Irene Diamond, consultant, CE provider, and developer of Active Modulation Therapy & Active Muscle Massage, speaks with us about what MTs can do when they can’t offer hands-on work. Diamond speaks about virtual/remote services within practitioners’ scope of practice and other options for serving clients when you can’t provide therapeutic touch.
This episode sponsored by ABMP.
00:00 Speaker 1: As a way to give back to the profession during this challenging time of COVID-19, ABMP is offering non-members free access and CE to some courses in the ABMP Education Center, each week, for a limited time. Simply register online, at abmp.com/ce for access. ABMP members earn free CE for all 200 plus courses in the ABMP Education Center, including the new Ruth Werner course, Taking the Danger out of Endangerment Sites.
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00:43 Darren Buford: Welcome to Conversations in Quarantine. My name is Darren Buford, I'm the Editor-in-Chief of the Massage & Bodywork magazine, and Senior Director of Communications for ABMP. Our goal is to speak with luminaries and experts in and around the massage profession, to talk about the effects of COVID-19 on body work practitioners, the fears, the frustrations and more importantly, to discuss next steps towards safely re-opening our doors, when the time is right. How to pivot now, how to prepare for the future, and discussing what the new normal might be. My guest today is Irene Diamond. Irene Diamond is the developer of active modulation therapy and active muscle massage, The Diamond Method. A consultant, a continuing education instructor, a Massage Therapy Hall of Fame inductee, and continues to practice in the San Francisco area. For a free marketing course, go to irenediamond.com.
01:32 DB: Hello, friend, how are you?
01:33 Irene Diamond: Hey, Darren. We have to talk about how to master this disaster.
01:38 DB: We do, absolutely. I've been looking forward to speaking with you. So, right now, what's the first thing an MT should do to support their clients who they cannot see in person?
01:50 ID: Yeah, a lot of therapists are going through withdrawals. [chuckle] They're used to touching and being in such close contact with their clients, that it really is a challenge for both sides. This is what I've observed, the therapists themselves are feeling helpless, at a loss, not able to really keep that connection that they once had, on a weekly basis, monthly basis, sometimes even daily basis, with their clients. And then the clients, on the other hand, are feeling that same distance, physically distanced. So, I think one of the most important things a therapist can do right now, clinic owners can do right now, is literally pick up the phone and call their clients.
02:30 ID: Now, you might not call people who haven't been in to your practice for a year or so, but definitely the people who've been in within the last three months. When I work with my coaching clients, three months is the period that we consider active clients, so even if they've been in once over the last three months prior to you shutting down, I suggest pick up the phone, call them. And it's not a sales call, it's a true, honest, heart-to-heart connection check-in. "How are you doing? I miss you. How's that neck pain that you are experiencing? Are you doing okay with food?" Like, just real serious questions of communicating one-on-one. Not as a provider and a client, but human to human.
03:13 ID: I think that goes so far in keeping not only the connection that was established way back, but also helping our clients see that we really do care about them, and we're not just thinking of them as a number, or as a paycheck. And so, number one, connecting with your clients, reaching out, seeing how they're doing. And then, if it's appropriate, you can transition into their therapeutic needs, because we are still a business. Now, that conversation transition may happen in that same phone call, or it may be, "Can I check in with you next week," or, "Can I check in with you in a couple of days?" The following conversation, asking them how they're doing with their therapeutic needs. So, that's the first thing, is really just seeing how they're doing.
04:03 ID: Second thing is, as those conversations evolve, identifying if there's any themes. The themes might be: We've got a lot of people who are in pain. We've got a lot of people, obviously, who have a lot of anxiety, a lot of stress. See where those patterns are, and see if they fit your practice model, see if they fit your skills and the focus of your business, and if they do, then we can start thinking about how can we serve our clients. Although we can't physically touch them, how can we still provide service?
04:37 DB: Would you recommend that... I know that I've been doing this myself, picking up the phone and speaking with people. But also I've kinda been taking it to just beyond just a phone call, and I've been doing a lot of videos, whether that's in FaceTime or whether that's in Zoom. I feel like that seeing a person really elevates that conversation. "Oh yes, there is a person there, on the other side." To me, especially like in establishing a formal therapeutic relationship, that seems like that might be valuable. Do you have any thoughts on that? Have you been doing that?
05:10 ID: Yeah, totally, but I'm okay in front of a camera.
[chuckle]
05:14 ID: You know, you and I feel comfortable with a video on us. So, there's that element of already comfort zone, and a lot of therapists don't have that. I'm all about like stepping out of your comfort zone and stretching, so if it's appropriate for you, people listening right now, to try it, absolutely, because then yes, they can see you. They see that... You know, they remember who you are, especially if it's a client. Maybe you remember them, and they might remember you, but then they see your face, and then it brings back all those memories of, "Oh, yeah. She is the one who did such and such with me," or, "She is the one who I really got a lot of relief from." So, whether it's over a quick little FaceTime, or a Zoom, or even... There's apps that you can create a video on your own computer and then email it to them, that obviously is best if you feel comfortable being able to jump in front of a camera.
