerns in the area can help you narrow down what areas your practice could focus on, based on what impairments are likely to be prevalent in that region.

It’s helpful and visually appealing to create charts and graphs to show the data you collect in this section. You can use Excel or similar programs to show how large your potential target markets are, how much of the population is likely to have conditions that you can treat, and so on.

Products and Services

In this section, you’ll describe all the various services (and products) your practice will offer. You will want to break down each service / product with a brief description.

Assume your reader doesn’t know anything about massage therapy. After reading this section, they should have a good idea of what a typical treatment will entail (intake, assessment, treatment, home care, etc.).

Sales and Marketing

The Sales and Marketing section is where you will outline your price list, and how clients may purchase your services (in clinic, online, etc.).

You will also use this section to describe your marketing efforts. How will you market reach your target demographic? What will make them want to buy your services? Be specific here – instead of “I will do short in-person seminars running groups”, specify which running clubs you’ll approach, the length and topic of the seminar, a proposed schedule for the talks, and so on. Include several different marketing approaches here, and be mindful of potential costs… you’ll need to know how much each marketing activity will cost for your Financial Plan. Outline how you track to see which marketing activities are working and which aren’t.

Need some marketing ideas? Check out the ClinicWise article “RMT Marketing Strategies“.

Competitive Analysis

Identifying how much competition you will have in your chosen region, and the relative strengths and weaknesses of each of those competitors, is a big part of determining whether starting a business in that area is viable.

You can use Google Maps to search for massage therapy businesses in a specific region. On the map, you can see the areas that have high or low concentrations of massage clinics. You can also use the “Street View” function to see what the area looks like – is it an industrial area or more of a suburb? Is there a major attraction (mall, big box store) nearby, or is it almost entirely residential? Does the area look very wealthy, more low-income? Where are the major employers, likely to offer their employees benefits, relative to the area?

Once you have found a region you like, and have identified your nearby competitors – I would recommend other clinics within a 3-5km radius of where you want to open your clinic, but it depends on the population of the area – you will want to research each one. Check out their location, as well as their marketing materials, to identify strengths and weaknesses. Do they have easy access to parking? Are they located for a lot of walk-in traffic? Are they visible from a busy street? Does the location look profession? Is their marketing appealing? How many practitioners do they have, and what services do each offer? Are their prices above, below, or on par with the other competitors? What makes them stand out from the other clinics? What might turn a client off from visiting that clinic? Are there any elements that would appeal to (or dissuade business from) your target market?

For each competitor, briefly discuss how you will compete against their relative strengths and weaknesses. Make sure to detail what will make you stand out from them. Will you offer services none of the other clinics do?

Management Team

The Management Team section is where you provide the professional biographical information for all key people involved in the business. In a typical sole proprietor massage therapy practice, this might be just the owner of the business, but in larger practices it could also include proposed co-owners, clinic managers, chief operational / financial / sales officers, and so on. A list of each person’s qualifications is important to show they have the skill set required to make sure the business operates effectively.

Financial Plan

The Financial Plan section is likely going to be the most detailed and time-consuming component of your business plan. However, it’s also arguably the most useful part, as it will help you figure out if your business is financially viable or not.

In the Financial Plan, you’re going to include all financial information related to your business. This includes:

Start up costs. What investments will you need to make before you even open the doors? You’ll need to factor in things like registration and insurance, any deposits or down payments for property / renovations / vehicle / etc., stocking your initial supplies, purchasing office and treatment equipment, legal / consulting fees, and so on. Create a spreadsheet and list every single item, along with it’s cost. Don’t estimate costs – research the cost of each item so you have a realistic idea of what the actual total will be.

Ongoing expenses. What monthly / yearly costs will your business incur, just to stay open? Lease payments, hydro and other utilities, yearly registration and insurance renewal, online booking / record keeping systems costs, and other monthly or yearly expenses should all be itemized and listed.

Marketing and promotions. Any new business will likely need to invest a significant amount of resources into acquiring new clients. We often her the value of word-of-mouth marketing, but we need to get clients in the door first. Depending on your target market, and considering the marketing initiatives you described in the Sales and Marketing section, compile a list of all the costs associated with your planned marketing activities. Many of those costs may be on-going.

Occasional / per-treatment expenses. Some expenses fluctuate based on how busy you are. For instance, any supplies you use as part of a treatment will be consumed more often when you get busier. List all costs related to offering your services (locations, acupuncture needles, cleaning supplies, etc.), and break down roughly how much of each supply you use per typical treatment.

Debt repayment. Many small businesses will require to take out loans to cover their start up costs. Make sure to factor in debt repayment into your financial plan. Other debts like student loan payments should may also be considered business expenses – separate out how much is payment on the principle, and how much is interest payment, as you can possibly deduct the interest you paid at income tax time.

Expansions / Renovations / Repairs. Any successful business should have a plan in place for growth. You may want to upgrade equipment (like going from manual to hydraulic tables), renovate your space, of even more into a larger space after your business grows to particular size. On the other end of the spectrum, things break, and money may need be invested periodically for repairs. You’ll want to plan to set money aside regularly to allow for repairs and long-term growth.

Income taxes. As a business owner, you will be responsible for setting aside money for income tax. Your income tax rate varies based on the amount of money you earn during the year (you can find more information on that here). Remember to factor that in as you calculate your income.

Salaries  / IC payments. Most successful clinics eventually need to hire additional therapists in order to expand.  You will want to include any staff payments in your financial plans as well. Some clinics prefer to make their staff employees, otherwise prefer to go the independent contractor route. The rules for employees and contractors are different, both in payment structure and in labour conditions, so make sure you have a firm understanding of the difference  before deciding how to proceed.

Projections. Projections refers to how much income (gross and net) the business is expected to generate. Calculating projections isn’t an exact science, as you’ll need to create estimates about the number of clients you’ll acquire, especially earning on. As a general rule, it’s better to be conservative and low ball the number of clients you’ll acquire for the purpose of creating projections. You would typically break this down into weekly or monthly segments. If you’re not sure where to start with your projections, you can refer to the ClinicWise article “How much should I charge for my fees?“.  It features an Excel spreadsheet tool you can download and play around with some numbers to see how much income you can expect to earn with different service pricing.

The information is usually presented in a table (spreadsheet) format, which is set up to do the calculations for you. That makes it easier to adjust the calculations if one of the amounts changes. The scope of the Financial Plan in your business plan should cover at least a  couple of years.

Addendum(s)

At the very end of your business plan, you should include your references. Typically this is supporting evidence for the claims you make throughout the business plan – print outs of pricing for equipment, raw demographic data, resumes for your management team, and so on.  You don’t have to include price lists for cheap office supplies like paper and pens, but any large purchase (massage tables, bulk lotion, office furniture, commercial lease pricing, etc.) should be included as reference.

 

That’s it! Take your time when creating a thorough business plan. It’s better to have accurate figures rather than hasty ones, or you’ll only end up making uninformed decisions and hurting your business in the long run. It’s always a good idea to have your business plan reviewed by someone you trust who is familiar with business operations, as well as an accountant or someone in the financial industry to help you figure out if your projections are realistic.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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3 Tips to Extend Your Massage Therapy Career

exhaustionmanage

Massage therapy is a very physical job and far too many therapists are experiencing pain and burn out that is totally avoidable. Massage does not have to be hard on your body or be a short career.

The thing is that when you don’t take care of your body or your body mechanics when you are working you end up short changing your income year after year.

The good news is that with some simple corrections you can change things so that you can treat with far less effort and extend your career many years. You invested a lot of time and effort into your training so why not get the most return on investment.

Massage Therapists aren’t miracle workers!

The first thing to cut out of your practice to extend your career is trying to fix years of pain in one session. Your client likely did not get to this point overnight, so it is crazy to think that you can fix it in one or two sessions. When you give this up, you stop over extending yourself and this leads to better outcomes for the client as well since you are less likely to over treat during each session.

A better solution to this for you and for your client is to map out a treatment plan that allows you to make the changes in a time frame that gives the body time to adjust without post massage soreness. You always have the option to look at that treatment plan and tweak it along the way according to their progress. This is a gentler and more effective method for client recovery, and then you get to position yourself as an expert and to steer the treatments.

Try to avoid unnecessary heavy lifting

The second thing to cut out is lifting whenever possible. I have been a big advocate of the removal of what I call “diaper draping” for the leg. The big reason is that when I see therapists in my workshops using this method they are straining to lift the leg and all of them are in an awkward position to do it. This is not necessary once you have passed your licensing exam and your back will thank you for letting it go. Each time you lift, you are at risk for low back injury which can cost you huge in lost earning hours.

In my courses I show people the fold method of draping the leg that I was taught in school. It is just as secure for the client and is way easier on your body. You fold the sheet so that it uncovers most of the o leg (just the one you are treating), then fold it over again and tuck under the same leg (this is about ¾ up the inner thigh) and in at the ASIS (pelvis). This allows you access to the upper thigh and glut area (tuck into the underwear if needed) and stops that annoying sheet rolling back down on you and getting in your way. As a client I can assure you that this method is way more comfortable and feels just as secure.

For a sample of what to expect in my Body Mechanics for Massage Workshop (available in our on-line shop @ wholebodyhealing.com), check out this video clip!

YOU are your most important client

The third big thing to give up is the habit of putting yourself last. You are the main equipment in your practice. If you were running a machine and wanted to make sure it was going to last. You would do regular maintenance. You would not expect that machine to run past the peak levels it is capable of or expect it to run without any downtime. When you treat your body like the valuable piece of equipment that you are going to get a long term use out of then you will treat it differently.

I love to get therapists to think in terms of being a Massage Athlete. As such you want to have cross training fitness that you do and you want to eat such that you support your nutritional needs. Yoga and Pilates are two of my favs for RMT training, and if you are a keener then adding in some aerobic activity is fantastic.

When it comes to food, you will do well to consider scheduling breaks that allow you time to not only eat but also digest what you have eaten. Remember that the body needs 20 min to move the food from the stomach into the intestines and then more time to extract the nutrients from there. When you rush out and start working right away your body diverts energy from digestion so you can use your muscles, thus depriving you of nutrients. Book off an hour for lunch or dinner breaks and sit and relax after eating – pretend you are in France and let your body do what it needs to.

You may also want to add in some quality supplements like Magnesium and B complex to support your Massage Athlete body at optimal levels (feel free to consult a professional for a more comprehensive look at your needs).

Remember… Self care = increased income!

Make your personal care a priority both in and out of the massage room and I promise you will earn more money.

For more great tips, tricks and techniques to work less and earn more pick up this great workshop and jump on our mailing list.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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A Beginner’s Guide to Reading Massage Therapy Research

reading research
As massage therapists, we’re often told we need to keep up with the latest research to make sure our practice is as evidence-based as possible. Unfortunately, many of us have very little experience in reading and evaluating research, so keeping up with the newest evidence can be intimidating. How do we know if a particular piece of research is good, and should be considered when we create our treatment plans?

Hierarchy of Evidence

Hierarchy of EvidenceBefore we delve into the details of what makes a good study, it’s important to understand that scientific evidence forms a hierarchy. The higher up the hierarchy, the better the quality of the evidence. Although there are some variations on the hierarchy, some including more levels than others, the order is always the same. The most common levels include, from top to bottom:

Systematic Reviews compare many studies on the same topic and evaluate them to see if the conclusions about the topic are consistent.

