Community, Commentary and Curriculum
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How Massage Franchises and Spas are Influencing Massage Therapy Practice
Posted January 8, 2009    Feedback comment@mtcoach.com  

In October[i] AMTA president Mary Beth Braun announced that a massive change is happening in the way massage practitioners work in the United States.  More massage therapists are now working as employees rather than as self-employed individuals.

Massage is going main stream with franchised-based business models opening up across the United States.  Franchises offer clear branding, consistent experience and typically lower prices in high-traffic commercial sites.  “Franchises offer a comfortable approach to trying massage for the first time” notes Massage Envy CEO John Leonesio.  Massage Envy, one of at least 10 franchise models in the U.S., provides more than 400,000 massage sessions/month, employs 7500 massage practitioners and ranks 82^nd on Entrepreneur Magazine’s Franchise 500 list for 2008.[ii]

Franchises offer a variety of services, extended hours and a reliable product.  Clients/patients who frequent a franchise know what to expect, and a highly visible commercial location may entice non-massage clients/patients to give massage a try.  Consumers pine for security in their purchases – that’s why they go to McDonald’s, Wal-Mart and Starbucks.  You can argue that you can make a better hamburger than McDonald’s, but they sell billions of them every year. 

Practitioners may complain franchise-based models lack personal and individualized care, offering cookie-cutter / assembly line massage.  Further, they may say discounting and price-cutting practises threaten the integrity of the work and will put many sole providers out of work.  Proponents of franchises respond that, by going mainsteam massage becomes available to more people, providing a consistent, reliable experience in an attractive, professional setting.  Almost a quarter of Massage Envy clients who make their first appointment have never received massage before.

I imagine other health care providers in the position of authorizing massage therapy treatment plans - physicians, physiotherapists, nurse practitioners and chiropractors – may be consciously or subconsciously encouraged by the highly visible commercial franchises to view massage as a solid and viable adjunct to their own therapeutic applications.  “It doesn’t help” may over time become “It wouldn’t hurt”.

Benefits for the practitioner include ready-to-go marketing and administration systems already in place.  Practitioners who do not have the will or skill to effectively market them selves and operate administrative systems to manage invoicing, payment, insurance claims and accounting could be attracted to working in a turn-key operation.  And of course there’s the start up costs of sole-proprietorship – rent and utility security payments, leasehold improvements, equipment, advertising, supplies…it can cost tens of thousands of dollars to get a massage business up and running with no guaranteed income for many months. Some franchises offer vacation pay, health benefits and a base pay for non-filled appointments.

“But what about the pay?”  One of the greatest criticisms I’ve heard for massage franchises is most of the service fee goes to the operating costs and profits of the franchise.  When a practitioner makes a comparison between being employed in a franchise or working as a sole practitioner they may consider the following questions: 

• Do I have the skills, the time, money and energy to manage my practice’s marketing and administration?
• How effective will I be in generating enough work to sustain my business?
• How much is my non-hands-on time (spent in marketing/administration) worth to me?
• What is the value to me for vacation and sick pay, health benefits, employment insurance and other employee perks?
• Would I actually be farther ahead financially working for myself?

I highly recommend two articles on massage franchises that appeared in Massage Magazine.  Massage Franchises[iii] by Karen Menehan and the Expert Advice column on responding to a massage franchise opening in your neighbourhood[iv] by Melanie Rubin. 

The marketplace welcomes many practitioners and forms of delivery for massage, so it may be alarmist to suggest the profession would completely convert to the franchise model.  There are however many benefits to the exposure massage franchises will bring, and massage franchises will likely continue to change the landscape of the way massage therapists practice.

