The Guide to Massage Career Pathways

May 29, 2023

In this guide, we will explore the part-time career pathway, self-employment, employment and the combined career pathway.

In massage therapy, part-time practice, which can vary from a few hours per week to half time and three-quarters time, is common. This is a great option for those wanting supplemental income.

Part-time work might look like a second career for retirees, a doable job for a family with two working adults plus children, or simply augmentation of another income while being of service as a massage therapist.

Part-time work makes more financial sense when one is an employee because there are no business overhead costs to cover. Many employers are happy to have part-time massage therapists and will accommodate scheduling requests when possible. The employer is more likely to adapt to individual part-time scheduling if the massage therapist will work peak, high-demand hours, which are weekends and some evenings.

It is also common to combine two or three part-time positions for a varied full-time practice; for example, a schedule could consist of three days at a chiropractic clinic and a couple of shifts at a massage therapy franchise.

For ethical purposes, the massage therapist should provide massage services to different client populations; such as, seeing one client base at a franchise and seeing another client base at a home health service. Always disclose dual employment arrangements to both employers, in order to maintain professional ethics.

You can also work part-time as a massage therapist and part-time at a non-massage occupation, which will allow your body to rest between sessions. You could also cross-train into a similar occupation, such as esthetician, yoga teacher, certified nursing assistant, personal trainer or emergency medical technician—or another.

There are advantages to self-employment, including more freedom to self-direct the business structure and choose the techniques one practices, flexibility in scheduling work hours, long-term financial security and professional status.

Sole practitioner, or self-employed, massage therapists may work from a home office or go to a client’s location to keep overhead costs low. It is also possible to rent a workspace or share space with other massage therapists. This arrangement helps manage overhead costs.

Self-employed massage therapists do not have issues with difficult group dynamics or lack of teamwork, both of which might arise in employment.

Disadvantages of self-employment include numerous responsibilities, both for business concerns and for client services; as well as isolation, lack of peer support and supervision if working alone, and the inability to leave the business for any length of time.

Self-employed people must be self-starters with a broad range of professional and business skills. There is full responsibility for self-employment taxes and insurances. It takes time to build a client base for a reliable income. Professional status is related more to massage skills and professionalism than business ownership.

Some people think self-employed individuals get to be their own boss; not so. Every client becomes the boss. However, those people who are self-employed do determine and enforce their own business policies and professional boundaries.

The massage profession has seen a steady increase in jobs and career opportunities in which the massage practitioner works for an individual or a company at a wage-based income.

It has been 20 years since massage therapy employment became commonly available. This occurred primarily through the expanding franchise business model. Now, employment for massage therapists is available in many sectors.

Opportunities for employment exist within personal service, hospitality, fitness, wellness centers, franchises, recreational industries and medical establishments. Massage professionals are employed by physicians, physical therapists, mental health professionals and other health care providers.

The massage therapy community did not embrace employment when it began to expand in the early 2000s, seeing it as a major shift in the status quo. Unfortunately, even today people will disparage massage therapy employment. Twenty years ago, employers were new to the massage world. In the beginning, there were unrealistic work expectations and wage calculation issues.

However, most employers have learned from the past. Today’s employers value massage therapists, recognize the importance of self-care, and have increased income to the point where one national survey found that massage employees make more income than self-employed massage therapists. Most employers provide some continuing education and other employee benefits.

There are advantages to being an employee. You are not responsible for any of the business concerns and can focus most of your professional energy on client services. The employer pays the rent, covers marketing costs and purchases the table, linens and all other massage-related supplies. Business owners or managers enforce business policies, offering a layer of protection from conflict with colleagues or clients. Employee status usually involves working with other professionals in some way, creating an environment of support and mentoring.

In addition, you also have such government protections as Equal Employment Opportunity laws, the Department of Labor’s Unemployment Insurance programs, and the Department of Labor-enforced Fair Labor Standards Act, which sets basic minimum wage and overtime pay standards. Employers must also manage payroll taxes for each employee to cover potential unemployment benefits and future Social Security and Medicare costs. Employers also have to withhold income taxes.

Disadvantages of working for someone else are found on the flip side of solo-practice advantages: The employed massage therapist doesn’t get to direct the business structure or choose the techniques offered in a session. The employee might not have as much flexibility in work hours. Issues related to group dynamics or lack of teamwork might arise. Employees work in a shared workspace and do not choose the décor.

It is also possible the employer does not run an ethical and efficient business. If you are an excellent employee, you deserve to work for an excellent employer. Also, if you are not an excellent employee, the employer has the right to terminate your employment.

An option for massage therapists is the combined career pathway. Because massage therapists are able to work in a variety of settings, a combined practice is an option—part employee and part self-employed.

If employed it is essential that you behave in a manner that is ethical and loyal to your employer. Always tell the employer you also work as a self-employed practitioner. Be an excellent employee. Do not attempt to move clients from the employer’s business to a self-employed private practice. Maintain a reliable employment schedule.

This is also key: When developing a combined career path, make sure the private practice is distinctly different from the employer’s business. As examples:

• Employee works in a medical pain clinic and is self-employed providing on-site massage to athletes

• Employee works in a local spa and is self-employed providing massage to a few homebound clients

• Employee works in a massage franchise and is self-employed at a home office if living at least 30 minutes from the franchise location

• Employee works at a chiropractic office and is self-employed in shared practice rental space working with people who are not patients of the chiropractor

The concern of the combined career concept is the employer often ends up with an unequal deal, as the self-employed aspect of the employee’s massage practice may grow and reduce availability on the employee schedule.

The combined practice works only when it is a win-win situation. If you plan to leave the employer and focus on being self-employed full-time, communicate, and be responsible and respectful.

Be logical when investigating career options. Avoid give in to pressure by others in the massage therapy community who may provide biased or outdated information on both employment and self-employment.

The research-based understanding of massage, and practice of massage, are what have led to so many career options—and this aspect of the massage career pathway will continue to evolve.

Sandy Fritz is a founding member of the Alliance for Massage Therapy Education and the author of massage textbooks including “Mosby’s Fundamentals of Therapeutic Massage”; “Mosby’s Essential Sciences for Therapeutic Massage: Anatomy, Physiology, Biomechanics, and Pathology”; and “Sports & Exercise Massage: Comprehensive Care for Athletics, Fitness, & Rehabilitation.”

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