It's embarassing to admit, but over the years I've used a nickname for particularly challenging clients so I can talk about working with them in peer review without saying who they are or giving out other details.  Most of the behaviors that set me off aren't unpleasant on their own, but in extreme, well, the examples will probably speak for themselves:

* The person who does not appear to know what soap is.
   Enough said.

* The excessive moaner.
   Feedback is welcome, but loud repetitions of "oh yeah, THAT'S
   it" are kind of smarmy.

* The person who doesn't know the difference between
   Massage Therapist and Psychotherapist.
   A. Immediate, hysterical sobbing at the first touch continued
        throughout the entire session.
   B. Relaying every traumatic personal event.
   C. Requests for advice on personal matters.

* The dedicated nudist.
   My license requires draping.  I don't make the law, but I do follow
   it.  I'm not going to risk my license for someone who keeps
   throwing the sheet on the floor.  Your preferences do not trump
   my livelihood.

* The person who thinks massage parlour jokes are original
   and/or funny.
   Even if that comment was amusing once, it probably no longer
   was by the tenth time I heard it.  Just so you know, I stopped
   counting years ago.

Not too long after that, the gentleman did call back and explained enough about his leg pain that my initial concern of deep vein thrombosis (a major contraindication to massage) seemed far less likely, though I still mentioned it as a possibility not to be taken lightly.  As an MT, I can't diagnose or prescribe treatment, but when someone calls and is in pain, if there's a common sense suggestion I can make I'm happy to do so.  Because gentle stretching is often effective and certainly not likely to cause problems, I suggested he try a stretch, which he did while still on the phone and said made an immediate difference.

I don't know his personal situation, but presume he's had deep tissue massage before since he thought that was what he needed.  It had not occurred to him to stretch, which reinforces my personal belief that basic care and maintenance of the human body would be an infinitely useful subject to offer in primary education.  There are so many things most people don't realize they can easily do to feel better.

I was able to pass on a couple of phone numbers for massage therapists I trust who (as far as I knew) wouldn't also be out of town for the weekend and figured that was the end of it.

He surprised me by thanking me for calling him back when I was on the way out of town and offering a suggestions that he found helpful.  He said while here he grew to appreciate the Charlottesville community and indicated he would not have imagined a return call from someone unable to book a session.  My simple suggestion of a stretch was also something he said was (I forget his exact wording) above and beyond, and he would tell the people he works with about me the next day.  Because I was in the car (using a handsfree device - if you don't have one, please consider the small cost of one compared to a car accident) I didn't think to ask where he found my phone number or where he was from.

When, exactly, did common courtesy become superior customer service?  From my perspective, I returned a phone call.  That's hardly something of note, especially for a small business owner responding to a potential client.  For him, I did something special.  I don't know what that says about me, about his expectations, or about the way the personal touch has been removed from so many aspects of our lives.  Perhaps the most important point to all of this is the reminder that it's often the small things we do for others that mean the world to them.

I'm no expert in what is "usual and customary" for massage therapists who are employees or independent contractors.  My understanding is that the person actually doing the massage is paid a percentage of the actual fee charged in day spas, salons, and the like.  I remember the average being about 50%, though I've heard in recent years that some establishments which offer massage along with facials, body wraps, and other such treatments are now paying their hands-on providers 25 percent of the total fee they charge to the client.  Under those conditions, I understand why tipping may be common or even expected.  Certainly the idea of someone else making more than half of the rate my client thinks they are paying me is a large part of why I prefer to be an independent massage therapist.

My client's concern that she might have been underpaying me reminded me of how fortunate I am that I am in a position where it does not even cross my mind that my clients "should" pay more than my rates quoted online and in brochures.  For me, fee for service is fee for service, period.

Business has been booming, so what little time there is for writing has been diverted to the main website.  The good news there is that while business is brisk, our work continues to refine and improve - a thousand thank yous to those who have recently said they didn't know that was possible.

Thanks for your patience, and do check back on my writing soon.