Randomized-Controlled Trials (RCTs) are what we encounter often in published massage therapy research. They are experimental studies where one group is exposed to an intervention (like massage), and another group is exposed to a placebo (sham) treatment, no treatment at all, or sometimes both if there are enough participants for three groups. The participants should be randomized (placed randomly) into those groups, in order to minimize the chances of factors other than the massage treatment influencing the outcome of the study.

Case Control Studies and Cohort Studies are types of observational studies. In these types of studies, experimenters don’t try to control who is or isn’t exposed to the intervention (like in an RCT); they just observe the effect of the intervention on a group of people. In cohort studies, the ‘cohort’ is a group of people who have some common link (like all being born around the same time, or of a particular race), whereas in case control studies participants are chosen because they have a common health problem.

Case Series and Case Reports are descriptions of a particular patient’s experience with a health problem – their symptoms, how it’s impacting their lives, their daily routines, what treatments they received, their responses to those treatment(s), and so on. Case reports involve a single patient, case series involve multiple patients, and neither involves controls or randomization. Case studies and case reports can provide important information, but they cannot demonstrate a cause-and-effect relationship between the massage treatment and the outcome.

Anecdotes are personal experiences a patient describes regarding a particular treatment. They are highly subjective, and often don’t include any information aside from the benefit they believe they experienced from the treatment.

Animal Studies are experiments completed on animals. Their purpose, in health care, is to gather preliminary information about the effect of an intervention, and how it might impact human patients. However, results from animal studies are often exaggerated to support claims that haven’t been properly demonstrated in humans.

This article focuses mostly on RCTs, since they’re the most common type of published massage therapy research accessible to most of us, and they are fairly high up the evidence hierarchy. However, not all RCTs (or experimental studies) are designed equally. Being higher up on the hierarchy is good, but it’s not a guarantee that a particular piece of research is well designed.

Continued on page 2.

Understanding the CEU Cycle and Requirements for Ontario RMTs

Every year around October; RMTs start to stress over their CEUs. The first question always asked is: “Is this the year I am suppose to report?”. There is an easy way to figure this one out.  Your 3 year cycle will always begin on the November 1st following your registration. So IF you were registered on October 31st, 2015 your cycle begins November 1st, 2015. But if you were registered on November 1st, 2015 your cycle begins the next year on November 1st, 2016. The chart for this is located at the following CMTO link.

http://www.cmto.com/registrants/quality-assurance/ceu-cycles-and-due-dates/

The Second question will be “When is the CEU report due?” and/or “Is it due at the end of October? The answer is: The report is due by the first December 31st following the end of your cycle. This gives you 2 months between the end of your cycle and the time it is due; to compile the information that must be handed in.

In other words; you have some time to breathe still, if you started to panic in October about reporting. But if you don’t actually have all your CEUs; you do have to figure out how you will get them done before the day ends on October 31st.

Now online

The CMTO has now made reporting very easy by having an online portal that RMTs can fill in with their CEUs. Not only at the time of reporting, but all throughout your reporting cycle. This allows RMTs a place to also track their CEUs and ensure that they have what is needed before the end of the cycle rolls around.

To access this you must login to your CMTO account first. All CEU reports are kept confidential with your member account.

Why can I not Submit?

What many RMTs have noticed is that when they have reached their CEU total and want to now submit them officially, they can’t. Don’t fret about this. Your cycle does not end until Midnight on October 31st of your reporting year. Your ability to submit does not become active until, November 1st of your reporting year. This means that until November 1st officially arrives; you can still collect, and report, CEUs to the College. So if you already have your 30 CEUs logged into the site, sit back and wait for that Submit option to be active. You have not missed anything, nor have you “messed” something up.

This is most likely done to avoid having people submit totals, and then try to contact the CMTO to “add” or “modify” something. If the staff has to do this for 12000 RMTs; they will be wasting many, many hours that could be used for something else. We definitely do not want another reason for our fees to go up in any given year.

Mandatory Articles

Mandatory Articles are an easy 3 CEUs that every RMT will qualify for by reading all the CEU Articles in the TouchPoint magazine that were published during their cycle, and answering all the questions that followed. So really; all RMTs are responsible for obtaining their own 27 CEUs every cycle.

What seems to have people confused is exactly how to report them. The reason for this is; there is a two step process: First; record the CEUs earned, and second; verify you read them. In your report you can record all 3 CEUs on one line if you wish. Use ABA (activity code) CCL (competency code) and “Mandatory Articles from the TouchPoint”. try to find ‘where’ they should report them on their on-line forms. What will happen next is; after you finalize and “submit”, you will be asked to verify that you read the Mandatory Articles. This is because every single RMT will have this in common. The rest of our CEU’s will show an individual journey that each of us progressed through over a 3 year year stretch. These reports, being individualized, need to be fillable fields. There will be no individual verification for each one when you record them.

If you do not require the 3 CEUs (because you have tonnes); then you can just verify you read them without the need to record the 3 CEUs. So if you forget, and just submit; all you need to do is verify that the Mandatory Articles were read after submitting.

The CMTO is also now implementing a new component that allows RMTs to answer their Mandatory Article Questions through their CMTO account. This allows  the CMTO to have record, and proof, that did actually answer these questions.  Some RMTs will have seen this change already. What you will need to remember is that this is not enough. You are still required to have a physical record of the answers in your Portfolio. To do this you can simply print your answers and place the printout in your Portfolio.

Not Online

If you are not an RMT with direct access to the web at all times, or know someone like that, the RMT can still mail the forms to the CMTO. The catch is that the forms may be needed to be downloaded from, you guessed it, the web. An RMT can, however, request the forms be mailed to them through the Quality Assurance Committee. If this is the direction being utilized; please allow plenty of time to have them sent to you, and to send back to the CMTO. They are still required to be received by their office prior to December 31st. Considering that the CMTO offices shut down over the winter break; it is advisable to have them in prior to this break.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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Professional Portfolio Requirements for the Ontario Massage Therapist

Registered Massage Therapists in Ontario are asked by the Quality Assurance Committee of the CMTO (College of Massage Therapists of Ontario) to maintain a Professional Portfolio. This, simply put, is a place to physically collect proof of your Continuing Education activities while acting as an RMT. They require four (4) sections to be maintained at a minimum for each cycle (3 year term). Any other sections that are to be included are entirely up to the RMT to add. The process of creating, and maintaining, a Professional Portfolio does not have to be daunting.

According to the CMTO.com the four sections an RMT’s portfolio is to be divided into are:

  1. Completed Self Assessment Tool;
  2. A record of CEUs, identifying the number of Category A and Category B credits obtained, and which competency or modality each CEU relates to;
  3. Proof of CEUs collected including receipts, course attendance confirmations, conference brochures, etc.;
  4. Responses to questions from the mandatory CEU articles published in The College Standard.

Getting Started

Who sees this Portfoilio?

This is a question that gets asked a lot. Many RMT’s don’t understand why they must keep a Portfolio, and who may access it. The answer is really short; you, and the CMTO.

If you happen to be selected for a Peer Assessment, the Assessor will most likely ask for you to provide your professional portfolio. The Quality Assurance Committee may also request directly for you to submit your professional portfolio at any time. You must comply with this request in a timely manner.

They will be looking that you have completed the four sections, and they are up to date. They will also want to see that everything is contained within the same portfolio and not separate areas of your room or clinic.

Constructing the Portfolio

The simplest thing you can do for your portfolio is to keep all your papers in the same file folder (Yes, really, a single fold file folder in your cabinet) for a single, 3 year, cycle.

Files

image courtesy of Staples.ca

Another option is to use a hard cover binder to organize your items. This would be one of the most professional ways to maintain and store your originals, or hard-copies, of records for the Quality Assurance Committee. You can even include dividers to keep the four sections separate. These items, of course can be obtained from a dollar store or a business like Staples.

binders

image courtesy of Staples.ca

What is a Professional Portfolio?

A professional portfolio is more than just a requirement of the CMTO, it provides you with solid evidence that you have participated in learning. This also affords you the ability to examine your practice from a different angle.

Your portfolio is a collection of documentation that represents your learning experiences and outcomes. These documents will include: Your reflections, and answers, for the Mandatory CEU articles, records of CEUs you have obtained, proof of the CEU activities that you participated in, and your personalized Self Assessment Tool (SAT). This portfolio is most commonly utilized during a Peer Assessment, but can also be requested to be sent to the CMTO usually via the Quality Assurance committee.

Your portfolio is your responsibility to maintain as the CMTO recognizes that massage therapists are self-sufficient and competent members of their profession. You are expected to self-direct the maintenance of this important portfolio and are held fully accountable for it.

What does the portfolio do for me?

Your portfolio will benefit you by providing a place for you to reflect upon the activities you have participated in, the learning you have amassed, and fuse these into your active practice. You will have a tangible way to reflect not only upon your learning, but your preferred learning. It can chart a direction that you are steering your practice towards and answer that all important question; “where is my career going?”

A list of some of the things your portfolio can assist with

  • Identify areas of existing strength
  • Identify sort and long-term goals
  • Prioritize your future goals
  • Create plans to accomplish your identified goals
  • Gauge the impact of your learning on your practice

This can also be used to

  • Aid with your performance review (employee or independent contractor)
  • Prepare your CV (Curriculum Vitae, aka: Resume)
  • Prepare a Business Plan

Why have Professional Development?

First, and foremost, it is mandated by government legislation that all health care professions maintain high levels of competence and professional standards. But there is more to it than that.

As a health professional you have agreed to give the best possible care to your patients. You cannot do this by falling behind and remaining stagnant. You owe it to your patients to constantly update your knowledge, refresh your skills, and learn new things. Professional Development is, really, about being the best you can be for your patients.

The contributions of professional development to your practice are wide ranging. They allow therapists to maintain their relevance within the profession, as well as with other health care professions. It gives RMTs an ability to actually anticipate the changes that are occurring and to develop a plan to respond to these changes.

Self Assessment Tool (SAT)

The SAT was developed by the QA Committee of the CMTO to “help registrants (RMTs) identify competencies and areas that they feel need improvement and to develop a plan to address them”. This SAT is to be completed every three years (CEU cycle) by each and every registrant. The outcome of this completion is to be shared to the QA Committee.

The SAT is actually a personally subjective questionnaire developed with input from peers (what did you think those survey monkey things were for?) of the profession. It is intended to help you identify your current skill levels, and develop plans for self-improvement and enhancement. The CMTO is now switching to allowing RMTs to complete this tool online, but you are still required to print off a copy and maintain it in your physical Professional Portfolio.

This document will form the first section of your Professional Portfolio. It will not be fully completed until such time that you are near the end of your CEU cycle. It is expected that you begin this document at, or near, the onset of your cycle. To aid you with your current cycle; you can make a copy of pages 11, 12 and 13 from the SAT of your last cycle. This can be your reference for what you have planned to complete in the current cycle. If it is your first cycle, ie: new to the profession, you are expected to print off an SAT and complete it according to where you believe your entry-level skills rate. This will, again, serve the basis for guiding, and tracking, your activities in your cycle. Key point: do not wait til the end of your cycle.