06:03 DB: You mentioned clients in the past three months. Is there anything you could do, or should do, with clients beyond that three-month window?
06:10 ID: Yes. So for therapists or businesses who have email addresses, keeping the communication, sending emails is one of the best things to do to all their clientele. If you have not gotten email addresses, then in that check-in phone call you could ask, simply, "May I have an email address for you? Would you like me to keep you in touch with what I'm doing or my thoughts or helpful tips I might have?" Because clients are looking for guidance. They are looking for someone to support them. Getting email addresses, sending emails to all the past clients. And there's something called list segmentation. So you might have people who you've seen within the three-month, those are your active clients. You might have people you haven't seen for three years, so those are past clients. So I teach a concept, I call it the three Rs. First R is recruiting, getting new clients in. Second R is retaining current clients, and the third R is reactivating past clients. So this is a perfect time to do all three. Some people think, "How I get new clients now?" Well, we can and we are, and it's something that can happen.
07:24 ID: So retaining current clients and reactivating past clients can be done through email. So that's a really good way to keep them in the loop. Obviously, some of them may say, "Hey I forgot about this person. Let me call them because my low back's been killing me, or the stress is driving me crazy, or I'm home with the kids, and I just need a way to decompress for 30 minutes or an hour." So keeping in touch with past clients, retaining conversations with current clients, and then the new clients coming in. Obviously, people can refer. And the beauty of being virtual if we start talking about how to provide services remotely or through the internet, through video, etcetera, they don't have to be in your city. They can be across the country or other countries as long as it's within your scope of practice and your insurance covers you, and your licensing covers you.
08:16 DB: So this is a perfect time to transition. There are many practitioners who live in a state where we are in full shut down mode right now, but there are some other states that are slowly opening or will be reopening. So if your doors are closed right now, how can therapists take their physical services online and provide remote services?
08:38 ID: Yeah. So I actually am working with people, teaching them that now. And it's a hard thing for people to get their mind around because you're thinking, "How can I touch somebody? How can I provide a massage through a screen?" Well, obviously, you can't. So I give the example of somebody who cleans your teeth, a dental hygienist. So, obviously, they cannot clean your teeth through the computer, but they can still provide tremendous value.
09:04 ID: How? Well, you can open your mouth, and they can see what your gums look like. They can see your teeth. They can do an assessment or an evaluation through the video, and then they can advise you. They can guide you. They can give you suggestions. They can support you. They calm your nerves if you're feeling like, "Oh oh, something's really bad," and then they help reassure you that maybe it's not so bad, it's just a little whatever. So if we take that same concept for a massage therapist, first and foremost, yes, take out the concept of touching through the computer, 'cause we can't. But there's so much more we can provide. And for people who are aware of the concept biopsychosocial, which has been discussed now for years, and a lot of people know it, but they don't understand it. This is a perfect opportunity to really dive in and grasp the concepts, because now is when you can apply. Not the bio piece so much, but more of the psycho and the social.
10:11 ID: Actually, sitting right beside me, I happen to have... [chuckle] I call it the diamond seven-step success framework. So in my method, the Diamond Method, a seven-step framework that we follow in providing a clinical session. Now, of the seven only one, the M, is the manual manipulation or the massage. So that leaves six other pieces of the framework that we provide that has nothing to do with touching. And so, virtually, those six other pieces still apply. So I'll give you an example. The D is discover. So discover and discuss with the client what's going on. "How long have you had it? How is it on a scale of zero to 10? When does it increase? When you move your head this way or in this way?" So this whole conversation piece. Some therapists are already doing that in their one-on-one therapy sessions when they see a client in person, but that is not a throwaway. Some people see it as sort of like, "Okay, that's just 'cause I need to get through that, so now I know what to do with my hands."
11:25 ID: But that in and of itself has tremendous value. The client appreciates that. Why? Because now they're being heard. If you schedule a session that is gonna be about 45 minutes to an hour, they know that you've got your eyeballs and your brain on them for that length of time, which in and of itself is a gift, and provides a tremendous boost to this therapeutic alliance that you're creating with your clients. And then I, we investigate and go even deeper. You can take them through assessments through the video. So if it's a neck pain, "So let me see you take your head to the left." And the therapist watches the quality of movement, they watch the client's facial expression, if they are grimacing. They watch the differences from right and left. So we're not evaluating in a sense of diagnosing, but we are assessing. We're understanding more about what's going on with this client who we are working with. And so that's just an example of how we can start to transition to provide services through video that absolutely provides value.