The Powerful Spa Industry 

Spas have become a major employer of massage therapists.  The International Spa Association’s 2002 Spa Industry Survey suggests average annual growth of medi-spas at 18 percent, with cumulative growth of 143 % since 1997.  An estimated 25% of spa revenues come from massage treatments.  Fourty percent of guests are first-time spa-goers.  The number of spa visits increased 71 percent between 1999 and 2001.  The total revenues for spas in 2001 was reported at $10.7 billion.[v]

Kailee Kline, massage therapist and past president of the Association of Premier Spas of Ontario, is excited about the growth of the spa industry.  Kline sees the spa industry as an important provider of health maintenance and illness prevention programs in our society, a trend that has existed in Europe for centuries.  Kline states:

 “In some European countries medical benefits provide coverage for an annual visit to the spa. Medical doctors are present to prescribe and oversee the treatment program. In fact, travel for the benefit of your health has been such an important part of the European culture that a viable industry known as ‘Health Tourism’ has been prominent for centuries, although not labelled as such, until recently.”^[vi]

Kline describes that the Association of Premier Spas of Ontario was established to encourage quality standards in an industry experiencing rapid growth.  The association has 39 members that apply a number of high standards, including the employment of only registered massage therapists to provide massage at their spas.  All spa members must fill out health history forms to ensure treatments are “appropriate, safe and productive.” 

At the launch of the association in May 2000, Elizabeth Witmer, Health Minister of Ontario, stated the Ministry was redirecting its focus away from illness towards wellness, and that the association could play a role towards achieving that goal.  The Canadian Tourism Commission (CTC) has been monitoring the growth of the spa industry, and is examining “the feasibility of positioning Canada internationally as a destination for Health and Wellness Tourism.”^[vii] 

Kline states that the baby boomer generation plans to maintain a high quality of health as they age.  They are also introducing aging parents to the spa experience, necessitating further the need for highly trained health professionals to staff the spas.  She reports there is a need for the current curriculum to prepare these professionals for spa work, as the current shortage directs some spa owners to turn business away, or to hire individuals with lesser qualifications and then train them in the spa methods. 

However, not all spas in Ontario appear to be operating at the high standards of the Association.  In the May 2004 issue of The Finger Print, Debra Curties, Academic Director of Sutherland-Chan Massage Therapy College shared several complaints from recent graduates regarding their experiences as spa employees.  She cited examples of therapists docked 10 minutes pay for taking case histories, and that is some instances taking case histories and keeping files was strongly discouraged.  This was, in effect, seen by the spa’s management as a way to lower their liability - to hide the evidence if adverse reactions occurred.   Curties described the work environment, where registered therapists provided services concomitantly with non-registered practitioners, and the “trend toward salarizing massage therapy jobs at levels well below $20 / hour.”^[viii] 

Corinne Flitton, assistant registrar to the College of Massage Therapists of Ontario (CMTO), admitted the College has no jurisdiction over spa owners, unless of course they themselves are massage therapists.   The College provides information to anyone wishing to understand the regulations regarding massage therapy, including the CMTO’s presence at the 2004 International Spa Show in Toronto. 

Flitton described that therapists are sometimes faced with difficult choices as they balance the standards of practice with the business systems employed by the spa.  She encourages therapists to be clear on the terms of employment before accepting any position with a spa, and that these terms should outline the requirement by the therapist to follow the Standards of Practice and the Code of Ethics.  She also encourages therapists to support each other in this constantly changing and ever complex environment.  Flitton encourages therapists having difficulty to call (their professional association), which advocates the interests of its members.^[ix] 

It appears the spa industry will continue to influence the massage therapy profession, creating more opportunities for massage therapists to be employed in providing spa services.  We may see dramatic shifts from self-employed therapists to spa employees, with increased need for skills in spa treatments, communication, and team-building to effectively work within this burgeoning industry. 

The shear power of the Spa industry may also have considerable influence on salaries paid to massage therapists, work hours and the way spa-therapists practise.  Because massage therapists tend to be the highest paid staff in the aesthetics/spa environment, we may expect to see downward pressure on their salaries.  dqd

© 2009, Donald Q. Dillon, RMT.  All Rights Reserved.

No part of this article may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.

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