The CEU Record

During your 3 cycle the QA Committee expects you to accumulate 30 CEU’s. These are calculated at 1 CEU for every 2 hours of activity. 20 must be obtained from Category A and the remaining 10 can be from Category A or B.

In this second section of the Portfolio you simply need to represent the sum of your CEU efforts. Therefore it can be a really short section using just the CEU Reporting Form (available as a download from cmto.com). In essence; at least two pages in length.

The CMTO is now having RMTs maintain a virtual copy their CEU Record in their personal portals at cmto.com. But, again, they are wanting you to have physical copies (printouts) maintained in your Portfolio.

Proof of CEU Activities

protectorThis third section will be the expanded version of the CEU Record section. This is where you will keep your receipts, course attendance record, brochures, copies of certificates, peer conferencing, articles read, seminars presented, articles written, (eg: The author is getting CEU’s for writing this), research Project work, etc…

 

If you are using a binder of some kind, then in this section you can keep “sleeves” in which to place smaller items, or items you don’t wish to damage with hole punches (ie: certificate originals). These can be as simple as a page protector.

Mandatory Articles

With the publication of each TouchPoint magazine from the CMTO, there are articles that are denoted as “Mandatory Articles”. Each RMT is expected to read these articles and complete a short questionnaire about each one. By reading, and responding to, all the articles in a cycle an RMT will earn 3 Category A CEU’s, maximum (meaning you now only need to get 17 Category A CEUs minimum).

The questionnaire may require a short essay answer to be written to show you obtained useful information from the article and can supply critical thinking when discussing it. Print out a copy of the questions asked and reference the source they came from. Place this printout, directly followed by the answer sheet, into your portfolio. Get these done as soon as you can, as the QA committee may request your Portfolio at any time, and they want to see you are up to date with the articles. This will also be true when a Peer Assessor comes to visit you.

Extras

That is it, really, and anything else beyond the above discussed 4 sections will be added at your own desire. Do not be surprised when your peer assessor skips right over the extras. It is’t a slight to you; they just do not require it as part of their check-list when they visit you. So, right now, you have the information needed to meet your minimum requirements for a Professional Portfolio.

 

References: cmto.com

Everything that is required for your professional portfolio base comes from the CMTO directly and can be found on their professional website. Any references that are used in this document are from the CMTO directly via their website. You can visit them at www.cmto.com to find these references. To create this document, of course, the author has navigated the website already and consolidated it for you. As of the publication date; all information is accurate to what has been released by the CMTO.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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Contract Basics for Registered Massage Therapists

massage therapy contract

Contracts. Whether you’re an independent (or sub-) contractor, a clinic owner yourself, or an employee, every massage therapist inevitably has to deal with a contract at some point in their career. Contract terms are a hot topic for many therapists, with most questions about how to handle different work-related situations often boiling down to “what does your contract say?”

Contracts exist to help establish clear expectations of both parties in an professional relationship. A good contract is detailed enough to cover most scenarios, while allowing some  reasonable flexibility for extenuating circumstances. The terms in a contract should be mutually agreed upon, and both parties should take the time to fully understand every clause in the contract. A contract is a binding agreement, but it’s not one you have to accept outright… you can always negotiate with a business owner (or new contractor) to have one, or several, of the clauses removed or adjusted in a way that leaves you both satisfied.

Unfortunately, many massage therapists aren’t familiar enough with employment contracts to know what to look for when deciding if a contract meets their needs, which leads to very uncomfortable situations when they expect one thing and the other party expects another. This short guide should help you decide if your contract touches on all the important stuff.

Treatment Equipment and Space Issues

Room sharing

You’re about to negotiate the use of a space, so you’ll need to know if the space is going to be shared with other people. If so, how many? Is it a set schedule, or a first-come-first-served arrangement, and how are conflicts handled? Who is responsible for cleaning the room?

Equipment  / supplies sharing

In many clinics, massage therapists may share equipment or supplies. These items may be supplied by the clinic owner, or one of the other contractors working out of the location. Who is responsible for providing the treatment supplies and equipment? If you’re sharing the space, can you leave equipment (like your table) inside the space? Who is responsible for maintenance of the equipment in the room, or replacing it if it breaks / is used up? If there is a flood, fire, or other damages caused to the therapist’s equipment while in the clinic, who is responsible for any costs to repair / replace the equipment?

Common space sharing

Nearly every clinic has a shared common area where clients may wait when they arrive early, make payments for their treatments, etc., as well as a washroom for staff / public use, and possibly other areas shared by multiple staff and contractors. Your contract should discuss who is responsible for maintaining those areas. If you are expected to do light office work like answer phones and business emails at the office, book appointments for other massage therapists as needed, and similar tasks,  the contract should outline what those expectations are, and if / how you are paid for those tasks.

Clinical Documentation Issues

Where / how are files stored

The contract should detail how the client’s treatment records are stored, and how long they are kept. The CMTO requires that records are kept for at least 10 years following the date of the client’s last appointment (or the date they turn 18, whichever is later) , but the clinic may keep the files longer if they wish. You’ll want to make sure that the process the clinic uses to store files doesn’t conflict with CMTO, PHIPA, and RHPA  requirements. If they are storing files using a clinic management system, make sure it’s compliant with our privacy requirements.

Who has access to files

In many multi-practitioner clinics, client files are shared between therapists, and other people working at the clinic (like a receptionist or accountant) may have access to some or all of your clients’ records. The contract should detail who has access to those records, and in what context if necessary. It should also detail who the privacy officer at the clinic is, in case you have any concerns regarding file access. If you are expected to be the privacy officer for your records, when / how you can access your records should be detailed… do you have a key to the area where the files are stored? Can you access the clinic after hours?

Scheduling Issues

Who sets work hours

One common reason for tension between contractor and business owner is a contract that doesn’t clearly define who has ultimate control over the therapist’s work schedule, and what the expectations are for availability. Make sure your contract very clearly outlines who determines when the therapist works, as well as what’s expected during “down time” when there isn’t a client scheduled. Is the therapist only expected to come in when they have someone booked? If a client cancels, can they leave? If they are expected to stick around during these hours, are there specific tasks they are supposed to do? Keep in mind that a lot of these questions will impact how the therapist should be classified – if they have minimal control over their hours, have to do office work or clean during down time periods, etc., they are likely to be considered employees by the CRA. Misclassifying staff can have serious consequences, so make sure you consult with the CRA first if you think you might be walking the line.

How often are hours subject to change

Work schedules change for a large number of reasons – seasonal hours, other employment positions, business growth, etc. The contract should discuss the process for changing the massage therapist’s regular hours. Who makes the final call? How much notice needs to be given? Is there is a minimum or maximum number of hours that need to be adhered to? How often can the regular hours be updated?

Holidays, sick days, and prolonged absence expectations 

Independent contractors are not “employees” when it comes to labour laws. There are no clear requirements in place for handling holidays, sick days, and prolonged absence periods (like maternity leave). This lack of clear guidelines makes it especially important that your contract explicitly discusses these items so that both parties know what to expect if the therapist wants or needs time away from the clinic.  How much time does the therapist want for holidays during the year? How are sick days handled – is there a limit on their number? What happens if appointments have to be rescheduled due to therapist illness? How is prolonged absence handled? A clinic hiring an independent contractor doesn’t have any obligations if the therapist goes on maternity / paternity leave (no maternity / paternity pay or job security), so outlining the expectations for these scenarios will help prevent any issues if they occur.

Locum (subletting) options and expectations

In the event of prolonged absence, many therapists consider using a locum – another therapist who will occupy their space and treat their clients during their absence. Your contract should discuss the expectations in this area. Can the therapist use a locum, or does the clinic want to reserve the right to rent the space to someone else themselves? If a locum is hired, how are the finances handled… does the locum pay the therapist or the clinic? What happens if the prolonged leave needs to be shortened or extended? Will the locum be using their own equipment, or sharing the therapist’s or clinic’s equipment? Do they have to adhere to the same schedule the regular therapist had in place?

Keep in mind that a separate contract will need to be created between the locum either the therapist or the clinic (or maybe both) as well.

Cancellation Policies

Good contracts will outline how client cancellations are handled by the clinic. If a client doesn’t show up for an appointment, are they billed anyway? Are they billed a partial amount? Are they given a freebie? If the clinic is paid a partial or complete fee for the service, is the therapist paid as per normal? Is the policy enforced?

Financial Issues

Who sets the fee schedule

This is another area of contention for a lot of therapists without explicitly detailed contracts. Which party has control over the fees being charged? How often can the fees be changed? Are discounting or sliding-scale fee structures allowed? If so, which party absorbs the loss in income? Can each therapist offer different prices? There are a lot of potential areas for confusion (and eventual disagreement) if the expectations and responsibilities of each party are not spelled out in detail in this area.

The same issues of employee classification we discussed in the scheduling section apply here. The more control the clinic has over the fee structure of the therapist, the more likely they should actually be classified as employees and not independent contractors. Make sure to contact the CRA if you’re not sure how your staff should be classified.

How often is payment made

This is a point missing in many contracts. If the therapist is paying monthly rent, exactly when is the payment due? What is the process if they pay late? If the clinic is paying the therapist’s invoice for their cut, how often is this done? What is the interest rate if they pay late? What happens if the client doesn’t pay the clinic / therapist on time? What about insurance or MVA claims, in which payment might come in several days or weeks after the service is provided?

Who does the client pay for services

Who the client is actually paying for the service will determine a number of things: how each party will handle their taxes, who should invoice whom at the end of the month (or other payment period), whose information should appear on receipts, and others. For example, does the therapist collect all the money and pay the clinic their rent and administrative fees every month? Does the clinic collect all the money for services rendered and pay the therapist their “cut” every few weeks? Your contract should be very clear on who is collecting the money from the client, and which party is paying the other at the end of each payment period. Who the client is paying for the service also has a huge impact on HST requirements.

How is HST handled

Which party the client is paying for the service, and whether or not that party is registered (either voluntarily or by requirement) to collect HST, will determine whether or not HST should be applied to the service. If you’re not sure whether or not you are currently required to register for HST collection, you can check out my article on HST basics to read up on the requirements and figure it out. Even if the therapist isn’t registered to collect HST, it’s possible the clinic will have to charge HST on the service if the clients pay the clinic for the service.

In some scenarios, the clinic will collect and remit 100% of the HST collected, in other scenarios, it might be more appropriate for the therapist to collect and remit it all, or the collection / remission may be split up between the two parties. There are a number of acceptable ways of doing it, but your contract should outline what process you plan to use.

Also, the contract should be clear about what happens if / when the therapist is eventually required to collect and remit HST (once they hit the required limit) if they aren’t registered already. Will the fees go up? Will the therapist (or clinic) absorb a portion of the increase, and if so, by what amounts?

Who is responsible for payment processing fees

If your clinic has a payment processing machine (credit / debit card machine), your contract should outline who is responsible for paying the fees for each transaction. Will the clinic absorb the cost? Will the therapist be expected to pay a fee to the clinic each time they use the machine? Is the therapist permitted to use the machine at all, or should they use their own?

Who is responsible for all relevant business and operational expenses

The contract should explain who is responsible for payment for any operational costs. If the therapist has to purchase their own supplies, which supplies they are expected to provide should be clearly outlined, and which (if any) supplies and equipment the clinic will provide should be listed as well. The expectations for use of resources like computer equipment, fax machine, support staff, software (like clinic management programs or online schedulers), and other similar things should be made clear in the contract. If maintenance, repairs, replacement, or labour costs increase, it should be clear who is responsible for those costs.