Thursday, the Senate passed legislation which limits the "swipe fees" charged to debit cards. Because TYRMassage has accepted card payments for several years, I'm tracking this entire Act because of that portion of it.

Information is here:
http://thehill.com/blogs/on-the-money/banking-financial-institutions/97871-durbin-wins-battle-to-pass-qinterchange-feeq-legislation

and here:
http://www.paymentsnews.com/2010/05/sen-durbins-interchange-fee-amendment-passes-senate-on-64-33-vote.html

An explaination of of what these fees are can be found here:
http://en.wikipedia.org/wiki/Interchange_fee

More than one story has referred to interchange fees as something that will not ultimately be charged to either the card issuers or the "big businesses" which accept them because both will pass those fees directly on to the consumer. Yes, many businesses do charge processing fees when credit cards are involved. Treat Yourself Right is not one of them.

Use of a card is a convenience for many people. It does cost me a flat fee and a percentage of the entire amount to accept a card. That fee is not passed on; I consider it part of the cost of doing business and providing more options for my clients.

The legislation has yet to become law, so fees could still well skyrocket. The idea that I would feel the need to pass those charges on to my clients under the name of "processing fee" or to readjust all rates to make available a "cash discount" is something I find ethically objectionable.

Rates at Treat Yourself Right are rates. Offering a convenience, and then charging extra for it will not be happening in this office. That might not be the most business-saavy decision, and I point out there are currencies other than cash (or checks, credit, and debit cards.) My standards are worth far more than the few dollars I'm out each month to offer more options.

Last fall, I noticed I was having difficulty checking the time on the tiny clock I keep in the corner in my office.  Having needed glasses when I was younger, I wasn't at all upset to now need them again.  I had a nearly two decade reprieve from vision correction, so this was no blow to my "19 Forever" mentality.  That is, until the eye doctor used the word "bifocals."

"You're kidding, right?"  I asked.

No, he was not kidding.  After a bit of thought, I decided to go with contact lenses, since the last thing I need is to have my glasses slip off my nose and land on a client's back just as they are about to drift off to sleep.  Thus began my adventures in sticking little bits of plastic in my eyes every morning in a vain (ha!) attempt to deny the wear on my eyes from everything they've seen.

Enter allergy season.  I'm not severely affected (thank you, local honey taken daily starting in January) yet this year, my eyes were very much affected, thanks to the lenses.  Vanity, thy name is 40-something female, and thy slayer is airborne pollen.

Last week, I admitted defeat and put on my brand-new bifocals.

In the following days, I have learned a lot about myself.  I have learned that my head is constantly in motion, usually tilted to one side or the other, so I end up with a strange combination of clear and blurred vision as the reading portion of my lens edges up into my distance-viewing range.  I have learned that, yes, I really do need vision correction of some sort, because looking over the top of the lenses gives me an immediate comparison that use of contacts (which still take me sometimes a quarter of an hour to insert) can not.  I have also learned that for all my head bobbing about, I don't look down at enough of an angle to keep walking down a flight of stairs anything but a (not so) funhouse experience.

"Disorienting" does not even begin to describe the experience of glancing down to track the steps, only to have them suddenly blurred because they're not in the target zone.  In talking with other people I know who wear bifocals, this experience is standard, and will continue to be an undertaking which requires being mindful.  Added bonus:  when working in Maryland, I often need to go up or down a flight of stairs with my portable massage table.

I have now decided to add to my quest for a way to prevent clients' sinuses from backing up while face down on the table and patenting that apparatus or method so I can work by choice rather than necessity.  I am also looking to develop a method by which massage therapists who offer mobile service can safely, easily, and without too much thought carry their gear up and down staircases while wearing bifocals.  If I manage intellectual property rights on that, I suspect every massage therapist in the "aging population" demographic will be more than happy to kick in a few bucks to take the workshop or buy the book.