12:38 DB: Is there a difference in how practitioners would charge for remote surfaces?
12:44 ID: The example I like to give is if you think of the other industries service providers, and their fee structure, who's making the most money? The advisors. Why. Not because we're paying a financial advisor to fill in the paperwork and submit it to the IRS. No. Because we're going to them for their advice, their strategy their understanding of our situation. And how we can get the best clinical results with our numbers with our books. So these advisors are the ones who provide a higher level of service to their clients. They take on the term fiduciary, responsibility. Because again, in a perfect world, they're advising based on what's good for us, not what's good for their own pocketbook, and I see us doing the same thing as therapeutic providers.
13:41 ID: When we can become an advisor. Our clients are happy to pay us. That's the strange thing, is clients want our high level service. And too many providers are afraid it's a big responsibility. See, that's the thing. It's a huge responsibility to take on ownership, and it's not like you're being responsible for their outcome, but you're responsible for guiding them, based again, on your total scope of practice, you're not going out of your scope at all, and you're honest about that. You might say, "I don't know this condition, I'm not familiar with it, I can't advise you. But if it's something that you have experience with or knowledge with and you've helped many people before and you know that it takes three sessions, it takes some stretching and some strengthening and or massage. Well, then that's what you tell them, if it's within your scope.
14:34 DB: Let's transition just for a second. Are there ways that clinic owners can generate revenue during the shelter in place right now.
14:43 ID: In addition to online services? Yeah, product sales is a super easy one. So people are at home. What tools, what supplements what relaxation music, any of these things. Again, that solves a problem. We can provide that and we can retail it, and it doesn't have to be things that you then mail to the client, it could be you work with an affiliate arrangement with other businesses, who have the products and they can mail them out. So you act as this middle person. There's a lot of therapists who do have online stores. There's an educator out of Canada, Dan Dylan, he and I put together a training. A few years ago. And we went over 12 different ways therapist can provide services to other people within our industry, that's not hands-on.
15:39 ID: So, for example, let's say they're good with website stuff, so for example, making somebody's website found on Google easier, it's called search engine optimization. So if somebody may be really good at that. Well, that's the service that they can provide to others in the industry. That is not hands-on. Maybe they're really good at marketing, they can do marketing for whether other massage therapist or any other business, they can do the financial piece. A lot of therapists are really great with providing therapy but they don't know how to balance their books. So if somebody's good at balancing books, they can provide that as a service. So again, I just see it as so much potential. There's so many opportunities for therapists to make money.
16:25 DB: This goes back to what you mentioned earlier with regards to expertise leadership and guidance. And I am speaking with that person right now, the session is over. What better time to do that. We see that in our sister associations with aesthetics and hairstylists those are Sister associations to ABMP, and back bar sells for them or it's tremendous that's a tremendous amount of revenue that they generate in addition to the services they provide. It's one of the things I wanted to bring up, because over the years, massage therapists have had the difficulty in transitioning between the healing services, the therapeutic services that they provide, and selling.
17:04 ID: That's right, and again, Darren. So with hairstylist, the sales of the color or the conditioner or the whatever, why is it easier for them to sell? Because they're focused on the outcome for the client? I go home, my hair looks fabulous. I wanna continue that at home, here's the product that's gonna allow me to do that. So the hairstylists think in terms of, again, the outcome the result. Massage therapists are thinking massage. But if they're thinking foot pain relief then an orthotic that goes in the shoe that cushion goes along with foot pain relief. So it's just a continuum of care. And yes, there's a retail aspect, but it's just, again, it's a whole different mindset, you're not being pushy when you're serving the client at a higher level. If you're trying to sell them a pen, and it has nothing to do with their clinical outcome, then it becomes salesy, 'cause they don't need the pen or the whatever. It's the mindset shift, it's a mindset shift. Are you massage therapist or are you a problem-solver? And if we are a problem solver, they want the solution to their problem and that can look like a whole bunch of different thing.
18:25 DB: Do you think that we will see a huge difference in how MTs practice after we go back to work? When states reopen local municipalities when that starts to happen. Will we see a difference in how they practice?
18:39 ID: I hope so. I mean for a lot of different reasons for health and safety reasons, yes, of course I hope so. Cleanliness awareness of disinfecting at least in the short term. A year or two. And you know people have short memories, and we kind of fall back into old habits. I think in that case, yes, in that regard, yes, for cleanliness and health safety. But from a business standpoint, I hope that people who have gone online, or who have diversified their practice through other services, that they can offer I hope they continue that and understand and recognize the value of having a few revenue streams as opposed to just one. Because again, too many people right now, they'll either be forced to shut their business completely because they don't have the cash flow.