Marketing expectations

Marketing expectations can be a lot more complicated than it might seem at first. There are some obvious items, like who is responsible for paying for items like newspaper, radio, tv or online advertising, but there are many other things to consider. Are therapists expected to market themselves, or will the clinic handle all of the marketing? Is the therapist expected to attend any particular marketing events like marathons, fundraisers, home / trade shows, or other events on behalf of the clinic? Is all of the marketing to be done under the name of the clinic, or can the therapist market their own brand? Who has the final say in what content appears on the clinic’s website, print ads, or other materials? Who is responsible for designing / printing business cards, brochures, and other internal materials? Is the expectation that the client will always contact the clinic, or can the marketing materials include the therapist’s cell phone number or other contact information?

Time frame for renegotiation

You should include a time frame for renegotiating the terms in the contract. A therapist who has built a following of clients, and who requires very little oversight or marketing support will represent a much different investment than a new therapist without any existing client base. You’ll periodically want to go over your contract and amend the terms so that both parties feel they are still benefiting from the arrangement. Things like fee schedule changes, work schedule adjustments, percentage splits, may need occasional adjustments, so setting up a time frame to go over the contract again periodically helps facilitate the process.

Leaving the Practice

Non-competition / Non-solicitation clauses

If your contract includes a non-competition or non-solicitation clause, it should be reasonable and mutually agreed upon. What is reasonable will depend on many factors, like how big your town is, if you have access to a vehicle, where you intend on working once you leave, and what limitations are being imposed on you. The purpose of a non-competition / solicitation clause isn’t to limit your ability to find gainful employment (which wouldn’t be legal), or to prevent clients from seeking care from a therapist they choose (which would also be illegal). These clauses are meant to help minimize any significant loss of business assets (clients) when a therapist moves on. I’ve already written a lot more about this topic in a previous article, so check it out for more information on this subject.

Notice required before leaving

Any notice expectations for leaving the practice should be outlined in the contract. How much notice does the therapist have to give the client owner? If the clinic owner wants to discontinue the business relationship with the therapist, how much notice do they need to provide?

Expectations for notifying clients

The CMTO requires three things happen with clients when a therapist is leaving a practice.

  1. The client is notified that the massage therapist is leaving / has left.
  2. The client is made aware of where they can access their health record as needed.
  3. The client is referred to another health care provided for continuation of care (if necessary). This can be another therapist in the same clinic, but it doesn’t have to be.

There is no requirement on the part of the therapist to tell the client where they are going, which is a common misunderstanding of the regulation. The regulations also say that the therapist can make arrangements for someone else to notify the clients; they don’t have to do it personally. However, the therapist (not the clinic) is ultimately responsible for ensuring the clients are notified. Your contract should describe who will notify the clients of the therapist’s departure. It is also a good idea to mutually draft the “departure notice” that will go to clients as soon as you start at the clinic, and write it into the contract. That way, when the massage therapist is ready to move on, you’ve both already agreed on the wording that will be used with clients. It’s always best to figure that out in advance, in case the terms of your departure aren’t amicable.

Escape (exit) clauses

Escape clauses describe what happens if either party wants to sever the agreement. Although this can be caused by one party not living up to their end of the arrangement (ex: a clinic owner who wants the therapist to do office work despite it not being a part of their arrangement, or a therapist who abuses their sick days and cancels appointments on a regular basis), it could also be for unforeseen circumstances like a car accident preventing the therapist from treating their clients. Regardless of the reason, there should be a clear process in the contract describing how either party can terminate the contract at any time. How much notice is required? Will the massage therapist have continued access to the building for a certain time after they leave? What will clients be told if they ask where the therapist has gone? What happens to the client files – are they staying at the clinic, or going with the therapist? What is the process if the therapist requires access to any notes left at the clinic after they’ve departed?

Solid, detailed contracts make for much smoother business arrangements. Not having a detailed contract might seem more “friendly” or “easy-going” at first, but it is one of the biggest reasons for conflict in a business relationship. It’s better to settle all the details right from the get-go than assuming you’ll always agree on business decisions and never “need” a contract. This article has detailed some of the most common clauses and terms found in massage therapy contracts, and should be enough to get you started. Make sure you understand every part of every clause in the contract before you sign it, and don’t ever sign a contract that has terms you don’t agree with or intend to honour. A contract is a legally binding document, so not living up to your end can have serious consequences. Only sign a contract if both parties feel they are being treated fairly.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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How Much Should I Charge for My Fees?

Disclaimer: I am not an accountant, and nothing in this post should be viewed as formal accounting advice. The purpose of this post is for general information only – please consult an accountant if you need more detailed help with your finances.

how much should I charge for massage therapy

One of the first things a new massage therapist – or one opening a new practice – has to figure out is a fee schedule for their services. There are several things you’ll want to consider when creating your fees, to make sure you’ve covered all your bases.

Billable Working Hours

The first thing you’ll want to figure out is how many hours per day you can comfortably work, and then figure out how many of those hours are billable and non-billable. Billable hours make up only part of the hours you’ll actually work… the remaining hours are non-billable hours.

Billable hours are the hours you work in which you are generating income. For massage therapists (and most service providers), this means the hours which you are treating  a client.

Non-billable hours are the hours you work during which no income is being generated. This includes your time spent cleaning up between clients, doing administrative work, and other business tasks no one is paying you for directly.

The average work day for a massage therapist is made up of both billable and non-billable hours. Let’s say the RMT take clients from 9am to 5pm on a given day. For the sake of this example, let’s  also assume the therapist’s schedule is full of 60 minute appointments. Most RMTs say they need 15 minutes between clients to reset the room, charge the client leaving and welcoming the client coming in. In the 8 hours the therapist has available, they can only work an approximate 6 billable hours. About 25% of their scheduled time is spent on tasks that don’t generate income directly.

The time spent on billable vs non-billable activities will vary depending on the length of the treatment. A 30 minute treatment requires the same amount of cleanup and administrative time as a 60 minute treatment. If the above therapist has a full day of 30 minute treatments, they will only have 5 billable hours total for the day. About 37% of their scheduled time is spent on tasks that don’t generate income directly.

If your billable hours don’t make up a majority of the scheduled hours that you have, you should probably adjust your schedule a bit to decrease your non-billable time. Sometimes it’s a matter of changing your process – for instance, using an online scheduling system that sends out reminder emails automatically instead of manually emailing or texting clients remindrs every day.

Expenses (Business and Personal)

The next thing you’ll want to do is add up all of your expenses. Most business plans suggest that you add up all your regular business expenses, but I’d actually suggest including your personal expenses too (separately). Try to be as accurate as you can when figuring out your expenses – if the cost for something fluctuates from month to month, I’d recommend the higher cost in your estimates. That way if your estimates are off and it ends up costing less, you have some extra money instead of coming up short.

Some common monthly business expenses include:

  • Rent
  • Heat
  • Hydro
  • Advertising
  • Meals and Entertainment
  • Bank / point of sale charges
  • Office supplies
  • Professional and accounting fees
  • Travel
  • Phone and internet
  • Postage and delivery

Some common yearly business expenses include:

  • Insurance
  • CMTO Membership
  • RMTAO Membership
  • CEU Courses

Some common monthly personal expenses include:

  • Mortgage / Rent
  • Heat
  • Hydro
  • Phone & Internet
  • Cable
  • Banking fees
  • Car payments
  • Debt repayment
  • Groceries

You can likely think of a few more, but that’s a good place to get started.

Break-Even Analysis

Now that you have all of your expenses figured out, you’ll want to do a ‘break-even analysis’. For a single-client service-based business like massage therapy (we can only treat 1 client at a time), this means figuring out the minimum amount of money we need to charge per hour to cover our expenses. We are essentially dividing our total expenses by the number of scheduled available hours we have per month.

Once we have that figured out, we can convert that into how much we need to charge per service (based on what % of an hour that service uses) in order to just cover expenses and break-even.  In addition to covering your regular expenses, you’ll want to figure out how much the cost is for the supplies required to offer that service (laundry for the sheets, cleaner for the table, lotion / oil / gel, etc.) and add that the break-even amount for the service too.

A real break-even analysis is usually only focused on covering business expenses. However, as sole proprietors, it’s often helpful to consider how much we need to make in order to break-even with personal expenses too, to make sure we can cover all of our monthly bills.

We also have to consider how “full” our schedule is. If we work fewer hours, then more of our income goes toward expenses, so the break-even number for a less-full schedule is higher than if the schedule was fully booked.

Competition

Once you have an estimate of how much you need to charge at minimum, it’s time to consider what’s appropriate as a maximum, and what is a sustainable fee structure for your area. This is done by checking out your competition.

Knowing who your competition is can be more difficult than it sounds. While many locations offer massage therapy, each clinic might offer services or perks that are different from yours. To get a true sense of your competition, you’ll want to get the fee schedules from clinics in your area who offer services that are very similar to yours. This doesn’t just mean the same time denominations – it also means that any ‘add-ons’ for those services are similar to yours. If a spa down the street offers a 30 minute massage therapy treatment, but it’s part of a larger spa service that includes a stream-room period or something similar, than it’s not really the same service as a 30 minute massage therapy treatment by itself.

Once you have identified 5 (or more) businesses nearby that offer comparable services to yours, find out what their fee schedule is by visiting their website, contacting them by phone, or making a stop at their location. This can also be a great networking and referral building activity too, as you each might offer services the other doesn’t. You should also find out if their posted fees are inclusive of HST not not, and only compare the prices without HST added.

Once you have the pricing from each competitor, you can figure out what the average cost for services are in your area.  As a general rule, you don’t want to price yourself too high – even being exceptionally good at massage won’t bring clients back if you’re charging way more than everyone else.  You definitely don’t need to undercut your competition (offering a lower price as an incentive to see you instead of them) either. Since price can effect people’s perception of quality, being known as the “cheap” massage therapy clinic isn’t ideal. Aiming for somewhere in the middle is usually safe to attract clients, and keeps the market in the area healthy for everyone. If you do want to charge more than your competitors, you’ll want to make sure your marketing reinforces why your services have more value (do you have add-ons that others don’t? Treat a specific niche market primarily? Etc).

Profit Projections

Of course, covering your expenses and making sure you’re not priced out of your market is important, but so is having some disposal income and saving for the future!  Using the average cost for services in your area, you’ll want to figure out how much gross income you can expect to make in a year. I’d recommend figuring out the maximum gross income (assuming your billable hours are completely booked), and then again using a very conservative number of billable hours booked. Remember that your tax bracket (what percentage of your income you are taxed) is calculated based on your gross income (before write offs). It’s also used to determine whether or not you need to collect HST. You can use these projections and estimates to plan a bit ahead of time for tax season.

Once you’ve figured out the gross income, subtract the break-even amounts (regular expenses + (costs per treatment x number of treatments)) for the year. That will leave you with your net income. If you decided to include personal expenses in your break-even numbers, it will give you an idea of your disposable / saving income (before taxes).

If the number seems uncomfortably low, you know you’ll need to increase your service fees , find a way to reduce your expenses a bit, or increase your billable hours.