For me, it took a while to establish a regular schedule of receiving work for myself.  Scheduling can be an issue, especially when building an exchange between new (or new to the area) therapists and everyone is hungry for new clients.  Years ago, I discovered the hard way that if I was willing to reschedule my massage so I could work with a client, I simply would not get a massage, ever.  At times it seemed as if there was a message visible to everyone except me which flashed in bright neon:  "Massage Session Available only during This Specific Hour" and of course that hour was the one during which I'd arranged some table time for myself.  In 2000 when I had a grand total of perhaps a dozen clients, most of whom called me only once every few months, I was willing to work at whatever time the client suggested.  It is only because I'm stubborn that it took me several months to figure out that the work I could offer my clients was not as effective when I failed to get enough sleep, allow enough travel time, and take care of my own muscles, which now faced very different demands than when I'd worked a desk job.

In addition to practicing what we preach, part of the reason it's important for us as massage providers to receive work is purely structural.  Keeping our bodies functioning well is more important for us to maintain quality in our work.  It is important to receive massage to remember what works and what doesn't.  Lying face down on a massage table reminds me in no uncertain terms that doing so for long periods of time when sinuses are already sensitive to the touch thanks to allergens will not be the most pleasant experience for my clients.  Having my feet wrapped in warm towels while on someone else's table reminds me that the heat is still welcome, even when I don't need the space heater to warm up my office.  In my opinion, the difference between a good massage and a great one is not the application of the modalities, it is the attention to the individual.

Recently, I had the opportunity to experience issue-specific massage, rather than maintenance massage.  Fortunately, the literal pain in my neck didn't start until the night before my already-scheduled session with another therapist I've been exchanging with for years.  Had it begun when I had another 10 days or so before my next session, I would have needed to call around to see who I could book with on relatively short notice.

Most of the time, my body agrees to do what I ask of it without complaint, so I have the luxury of viewing my own aches and pains as insight into what my clients may be experiencing.  Of course what I'm experiencing is particular to me and everything I've done to set it off.  It is also a reminder of what it feels like to be in constant discomfort, which I'm glad to say is not my personal usual state of being.  It did, however serve as a perfect reminder of why it is so important to pay attention every session.

I've grown comfortable with making the decision once I realize the individual I'm working with is deferring to my expertise because they truly don't have a strong opinion on where we should spend the last five minutes of their session.  Other times, people simply want to not be the one making a decision and will reply "work anywhere  you want" or "anywhere you think needs it" when I ask for their input.  Still, the concern of being "That Person," the one who tells you what you need because they're The Expert and therefore know what you need better than you do yourself, is something I make it a point to keep in check.

I've been to bodyworkers who have displayed a "take charge" attitude as soon as I've arrived in their office, as if I am somehow damaged and in need of repair.  Admittedly, there have been times when that's exactly how I felt when I made the call to schedule the appointment.  Other times, however, I was looking for maintenence, and what I wanted was some attention to long-standing issues in my body.  Whether a new (to me) provider would accept my history of my body, or would offer their own, unique, and oh-so-definitive reason, (never before considered by me, my regular MT, my physical therapist, or the orthopedist I'd consulted because, after all, this new provider is an Expert who can work magic no one else can) would tell me a lot about about their staying power on my list of providers for personal care or referrals.  I am open to different perspectives and angles previously unconsidered.  I am less open to them when preceeded by "no, what you think is the reason actually has nothing to do with it."

Massage therapists are hardly the only ones prone to falling into the "present myself as a miracle worker" trap.  Somehow, though, for our comparitive lack of training, the arrogance factor among some massage (and energy work) professionals is what one might expect from neurologists.  Massage has long been considered a holistic treatment.  How a provider can fail to recognize the physical mass of symptoms that just walked through the door has a mind that has been searching for answers since the symptoms became apparent does not fit with the concept of treating the whole person.

For me, it all comes back to integrity.  If I'm out of my depth, I refer clients or potential clients elsewhere.  If I believe I have insight and the individual wants to hear it, I'll share it.  I also do my best to be clear that what I relay is from my particular perspective and not to be taken as Absolute Truth.  As for those times when I have no idea, I have no trouble at all saying "I don't know."  Perhaps I owe that to my teachers over a decade ago who were also willing to say "we don't know what happens, but the lactic acid theory has been ruled out."