19:29 ID: And for anybody in business hopefully people recognize it's the cash flow that sustains a practice. The money coming in the money going out, if you don't have the money coming in, but you still have money going out, you may not be able to open your door. So if the therapeutic component disappears even if it's just temporarily, but you have other streams coming in, that's what will sustain many practices. So, I hope people will keep those going and recognize that there is so much value. It also for people who maybe they've been in practice for a bunch of years and their physical body is ready to retire but they still wanna keep working and they still want revenue streams, they can close their physical doors as a therapist and still continue to be working. So yeah, I think in that regard, I do think it'll look different.
20:21 DB: In that same vein, what do you think will separate the therapists who master this situation right now, and those who will have to close their doors?
20:31 ID: Yeah. Good question. So the biggest thing is people's ability, and I don't wanna use the word but I'll use the word to pivot. It's such a cliche word now, but literally, those who can make decisions and who can pivot their business and change and course correct as we navigate through this, those are the people who are gonna keep their doors open. So we have to step back and recognize our practice may look a little different or completely 360 degrees different, and if we're okay with that and we're open-minded and we see possibility as opposed to problems, those are the people who are going to be able to get through this, because it's just a matter of optimistic approach. Okay, here's a challenge as a business person, as an entrepreneur, what do I need to do to either get around the problem get over the problem moved the problem? Those are people who do well, the people who see the problem go, "What a really big wall. There's no way I'm getting over that wall. I guess I'll just sit here and watch TV or put my head in the sand and hope it goes away.: Those are the people who are gonna be left behind or of course have to shut their doors. And there's a difference between people who are working for someone else, and people who are their own business.
21:54 ID: So I think a lot of people who are working for other clinics or practices or franchises, many of those people they're coming to me now and they're saying, "Okay, I'm ready to start my own practice." Because they see, either things that were being done that they didn't like. And now they've just said, "Okay, I'm done with us, let me move on and create my own dream practice." And so there will be a lot of new entrepreneurs going into business. And I think that's gonna be great. Again, it takes a certain person to run their own show. Not everybody's cut out to be a business owner, lots of people are great at being a support person within a business.
22:35 ID: And so, the support people are also having a chance right now to think about... To sit back and reflect, what was working, what was not working? When we open our doors again, what do I want? If you have employees, this is a perfect opportunity to clean house, to start fresh. If there's some people who worked for you and you didn't like them. You didn't like their attitude. See if you can up level them so they can change their attitude and they can be a team player, in your practice, in your business. Or, worst case scenario, you don't invite them back. But it really is a good chance for us to pause and to reflect and to consider, because as you know, we're always just marching forward, and we don't usually stop and think and analyze, and this is a fresh start, from so many businesses. Darwinian theory, right? [chuckle]
23:30 DB: What do you think MTs can do right now to take care of themselves; self-care, in this really challenging time?
23:37 ID: Yeah, self-care. Everybody has got their own way of taking care of themselves, but first and foremost, they must, literally life or death, literally. So the basic stuff, eating well, lots of hydration getting outside and nature as often as possible, at least once a day, hopefully stare at a tree. Studies show that when you see nature, you're a healthier. There sadly are people who are self-quarantine with an abusive situations or situations that are just not that hospitable I guess, is the word I come up with. So figuring out for each person, what do they need to feel their best, to be able take time, even if it's 20 minutes a day if you meditate, or you exercise or just sit and breathe, focusing on what they need for themselves to be feeling as well as possible.
24:42 ID: Because it's like on the airplane, if you put on your own math you take care of yourself first, then you can take care of others. And if you're not taking care of yourself, you then might become a burden on others. And in this situation with this virus, we really do need to make sure we're physically strong and capable to get through this, and then the mentally strong and emotionally strong. And luckily with Internet, we can find a relaxation meditation thing if we want to, we can talk with a colleague, we can reach out to a family member. There's so many ways of supporting ourselves, that people need to think about what do I need, what will help me. You can get ideas for other people, but really what does Irene want? What will make Irene feel good? And it's not about being selfish, it's about self-preservation to be able to help everybody else around you get through this as well, really important.
25:43 DB: I wanna thank Irene for joining us today. To find out more information about our Irene Diamond. Go to in irenediamond.com. Thank you so much, friend, this has been really great conversation, and I'm sure that our practitioners are gonna want to learn more and know more about how to... The word you don't wanna say, pivot right now in the situation, and maybe set themselves up, and more importantly, if they can right now, but also in the future as well.
26:08 ID: Yeah, for sure. It's an important time. It's an important transition time for all of us individually, as people, as our businesses and as a profession. And I am excited about where this can go, and I hope other people see the possibility. Thank you for you letting me share my thoughts.
26:26 DB: Absolutely, thank you so much.
26:28 ID: Alright, take care.
26:31 S1: Thank you for listening. If you haven't already done so, please subscribe to the ABMP Podcast on iTunes, Google Play or wherever you find your favorite podcast.