Hate doing math? You’re not alone.

It’s pretty intimidating trying to do all the necessarily math to figure out your break-even numbers, compare your prices, cover all your expenses and estimate how much money you’ll make. For the non number-lovers out there, we’ve put together a free spreadsheet document that does most of the math for you. It was designed to help you figure out a price that makes sense for the four most common services an RMT clinic offers: 30, 45, 60 and 90 minute massage therapy treatments.

Click here to download a copy of the “how-much-should-I-charge” Excel spreadsheet

This spreadsheet document has multiple pages, which can be accessed by using the tabs at the bottom of the page:

document page tabs

Each page includes boxes for you to enter numbers (like your expenses and competitor’s prices), and some boxes  hat are calculated automatically with formulas. Only the boxes you can enter information (the ones with yellow backgrounds) are editable, so you can play around without worrying about accidentally deleting an important formula. It’s pretty easy to use.

There is some example information entered into each box already. Once you’ve replaced it with your actual expenses, test prices, and so on, it’ll will give you an idea of what to expect. When you’ve entered your information into each page, return back to the Summary page and adjust your prices to see how the change will affect your business!

Keep in mind that this spreadsheet is no substitute for a real accountant, but it may help to give you a rough estimate of what to expect and help you figure out what is reasonable to charge given your situation.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
Follow Me

Search Engine Optimization (SEO) for RMTs

Search Engine Optimization (SEO) is the process of making your website as search-engine-friendly as possible. When search engines like Google organize the results of a particular search, they rank which websites will appear closer to the top based on several factors. Many of those factors don’t require much (or any) technological prowess, and collectively they can play a significant role in boosting your website’s rank during searches. It’s important to know that there’s no way to guarantee you’ll be the number one result in searches… If someone tries to sell you a service with that guarantee, it’s very likely they aren’t a trustworthy agency. However, the more steps you take to improve your SEO, the more likely it will be that you’ll show up at least on the first page or two of search results.

This article will go over some of the easier steps that you can take to improve your SEO. First, we’ll explore the different type of search results, and how they work in relation to search engine optimization.

Different Types of Search Results

The term ‘search result’, in the context of online searching, refers to the list of links that show up when a user types a term or phrase into a search engine.

Clicking on a search result will take searchers to a specific website or web page, which is identified by the link itself. The most common type of search result is a text link, which is usually blue. Links can also be images or even videos. However, regardless of the type of link, each search result acts in the same way taking users to a website. Searching for a given term or phrase might yield thousands or even millions of results, which are spread out over multiple pages. It’s pretty rare for people to look at more than the first page of results, so it’s in your best interest to show up near the top of that list.

There are many different search engines, but this article will focus specifically on Google. Google is by far the most popular search engine in North America, which makes it the one to be most concerned with.

Google has 3 major types of results, some (or all) of which may show up during a single search.

  • Pay-Per-Click results, which are essentially ads in the form of search results. Website owners can pay to have their link show up in prominent places.
  • Organic search results, which is the type that search engine optimization targets. Organic results make up the bulk of search results, and are shown in an order determined by the search engine.
  • “Google Maps” results, which are centered around the searcher’s location. These types of results are represented by plots on a map, and are helpful in showing searchers nearby services that relate to the topic they searched.

types of search results

In the screen shot, we can see an example of all three types of results in the locations they commonly appear. The red areas show the Pay Per Click results, right at the top of the list, and along the right hand side. The green area shows organic results, running down the central column, and continues downward to show about 12-15 links. The blue area shows a link to a map, which includes the Google Map results. Occasionally, these items will be shown in the central column as well.

Pay-Per-Click Results

Pay-per-click ads are the only type of search results that requires you to pay for better placement. Only website owners who are willing to pay for placement will show up in the ‘ads’ section. When they create an ad, website owners also create a list of search terms and phrases they would like to associate with their ad. Each item in this list is called a ‘keyword’.

The website owners also limit the amount of money they are willing to spend for each ‘click’ on one of their links. This limit is called a bid. Limits can also be placed on the amount of money to spend on bids in a particular day. When a user searches for a term, the search engine checks all the ads that have added that term as a keyword. Then, it checks to see how much each user is willing to pay to show up in the list of paid results. The users who are willing to pay the most, and haven’t spend their daily limit already, show up near the top of the paid results. The website owner only actually pays for their bid if a searcher clicks on their ad – that’s why the model is called Pay-Per-Click. There is no charge if the ad is shown by the searcher doesn’t click on it.

If you’re interested in getting more exposure via Pay-Per-Click marketing, the service you want to use is called Google AdWords. Creating an AdWords account is free, and has great support if you have any questions. If you’re trying to decide whether or not to use Pay-Per-Click ads, take a look at the pros and cons:

Pros:

  • Creating an AdWords account isn’t difficult, and gives you control over who sees your ad.
  • It takes little to no effort to show up high in search results through pay-per-click.
  • Bidding on multiple keywords means you get exposure for people searching for a wide variety of topics.

Cons:

  • If you rely on Pay-Per-Click as your sole means of getting exposure, it can get expensive in the long term.
  • If your ad balance is depleted, your ads stop showing until you replenish it.
  • Users may choose to block ads, or get annoyed with companies who use ad placement too heavily.

Ultimately the choice is yours… Pay-per-click can be a great way to get exposure, especially for new businesses or websites.

Google Maps (location based) Results

When looking for services like massage therapy clinics, often location can be a deciding factor for would-be clients. Finding a business close to home or work is definitely appealing. Google Maps shows businesses or services nearby that relate to the topic the user searched. Showing up on this map during location-based searches is obviously of huge benefit.

Each Google Maps result is shown as a point on the map, focused around the user’s current location. This is especially helpful when a user is searching for a business using a mobile device like a smartphone or tablet with built-in GPS. A searcher can also specify a starting point other than their current location, to find locations nearby their workplace, cottage, vacation spot, family member / friend’s house, etc..

Each result can be clicked to see more information about the business, like what the storefront looks like, and relevant contact information such as the company’s phone number and website.

Google Maps Results

On the above image, we can see several points listed on the map to the right, with a listing of what each point represents on the left. The order of the results is primarily based on location, but other factors play a role as well. Google Maps results also blend elements of pay-per-click and organic results. For instance, pay-per-click ads can also include location information, and show up on the map in the same way that they show up in regular results.

There’s also a special type of location-based result called a Google My Business (formally Google Places) result. Google My Business accounts are free, and allow website owners to list information to be included with their Google Maps results. Things like hours of operation, company logo, contact information, and a website can all be added. Creating a Google My Business account helps ensure your business shows up in Google Maps results.

Organic Search Results

When people talk about improving their search engine ranking, or SEO in general, they’re referring to showing up higher in organic results. The bulk of results that show up when a user searches for a topic are organic results. The competition in this area can be pretty steep.

Organic result rankings can’t be bought, the search engine determines what order they appear in, and which ones get priority. Google will attempt to show the links it believes are most relevant first. Relevant, in this case, refers to which results it thinks will be the most helpful to the searcher, based on the terms they searched for.
It does this by comparing each website against every other site to see which has more ‘relevant’ points.

Search engine optimization is the process of making sure a website has as many relevant points as possible, to encourage Google to show it closer to the top of the list of search results. The more relevant your website is determined to be, the higher up the list you’ll show up. There isn’t a single setting or practice you can follow to guarantee improved rankings… there are several things a search engine considers relevant, so you have to manage as many of them as you can. The best thing to do to improve your ranking is to break down the process into several small steps, then ensure that you do as many of those steps as possible.

Some of the things to consider, in no particular order, are:

  • The quantity and variety of media on the site
  • How recently and frequently you add content on the site
  • How many times the search terms show up on a web page, and where those words are located on the page
  • How many other websites have links to your site, and the quality of those websites
  • Integration of other Google products: submitting a site map to Google, creating a Google Places page, etc.
  • How much traffic your website gets, and how many people have clicked on your site while looking for similar terms
  • How your visitors interact with your website (commenting on things, visiting multiple pages) and social media integration on your site

There are other, more technical, things that can effect SEO ranking as well, be this article will focus (mostly) on the steps that people can do easily with minimal technical skill.

We’ll begin exploring the basics on page 2.

RMT Marketing Strategies

targeted marketing strategies for massage theapists

Marketing strategies to draw new clients is one of the most frequently discussed topics for massage therapists. A lot of therapists are hoping for a single activity, strategy, tool or service to fill their schedules indefinitely, but the reality of the situation is that marketing is an on-going process. Instead of trying to find a single solution, it’s often better to break down a marketing strategy into several smaller activities, events and demographics.

Marketing events that appeal to one client may not appeal to others. For instance, a marathon runner will likely have different treatment goals than a pregnant woman… the wording and approach used when marketing to each of those people should reflect their needs, impairments and interests. Trying to find a one-size-fits all strategy can be nearly impossible, so I’d recommend focusing your efforts on one target demographic – called a niche – at a time. This article will hopefully give you some ideas for your niche marketing efforts.

Types of Marketing Materials

Before you initiate any kind of marketing strategy, make sure you have some supporting materials.

Brochures and Flyers
Having several different print materials, each with its own target demographic, can be much more effective than trying to create a single brochure or flyer for general use. One brochure that focuses on massage treatments and home care suggestions for pregnancy-related impairments will draw more interest from  Lamaze class attendees than a more generalized flyer. Handing out brochures discussing sports injury recovery tips and sports massage would be better suited when giving a talk to a runners’ club. You don’t need a different brochure for each unique situation, but having a couple of specialized brochures, each focused on a particular niche, can draw more clients that a single brochure that is too general. Make sure that you use language the client will understand: laymen’s terms over anatomical terms, short, simple sentences, and images that reflect situations the client may encounter.

Presentation Materials
If you’re giving a talk or presentation to a group, you’ll probably want to product a slideshow or other similar presentation materials. Slideshows should be short, and not overly wordy. A good general rule to remember for slideshow structuring is “5 by 5” – each slide should have no more than 5 bullet points, each with 5 words or less. This is obviously just a guideline, but the idea is to keep the audience focused on what you’re saying instead of ignoring you in favour of reading from the screen. The slideshow’s materials should be tailored to the group you are presenting to – a general talk about massage therapy is less appealing than a talk about health issues that readily apply to most people in the room. If you’re looking for inexpensive space to rent for presentations, local libraries usually have space available for much cheaper than conference centers or hotels.

Online Materials
One benefit to online marketing materials is the significant cost savings. While it might not be practical to have a brochure for every single event or demographic you treat, you can easily create blog posts for each unique situation. Going to speak to some hockey players? Write a blog post on hockey injuries, common home care treatments, and the benefits of massage for hockey-specific aches and pains. Doing at-work treatments for factory workers? Create a post on common repetitive strain injuries common to factory work, and how massage can help. It doesn’t take long to create a blog post, you can reuse the content in other marketing materials like brochures and slideshows. Sharing your posts via social networking sites, especially to local special interest Groups (where appropriate), can be a good way to increase exposure and build credibility within a niche market without needing to spend a dollar. As an added benefit, your SEO ranking will improve if you blog often as well.