Excuse me?  Massage schools still "teach" their students the equivalent of an urban legend that research has repeatedly proven false?  This would not be quite so disturbing for me had I and my fellow classmates not been set straight on the body of research on this matter back in 1998.

Okay, so anyone who knows me and my pride in my primary massage education knows that I am an elitist when it comes to massage training.  I would not be honest if I failed to acknowledge that right up front.  When choosing a massage school, I selected the one that did not require me to relocate for the duration of my education which was more expensive and less convenient.  I felt I would be more prepared for the career I planned to enter upon graduation than if I took what appeared to be an easier route.

Knowing this about myself, I have tried (perhaps unsuccessfully) to come to terms with what I perceive to be the decline in quality of massage training over the last decade.  More and more people are seeking massage every year, more and more people are interested in becoming massage providers, and therefore more schools are needed.  I can accept that, and a faster start-to-graduation time does not necessarily mean the education in that time is less than it should be.  However, that one partial sentence in a trade journal suggests to me that perhaps the quality of massage education really is as inconsistent as I suspect.  Why on earth are students, future emissaries of massage therapy to the general public, taught a fallacy now that we already knew was not true 13 years ago?

Not everyone is drawn to hard science, and of course the average M.T. should not be expected to be up to date on all the research.  If you've ever read a full research report, you know there is a lot of data to weed through, and it hardly reads like a novel.  Personally, I tend to be more technically-minded than most and I certainly don't keep all of the details in my head.  There is a huge difference between the massage therapist who says "I don't focus on the biomechanical, I prefer the experiential approach" and the massage provider who asserts false information, intentionally or unintentionally, in an attempt to justify what most people admittedly consider a luxury.

False claims reflect poorly on the entire field and support the sterotype of the air-headed masseuse who can barely cross the street without getting hit by a bus.  Perhaps schools which teach their students massage mythology are giving the public what it wants.  Maybe the average person who receives massage prefers fluff and fairytales over structure and science.  I don't see that it needs to be an either/or, though perhaps the faceless public idealizes the massage provider as a bit of an idiot savant.

Please weigh in on this.  I've started a poll on the TYRMassage page on Facebook here:  http://www.facebook.com/pages/Charlottesville-VA/Treat-Yourself-Right-Massage-and-Bodywork/99816313062

Why this massage legend took such hold, I don't know. Most likely, "massage removes lactic acid from the muscles" had some potential reality until scientific research methods became refined enough to actually test the theory.  In the meantime, it sounded good, so the theory was relayed as "fact."  After all, people want to know the treatments they opt for will be effective, and it's easier to believe that when you know why it will be effective.

Scientific research on massage therapy offers many challenges.  Funding research on a prescription drug which can be patented and sold for enormous profit is one thing.  Spending a lot of money on researching a process which has been public domain for thousands of years won't yield much of a return. Fortunately, there are organizations either dedicated to or assisting to support research in massage therapy:

http://www6.miami.edu/touch-research/
http://nccam.nih.gov/health/massage/
http://www.massagetherapyfoundation.org/

just to name a few.  Massage research in the last decade has gained considerable ground, but it's still under-researched, especially when one considers the amount of money that goes into marketing research over competing brands of soft drinks.

Another bump in the road is that the Gold Standard of scientific research is a double-blind study.  Because of the highly personal nature of massage, even if there were a way to offer a placebo, there is no way to keep the treatment provider from knowing that a placebo is what the subject is receiving.  Right there, responses could be influenced so results are invalidated and any research is questionable in the eyes of the purists.

That we have not yet determined why massage is effective in reducing pain and inflammation can be very frustrating for anyone who wants a definitive answer.  It helps to keep in mind that a common approach to medical testing and research is not to prove the current supposition, but rather to rule it out.  It is much easier to look for the presence or abscence of one particular compound than it is to attempt to identify and catalogue each one that could possibly be in the sample in question.

We don't know what, exactly, massage moves or removes from muscle tissue, but one thing we do know for certain is that it is not lactic acid.