Discounts, Packages and Bundled Services
The topic of discounts is pretty controversial among massage therapists. The choice to offer discounts is entirely up to you, but if you do, make sure the discount is reasonable for your own benefit. The ultimate goal of a discount is to draw new business and increase revenue – since there is no guarantee that a discounted client will rebook at full price (or at all), offering a discount can mean a loss of revenue without long term gain. Instead of large discounts on entire hands-on treatments, you could consider bundling services into small packages, or offering low overhead add-ons to your treatments as a free bonus. A small homecare package with a theraband, a tennis ball, a leaflet on some popular stretches and self-massage, and a small pack of epsom salts can be given to clients without increasing your overhead per treatment by more than a few dollars. Offering a discounted – or free – upgrade (like adding hot stone to a treatment) instead of discounting the entire massage, can improve the value of the treatment without breaking the bank. You could also consider bundling services with other businesses for particular demographics – talking with a flower shop about offering a massage gift certificate and flower bouquet package for mother’s day can be an easy way to cross promote each other’s services without the need for either party to discount significantly.

Examples of Niche Markets

  • Athletics. Different sports and athletic activities have different common impairments. Tailor your materials to address the impairments, massage therapy modalities and home care activities that best suit the sport you are talking about. Instead of just approaching players, market services to coaches and league organizers and try to arrange treatments before or after games. Focusing on one sport at a time is often a wiser way to start.
  • Health conditions. If you’re fundraising or attending an event or facility focused on a particular health condition (cancer, MS, etc.), make sure your materials discuss that condition. You can talk about massage treatable impairments that commonly occur alongside the condition. If you’re attending a fundraising event, raffle or auction a gift certificate to an attendee of the event.
  • Pregnancy. Pre-natal and post-natal massage are very popular. Talk to Lamaze teachers, yoga instructors who teach pre-natal or mommy/baby classes, midwives, OBGYNs and other pregnancy specialists about cross promotions, guest speaking, short self massage or infant massage classes, or similar joint activities.
  • Corporate offices. Approach corporate offices or other large employers about offering info sessions about common workplace injuries, or coming in to provide chair massages to staff. Appealing to the HR department about the benefits of massage, and demonstrating that massage can be a cost effective means of keeping their staff healthy is a good way to help convince them to have you come in.
  • Particular age groups. Offering a free talk to staff of nursing homes on the benefits of massage for conditions commonly affecting their clientele can help build referrals. You could offer to do mobile treatments right at their facility. Talk to the schools in town and ask if you can supply them with hand outs detailing home care for treating sprains and strains, backpack carrying strategies, and other conditions that may impact children’s health. If possible, you could offer to attend a parent teacher night and speak with the parents as a group about home care solutions, and how massage might help with some impairments.
  • Cultures or special interest groups. Offering services to members of a particular culture or special interest group can be a great way to network. Many cultural groups have meetings or special events that you could attend. Offering to do provide treatments in an indigenous community, getting a booth at an LGBT event, or providing treatments for donations at a fundraiser for combating violence against women can be an opportunity to show support for a people or cause while networking.

You don’t have to focus on every niche market at once. It’s often easier to spread out your efforts throughout the year, which we’ll talk about on page 2.

How to Report CMTO CEUs Online

The CMTO allows you to report your CEU cycle via their website, instead of filling it out on paper. However, the process looks different than what you see on the paper form. Totally confused about how to complete the CMTO CEU Reporting form online? You’re not alone. Here are the basics of the process:

Go to the Registrant Login area

cmto-registrant-login

Enter your User ID and Password

cmto-login

Select CEU, and CEU Reporting

ceu-tabs

Click “View / Edit” next to your current cycle

ceu-view-edit

Click the “Enter Activity” button

activity-button

Fill in the details for the activity

This is where a lot of people are getting confused, since the details on the online form are different from the paper reporting form:

record-ceu-activity

The first two fields, Activity Type and Activity Category are significantly different from the paper form, where the CEU codes (which can be found at http://www.cmto.com/registrants/quality-assurance/continuing-education/ceus-reporting/ ) are typically entered by themselves. The Activity Type drop down field replaces what we would normally enter as the Activity Code:

ceu-activity-code

If you look at the CMTO’s list of Activity Codes, you’ll see each item in that list corresponds to one of the Activity Types in the drop down list provided:

AAW Attending workshops, seminars or courses – provide name of course, date attended, learning obtained
APW Presenting workshops, seminars or courses – can include preparation time, limited to only the first presentation of the information
ACO Membership on committees – limited to committees of the organizations listed in the guidelines
ACN Serving as an examiner, peer assessor, subject matter expert, or investigator – limited to contract positions with the College
ARE Participate in conducting or collaborating in formal research – identify the research project and how it relates to the practice of massage therapy
AWR Submitting articles for publication – provide the name of the article and periodical it was submitted to; may include the research time for the creation of the article
APE Conferring with peers – provide name of peer, their designation, outline the topics discussed
ABA Reviewing books, articles or videos – provide the name of the publication reviewed, the learning outcome and how it relates to the practice of massage therapy

The Activity Type tells the CMTO what type of activity you are entering. Did you attend a class? Did you read a book? Were you preparing a course? And so on. By itself, it doesn’t determine whether an activity counts toward category A or category B, just the medium of learning.

The next field, Activity Category is where we select the Competency or Modality code of the activity.

ceu-activity-category

The activity category is the subject or topic of the course / book / paper, and determines whether or not the activity falls under category A or B for the purpose of meeting our requirements. The category codes are divided into two major sections: competencies and modalities.

Competencies are all items related to the practice of massage therapy, but they aren’t necessarily specific techniques (modalities). They include things like Business Acumen and Anatomy, and are all category A. The list of competencies is:

CBA Business Acumen
CBD Business Development
CCF Client Focus
CCR Client Relations
CCC Communications
CCL Compliance
CCO Conflict Resolution
CIR Interprofessional Relations
COL On – going Learning
CPS Problem Solving and Decision Making
CRM Records Management
CSM Self Management
CAN Anatomy
CPY Physiology
CPA Pathology
CTH Massage Theory
CTE Massage Techniques
CCA Client Assessment
CPT Pre- treatments
CTX Applying Treatments
CHY Hydrotherapy
CRE Remedial Exercise
COC On- going Client Evaluation
CHK Health- care Services Knowledge
CPH Public Health

The second major division, Modalities, is divided into category A and category B. Category A modalities are considered directly within the scope of practice (and can be billed as massage therapy), and category B modalities are considered complimentary.

Category A modalities include:

MAR Active Release
MAC Acupressure
MAP Acupuncture
MAQ Aquatic Massage Therapy
MAN ANLI Assessments
MBA Baths
MCP Cold Packs
MCS Cranial Sacral Therapy including Unwinding
MDC Deep Connective Tissue
MDM Deep Muscle
MET Esalen Tissue
MHP Hot Packs
MST Hot Stone Therapy
MIH Indie Head Massage (Indian Head Massage is a different modality and is not eligible for CEUs)
MIM Infant massage
MMT Integrative Manual Therapy
MJB Joint Mobilization
MLS Labour support
MLL Lomi Lome
MLD Manual Lymph Drainage
MMM Meridian Massage
MME Muscle Energy
MMR Myofascial Release
MNT Neuromuscular Therapy
MNI NISA
MOB Orthobionomy
MPN PNF
MRF Reflexology
MRE Remedial Exercise including exercise therapy
MRO Rolfing
MSH Shiatsu including Moxibustion
MSM Sports Massage including athletic taping & bracing
MSC Strain/Counterstrain
MSI Structural Integration
MSW Swedish
MTH Traditional Thai / Thai Yoga Massage
MTP Trigger Point Therapy
MTN Tui Na
MVM Visceral Manipulation

Category B modalities include:

MAT Alexander Technique
MKN Kinesiology
MAM Aromatherapy
MMD Meditation
MFD Feldenkrais
MPL Pilates
MEL Electrical therapy techniques including:  IFC, TENS, Therapeutic Ultrasound, Pulsed High Frequency, Low Intensity Laser
MRI Reiki (1st degree only)
MTC Tai Chi
MTT Therapeutic Touch
MTH Touch for Health
MGI Guided Imagery
MTR Trager
MHT Healing Touch
MYO Yoga
MIT Inhalation Therapy

The dropdown list for Activity Category combines all the competency and modalities codes into a single list. You’ll want to pick the competency or modality that best reflects what was covered in the course / book / activity you are claiming.

The next field, Description, is where you type your description of the course, the book you read, the article you reviewed, etc. For a course, you’ll want to include who the instructor was, where it was held, how long it was, and other relevant details. If you were conferring with peers, you’ll want to include their names, where the conference was, and what was discussed. For books and articles, the bibliographical information like author, title, publication, and edition should be included.

Learning Outcome is the field in which you type what you learned during the activity and how it relates to massage therapy and your practice. You’ll want to indicate why you think the activity falls into the category you picked.

The field Activity Completed Date lets you enter which date you actually participated in the activity.

Units Claimed is where you enter the number of credits you are hoping to get for the activity. The credits are calculated at a rate of 1 credit per 2 hours. If you took a 6 hour course, you can claim 3 credits for it. If you read and researched a particular topic for 9 hours, you can claim 4.5 hours for it, and so on.

When you have finished entering the activity’s details, click the Save button. Repeat the process for every activity you want to claim.

 What about the Mandatory TouchPoint articles?

You don’t have to enter the mandatory articles as an activity***. When you submit your CEU Reporting Form after entering all of your activities, you’ll be prompted with a pop up which includes a check box, asking to confirm that you have read the mandatory article and completed their questions. When you check this box and confirm your form submission, the mandatory articles are added to the form for you automatically. You don’t need to submit your answers to the questions (unless the QA department explicitly asks you to), they’ll be checked by your peer assessor during your assessment.

***EDIT: Thank you to Justin Lewis for pointing that if you want to claim the 3 CEU credits for completing the mandatory articles, you DO need to add them as an activity. You will still be prompted with the pop up asking you to verify that you read them either way, but you won’t get the CEU credits for them unless you enter them as an activity. The codes to use are ABA (reviewing articles), and CCL (compliance). You can claim a maximum of 3 credits for the mandatory articles.

 

I hope this helps you complete you CEU cycle a bit more easily!

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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Massage Therapy Non-Compete Clauses

Before I begin, I just want to put up a disclaimer that I am not a lawyer, and nothing in this post should be construed as formal legal advice. If you need legal guidance, seek out the assistance of a contract lawyer.

non-compete clause massage therapy

Massage therapists seeking out independent contractor positions often run into “non-compete” clauses in their contracts, and aren’t quite sure how those clauses work, or why they exist. On various massage therapy forums, you’ll see RMTs asking questions like:

  • “Are non-compete clauses legal?”
  • “Are non-compete clauses enforceable?”
  • “Don’t clients have a right to pick their massage therapist?”
  • “Who owns the client, the massage therapist or the clinic?”
  • “Don’t I (or my clinic) have to tell clients where I will be relocating to?”

The aim of this post is to help address some of these concerns, and to (hopefully) answer some of those questions.

What are non-compete clauses?

Generally speaking, a non-compete clause in a contract is a “restrictive covenant”1… an agreement between business owner and employee / IC that places restrictions on the massage therapist regarding working somewhere else during (and for a period after) their employment at the business. These clauses typically include specifics on distance and time, such as not opening a new clinic within so many kilometers of the business for a period of 1 year after they leave.

The goal of a non-compete clause in a massage contract is to prevent a massage therapist from building up a client base at one business, then leaving and having all of those clients leave with them. One of a massage clinic’s most valuable assets is their client list – they are the source of income for a clinic, and so the clinic wants to protect that asset.

What are non-solicitation clauses?

Non-solicitation clauses are similar, but different from non-compete clauses. They don’t place limitations on the massage therapist’s ability to work / operate a business elsewhere, but they do limit the therapist from soliciting business from the clients they saw at the previous location2. An example of solicitation would be calling, emailing, or mailing their previous clients telling them where they are working now, and that they can come there for appointments instead of the previous location.

Often, you’ll see non-solicitation clauses and non-compete clauses in the same contract.

Are non-compete clauses legal or enforceable?

It’s not illegal to include non-compete clauses in contracts.

How enforceable a particular non-compete clause is will depend on a number of factors. A previous employer can’t legally prevent you from earning a living, so in order for a non-compete clause to be enforceable, the terms of the clause have to be reasonable3. If the clinic is located in a small town with a population of 10000 people covering a total area of 25 kilometers, a clause saying the massage therapist cannot work or operate a business within a radius of 25 kilometers from the previous location wouldn’t be reasonable. What is reasonable will depend on location, time frame, other stipulations in the clause, and personal circumstance for the therapist, among other factors. It’s also worth noting that, in general, courts tend to find non-solicitation clauses more reasonably enforceable than non-compete clauses.

With that being said, you shouldn’t rely on a non-compete clause being unenforceable. There is no guarantee that the court will side with you, and signing a contract without the intent to adhere to the terms of the contract isn’t ethical. Remember that a contract is an agreement between you and the business owner conducted in good faith – if you have a concern about anything in a contract, negotiate with the business owner to change the terms of the contract before you sign it. You sign a contract with the understanding that the business owner will hold up their end of the bargain, you should strive to do the same.

If you’re not sure whether a particular clause is reasonable for your location and circumstance, contact a contract lawyer to review it with you before signing – each situation is unique.

Who owns the client? The clinic or the RMT?

No one “owns” the client. Any client is free to seek out health care treatment wherever and from whomever they want, regardless of a contract between two parties.

However, the client list is a business asset, and can be owned by either party. A business can retain ownership over that list. It’s important to outline who retains ownership of it in the contract.

The same applies for the client’s treatment notes and other relevant documentation. The client owns the information in the notes, but the notes themselves might belong to the massage therapist, or the clinic, depending on what is outlined in the contract. The client can, of course, request copies at any time to use at their discretion, and the clinic / RMT must oblige the request. Even if you created the treatment notes, the contract might stipulate they remain property of the clinic once you leave, so make sure to negotiate terms you are comfortable with before signing.

What about the CMTO policies? Don’t we have to tell clients where we are going?

The CMTO policy regarding leaving a practice is:

The departing Massage Therapist has a responsibility to contact clients and notify them that he/she is leaving the practice. This may be done in person, by telephone or by letter. The purpose of this contact is to assist the client with the transfer of care to another provider, if necessary, and to advise them of how they can access their health record in the future.”4.

There is no requirement for the clinic or the RMT to tell the client where they will be practicing, only that they are leaving the current pratice, to arrange for continuing care if necessary (this can be with a different therapist), and where they can access their records in the future.

The CMTO also notes “In the event that the business owner will not permit the RMT to personally contact the clients, the therapist can make an arrangement to have someone from the clinic contact the clients to assist them with continuity of care”. There is no requirement for the clinic to let the RMT contact the clients directly, or to give them access to the client list once they depart. They are also not required to tell the client where the RMT is now working, just that they are no longer working at the clinic.

It’s important to remember that the clinic itself isn’t responsible for ensuring you are meeting your regulatory requirements. If something in a contract would prevent you from meeting your obligations, you’re responsible for changing those terms to ensure you’re not performing professional misconduct.

 

If you have any further questions about a particular clause, I would encourage you to contact a lawyer directly instead of relying on information from peers (including me). Each situation is unique, so what is true for one massage therapist might not be the case for another. You want to make sure you know what you’re agreeing to before you sign a contract at any clinic or place or employment.

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
Follow Me

  1. “Non Competition Agreements”, retrieved from “http://www.toronto-employmentlawyer.com/employment-law-practice/non-compete-agreement” on December 9th, 2014
  2. “Non-Solicitation Agreements”, retrieved from “http://www.toronto-employmentlawyer.com/employment-law-practice/non-solicitation-agreement” on December 9th, 2014
  3. “How enforceable are non-competition and non-solicitation agreements in employment contracts?”,  retrieved from “http://employmentlawottawa.com/2013/10/31/how-enforceable-are-non-competition-and-non-solicitation-agreements-in-employment-contracts/” on December 9th, 2014
  4. “Practice Advice”, retrieved from the “Leaving a Practice” tab at “http://www.cmto.com/registrants/practice-advice/” on December 9th, 2014

Common Red Flags for Email Scams

email scams massage therapists

Massage therapists have been receiving scam email messages for a long time. While email scams are not unique to RMTs, there are definitely scams that target massage therapy clinics and spas specifically. On social media sites and forums, it’s rare to go a few hours without someone posting an email they received and asking “is this a scam?” or “how does this scam work?” More recently, the scams are not only being sent via email… you’ll likely run into scams via text message or social media messaging as well.

Each scam will have its own minor variations, but there are some common trends (“red flags”) that you can use as a guide to figure out if that email about 12 new bookings really is too good to be true.

8 Red Flags to Look for in Scam Emails

1. Vague details about you and your practice

Email scams are sent out to thousands of people simultaneously. It would take a LOT of time for the scammers to personalize every message, so they don’t bother. Instead, they use generic terms to describe you or your place of business. Scam messages will rarely mention you or your business by name, and they’ll avoid even mentioning your city, using non-specific language like “coming to your area”, “arriving at your business” or similar.

2. Large groups of appointments

To be enticing, email scammers need to promise a large payout if you follow their instructions. In the world of a massage therapist, that usually means a large group of clients back-to-back. Email scams typically request appointments for 6-12 (or more) people, sometimes with multiple appointments for each person. Occasionally you’ll see a variation of this, where the scammer is trying to book a single person, but for multiple appointments over a short period. Examples might include a travelling sports team, or a celebrity or model who needs regular treatments.

In both cases, the idea is to make the would-be victim think that they are passing up a lot of income if they ignore the message. This is known as ‘baiting’.

3. The appointments are being booked long-distance

The scammer always claims they are from out-of-town, usually from another country or continent. They will often use fake names, and sometimes might even have websites for the teams, business, workplace, etc., to help build credibility. The appointments are always to be scheduled over a short period of time, while the group is “in your area”. The actual location they claim to be is usually different, but they are never local – it would be too easy for you to look into their back story that way.

4. The services they request are generic-sounding

“Swedish massage”, “luxury massage”, and that sort of language will be used to describe the services they want. There will be little to no mention of health care issues or complications. The idea is to make the treatments sound as simple as possible, to maximize the number of potential victims. The terminology is usually generic, so that regardless of whether the message is received by a health care facility or spa business, it’s likely that the business offers those services.

5. Poor spelling and grammar

Many of these scams originate from countries where English isn’t the national language, leading to a lot of spelling and grammar mistakes in the messages. It usually goes beyond a few typos – descriptive terms used in the message aren’t quite right (“constructing company” instead of “construction company”) and punctuation is often used incorrectly (periods, commas and spaces tend to be misplaced) in addition to poor spelling and grammar mistakes.

6. They do not want you to contact them by phone

The scammer will almost always request that contact be maintained by email, or more recently, via text message. Although I don’t suggest following up with scam messages, if you do, you’ll find the scammer almost never wants to talk on the phone. They only want to conduct business via non-verbal messages. This is often made clear in the email (or text message) itself.

7. Asking information about payment processing

Scammers will always ask about the types of payment you accept. Usually, these questions are specifically about credit card processing. They may only ask what type of credit card you accept, or might ask more information about international credit cards, wire transfers, cheques, or other forms of non-cash payment. Occasionally, they’ll even ask you about the type of point of sale machines your business uses! The scammer will usually want to pre-pay for your services too, either with a credit card or a cheque.

We’ll cover why this information is important to them shortly.

8. Paying a “driver” or other service provider

In addition to pre-paying for the treatments with you, the scammer will often mention a driver or other type of service provider that will need to be paid as well. They offer to include the fee for that service provider in their pre-payment, asking you to pay the driver or other provider directly. This is usually done to increase the payment they want you to process.

How do these scams work?

There are a couple of ways in which an email scam can work.

1. Monetary fraud via a refund

The most common reasons for these scam messages is to have you send them money directly, often via a wire transfer to avoid being traceable. The scammer will “over pay” for services (often using a stolen credit card), and will ask for you to wire them the difference. A few weeks (or even days) later, the payment is bounced because of the stolen card, and you’re out the money that you refunded. The same applies to cheques they overpay with.

2. Monetary fraud via extra charges

The scammers who ask you to provide information about your point of sale machine will sometimes give you instructions to follow on the machine, telling you it is to test their international credit card (or similar) can be used with the machine. They are actually getting you to authorize payments which you’re unaware of, refunding money to credit cards or bank accounts without your knowledge.

3. Phishing for personal information

Sometimes the scammer is just hoping to get personal information from you. They may ask for detailed information about you to confirm the appointment, including (but not limited to) your registration number. This information can be sold or used for identify fraud purposes.

What Do I Do If I Received a Scam Email?

Nothing. You can simply ignore the message (or text), and nothing bad will happen. Many therapists have tried to report the email to the authorities, but the unfortunate reality is that these messages are international, so the police cannot do much to help.

Some therapists have decided to follow up with the scammers, to ‘see what they were after’ as well. I’d recommend against this – once you have answered a scam email, you’re identified as a likely target, and open yourself up to receiving more messages in the future. It’s usually more productive not to answer at all than to tell them not to email you again.

 

Do you receive many scam emails? Think we missed any red flags or items that RMTs should out for? Let us know in the comments!

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
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Understanding the FSCO Service Provider role

FSCO HCAI fees for RMTs
It is very clear that many RMTs, and other Health Care Professionals, oppose the new Financial Services Commission of Ontario’s (FSCO) Service Provider License Registration being applied to RHPA Professionals and the accompanying fees. That topic has been discussed many times over, and will be discussed many times over. But; it is being rolled out, without question, on December 1st, 2014. All MVA Service Providers must be registered by November 30th, 2014 and are asked to have their application submitted by August 31st, 2014. So now it is time to focus on; what does it mean to RMTs and “how do you fit in”?

Do I need to register with FSCO?

The only Registration that you must legally maintain to practice is through the CMTO. The FSCO registration is only for Clinics/Service Providers wishing to bill an Auto Insurance Company directly through Health Claims for Auto Insurance (HCAI) and have them pay the RMT directly. The registration has nothing more to do with HCAI or the Insurance Companies.

The FSCO states a “Service Provider” must get a License to bill through HCAI. For all intents and purposes; the FSCO defines a Service Provider as:

1- Sole Proprietor

2- Corporation

3- Partnership

4- Limited Partnership

Can I still submit MVA Treatment Plans if I am not registered?

You can still use HCAI and submit the OCF 23 and OCF 18 without registering with FSCO. These are not affected by the changes that are happening with the Auto Insurance Industry through FSCO Registration.

If I am not registered; how do I get paid?

Billing the patient directly, and having them submit their invoices to their Insurance Company, will be the easiest way to avoid the FSCO registration. It is only the submission of the OCF 21 (invoice) through HCAI that requires obtaining a license.

Registering for the FSCO Service Provider License

Those are the easy questions, and answers, for people not wishing to register with the FSCO and not submit on-line direct billing in the future. The rest of this article will focus on helping people understand how to be part of the FSCO model if they do elect to do billing directly with HCAI.

Sole Proprietor

The first thing that has to be done is to identify what kind of business you own; for most RMTs, that will be the Sole Proprietorship. This means; you have a single-person operation and make the decisions about how your business operates. It will also mean that you will be required to pay the full $337 application fee, the $128 annual fee for each unique business location that you will be at, and finally $15 for each unique statutory benefit claimant. Unique claimant means each patient, and each time they have a MVA; not the number of OCFs that were submitted.

An example of a Sole Proprietor with multiple locations:

Joe Scapulat Massage Therapist works at Charles Mandibulane DC, Jennifer Hyoidson Physiotherapy, and also out of his home. Joe only treats MVA’s from the Chiropractic Office and Physiotherapy Clinic. In 2013, Joe treated a total of 14 patients. Therefore, Joe’s initial Licensing fee will be:

Application …………….$337.00

DC Location ……………$128.00

Physio Location ………..$128.00

14 x $15 ………………..$210.00

TOTAL ………………$803.00

Joe will need to pay $803.00 in his first year to be licensed through the FSCO. In subsequent years, it will be a minimum of $256.00 before the claimant fees are assessed, assuming he continues to provide post MVA care at 2 clinics.

The regulatory fee (defined as; the annual fee and the claimant fee) can be prorated though in the year of application. The application fiscal year for the FSCO Service Provider License is April 1 through to March 31 in the subsequent year.

The first year regulatory fee will be from Dec 1, 2014 to March 31, 2015; or 4 months. Therefore Joe’s fee would be prorated to $492.33 ($337 + $155.33) in that scenario.

Business models other than Sole Proprietorship

If your business type is any other besides Sole Proprietor, then the fees will be calculated in very much the same way, except they will be assessed to the business entity; and thus can be shared by all partners, or taken out of the profits of the business, or however the people who run the business decide to absorb it.

We will run another example below for these types of businesses. The Clinic has three locations, and each location accepts 2 new MVA patients per week, on average, for a total of 312 unique claimants per year.

Application …………….$337.00

Central Location ………$128.00

North Location ………..$128.00

East Location ………….$128.00

312 x $15 …………….. $4680.00

TOTAL ……………… $5401.00

Per clinic……………….$1800.33

For any of these business types, if you are the registrant, you will need to appoint a Principle Representative. This person will be responsible for filling out the application and complete the attestation. When you have decided who this will be, they can go to http://www.fsco.gov.on.ca/en/Pages/default.aspx and learn more.

Avoiding paying the full fee and minimizing your risk

This is most likely the section that a majority of RMTs will wish to follow, if you are looking to avoid paying the fees, or wanting to reduce the fees you could pay.

A RMT who works at a clinic, or multiple clinics, or even if they are a Sole Proprietor, has the ability to utilize said clinic’s FSCO License through their HCAI account. This means that you can still be an Independent Contractor and provide services at/for a clinic without having to register your own HCAI account.

Dependent Provider

In HCAI terms, this is for a practitioner who will supply services for a registered facility/service provider, but will have no capacity to access the HCAI system.

As the provider you, in simple terms, allow the facility to send in all forms electronically on your behalf through HCAI. You also agree to provide services on behalf of the facility and not submit forms yourself. But remember; it does not preclude you from supplying services to another facility/clinic and having them submit forms for you.

In this scenario you will most likely want to submit a paper version whatever form you want to use to the facility’s staff member who is the HCAI administrator. Be certain that the treatment plan has been approved by a Health Practitioner (OCF 23 or OCF 18) to start or continue a claim. The administrator can then transcribe the form for you into HCAI. They will also need to transcribe the appropriate follow-up invoices (OCF 21) for the submitted Treatment Plan.

To register with a facility under this type of arrangement the RMT must sign a Dependent Provider Form. Read this over, and determine further if this seems like the best option for your relationship with a facility/clinic/provider.

http://hcaiinfo.ca/Health_Care_Facility_Provider/documents/DEC%20Enrolment/DependentProviderTermsandConditions.pdf

Affiliated Provider

As an Affiliated Provider through HCAI you will be able to access the HCAI system. You will be provided with an HCAI User-ID that will allow you to use their system.

Being this type of provider means that; you will provide service for, and on behalf of, a registered facility. You will be able to access HCAI for submitting all forms, including the OCF 21, through the facility’s HCAI portal. Th facility will determine how much access you have. You may just have basic access to submit and view forms, or you may be granted access to manage the system. This will be between you and the facility.

You will still make paper versions of the OCF forms to keep for your records. These will help you to complete the online versions for submitting.

To register with a facility under this type of arrangement the RMT must sign an Affiliated Provider Form. Read this over and determine further if this seems like the best option for your relationship with a facility/provider.

http://www.hcaiinfo.ca/Health_Care_Facility_Provider/documents/forms/AppendixA_AffiliatedProviderForm.pdf

For both Provider types

By being either an Affiliated Provider or a Dependent Provider for all your MVA claims, you will not have to sign up individually to obtain a Service Provider License. This, of course, means that you will not have to pay the $377.00 fee to apply, nor the $128.00 annual fee. But it does not mean that you should outright expect to pay nothing.

For each MVA claim that you are part of, there will be a fee component that is assessed to the facility because of you. It will be crucial that you negotiate the terms of providing service ahead of time. Not having a clearly defined contract can result in you being levied with many fees that you did not plan/save for.

Some of the fees you will need to pre-determine how they will be absorbed, and who will absorb them, are the; 1) application fee 2) annual fee 3) per claimant fee.

It is my opinion that the clinic should be absorbing the one-time application fee of $337.00; as it is a “forever fee” and will essentially become less and less of an impact the longer the clinic exists. Plus it will apply to all providers who ever work for/with them, and it would be unfair for you to pay part of this fee when a subsequent provider will not. The fee should be considered part of the split the facility keeps from you and is thus paid from that revenue.

The yearly licensing fee should be absorbed the same way as the application fee, in my opinion. It should be absorbed by the clinic and considered part of the split collected by all providers in their facility.

By being a provider for the clinic you will be paying the facility monies already for rent/administrative fees. Therefore by having you provide a valuable service such as MVA care; you will already be making their investment worth more and pay them back more.

The $15.00 per claimant fee is the only real fee that is assessed sporadically and non-fixed; on a yearly basis. This is, in reality, the fee that needs to be negotiated as to how, and who, will pay. If you are the only provider on a claim then your claimant will generate a $15.00 assessed fee that will be charged to the facility in the following year. You can negotiate that this is part of your agreed upon split/rent, or you can agree to pay it separately. If you pay a split percentage to the facility; it is my opinion that it should be absorbed by the facility. If you pay rent, it is then my opinion that you should pay this fee to the facility above your rent.

Interpreting the Unique Statutory Benefit Claimant component

The FSCO has not been exactly clear on the interpretation of this component of their new licensing structure. But it does appear that it means for a single claimant who presents to the facility (Licensed Service Provider) for a unique MVA that they were involved in. This would mean that the $15 fee is assessed once per facility, per claimant, regardless of the number of providers who are involved in the case. Therefore the $15 will be assessed only once, and theoretically shared, amongst the providers.

Below is a chart to show the benefit of having a single registered provider over having multiple Licensed Service Providers within a single facility.

Examples

Clinic ‘A’ has 4 independent Service Providers; each with their own FSCO License. The Physiotherapist who owns the clinic has registered as the main facility. In a single year the clinic sees 100 individuals for post MVA care and each therapist is involved at some point.

Therapist Physiotherapist(Owner) Chiropractor Massage Therapist Kinesiologist
Annual License $128 $128 $128 $128
Per Claimant $1500 $1500 $1500 $1500
Totals $1628 $1628 $1628 $1628

Total collected by FSCO from Clinic ‘A’………………………..$6512.00

Clinic ‘B’ has decided to have the same set up and use 4 therapists to provide services to patients also. But the Physiotherapist who owns this clinic has decided to have each contractor work as an Affiliated Provider under her facility name. All the other parameters are the same as Clinic ‘A’.

Therapist Physiotherapist(Owner) Chiropractor Massage Therapist Kinesiologist
Annual License $128 $0 $0 $0
Per Claimant $1500 $0 $0 $0
Totals $1628 $0 $0 $0

Total collected by FSCO from Clinic ‘A’………………………..$1628.00

By pooling the resources of the professionals all working together, Clinic ‘B’ has saved $4884.00 in a single year over its twin clinic for the 100 unique claimants seen. This strategy, as I see it, is the most beneficial to everyone involved. This makes the Clinic ‘B’ model a strong point to negotiate from for your own contract to help cut costs. More importantly though; the whole Medical Team should look to adopt and take advantage of this model within a single facility.

The bigger the “facility” the smaller the costs.

How to help each other

Several RMTs will actually be Sole Proprietors working in a single location with other Sole Proprietor RMTs. Each of you will be required to pay the fee’s yourself separately, unless you decide to work together.

The principal RMT who is renting the space should be appointed as the FSCO Principal Representative. All other RMTs can then use that RMT’s HCAI account and become Affiliated Providers, at the same address, under them. You will all essentially become partners for post MVA care. As partners, it should be arranged to split the Application Fee and the Annual Fee equally. Each person should pay their own “per claimant” fees.

If you choose to do this; another option is to form an actual company. The cost of registering a business in Ontario, and using it to sign up for HCAI and a FSCO Service Provider License, can be cheaper than even 2 people obtaining separate Licenses. The name can be a “generic” Ontario business name with unique numbers following it assigned by the Government. Ie: Woodstock Massage Therapy Clinic 9876543212345 (Not verified as being unique). Only use this option if you are comfortable with creating and running a separate business entity as you will need to: create a bank account, do payroll/payouts (for each RMT), submit business taxes, etc..

______________________

Sources

www.fsco.gov.on.ca

www.hcaiinfo.ca

Bryan Quesnelle
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Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
Follow Me

Healthy Emotional Boundaries for Massage Therapists

Lee Kalpin, an RMT from Holland Landing, Ontario, has created a great instructional video on maintaining healthy emotional boundaries when dealing with members of the public.

As a rule, RMTs spend a great deal  more one on one time with their clients than most other health care providers. As a result, clients have a tendency to share a great deal of information about not just their health, but also a wide variety of issues occurring in their lives. On many occasions, this can lead to a blurring of professional boundaries for the massage therapist, including scope of practice issues, transference and counter-transference, and dual relationships when clients see us more as ‘friends’ than health care workers. As a result, maintaining healthy boundaries with our clients can be challenge, especially for repeat clients we have seen over long periods of time.


Bryan Quesnelle
Follow Me

Bryan Quesnelle

Massage Therapist and Web Developer at ClinicWise
I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.
Bryan Quesnelle
Follow Me