In March 2020, the world as we knew it radically changed. Massage clinics, franchises, and solo practitioners worldwide were ordered by local and national leaders to close their doors and stop providing manual therapy to clients. Because of these mandates, many therapists were left without a revenue stream. Even many seasoned practitioners who had been through other economic downturns were caught unprepared. However, many practitioners recognized long ago the importance of diversifying their practice and already had other streams of income in place.

Therapists who were able to weather the COVID-19 crisis are those who had a diversified approach to their practices and weren’t reliant solely on hands-on services to generate revenue.

Having had your physical doors closed for months, you can see how critically important it is to be prepared for any disaster through additional income diversification, as well as alternative ways to deliver your therapy services. Most businesses transitioned to include some elements of providing services online, and many of my coaching clients and I have successfully been providing therapy services in a format I call a “video visit,” which I prefer to “telehealth.”
For many massage therapists, it’s hard to imagine how to provide their therapy services through a computer.

Although it certainly is not possible to manually massage a client’s body through a computer screen, the good news is that it’s possible to provide amazing clinical results, such as reducing physical pain and relieving anxiety, via a video visit.

One of the first things to recognize when you transition from physical therapy touch to virtual therapy touch is to identify exactly what you are providing to your clients. I have observed that most therapists believe the only value to their clients comes from providing hands-on touch. Makes sense, right? You’re a massage therapist after all. Although I realize the concept of delivering something other than physical touch is unfamiliar to many practitioners, I submit that the value of a session with you comes from so much more than just physical touch.

Many massage schools do not teach the extremely unconventional notion that, as a manual therapist, you are providing many tangible and intangible benefits in addition to your physical touch. I can only scratch the surface here, but I suggest you look at the reality that you are providing a complete therapeutic alliance between you and your clients. If you are familiar with the biopsychosocial concept (the interconnection between biology, psychology, and socio-environmental factors), the simple act of a client scheduling an appointment with you begins to integrate all three aspects. Even when the session is held via video, your attention, advice, and guidance facilitates positive change for your client.

Most of the value your clients received from their sessions with you came from the entirety of their experience—not just how you applied your massage techniques. This is good news because that means you can still deliver brilliant clinical results via a video visit that clients are happy to pay for—even without you touching them.

To provide an effective video visit, you must first understand what your intent is for the session. The session structure may provide pain or stress relief for single clients or in a group format. Model your initial video sessions almost exactly as you would when the client comes to your office. The only physical difference, of course, is you’re “treating” them through a computer screen because you cannot place your hands on them.

I am currently working with a small group of therapists who are providing video visits. Some practitioners teach self-care techniques and methods that the client can continue to do on their own, which can range from self-massage, partner massage, strengthening, or stretching exercises to breath work. Other practitioners choose to use their session to advise their clients, guiding them through an actual therapy session. Rather than teaching the client what to do at home, the therapist proceeds with a plan of care based on the client’s presentation that day. Because the therapist cannot touch the client directly, they instruct the client on what to do to provide the manual pressure or manipulation. As the session progresses, the therapist advises the client where to place their hand to relieve their own pain or stiffness.

The most important (and difficult) part of providing video visits is creating and maintaining a therapeutic alliance with our clients. Building rapport and trust is different via video because we are now peeking into the client’s personal space, literally their living room, or bedroom—and they get to see into our space, if we’re hosting sessions from outside our office. Because many of the usual visual cues are skewed, we need to take extra care to show our empathy and understanding of their situation. We also see ourselves on the video, too, which for some providers is alarming and makes them uncomfortable. If you choose to take on video visits, continue to be your warm, genuine self. Ensure your clients feel comfortable with every step, and let them know they may end the session at any time if they need or want to.  

Video visits are effective for not only providing a solid clinical outcome that your clients will be happy to pay for, but also for giving them a way to refer their friends to you now rather than wait until your physical doors reopen.
In addition to—or instead of—video visits, how else can you diversify your practice? You can begin by providing complimentary services. Although my San Francisco pain relief and wellness center had its physical doors shut on March 16, 2020, I wasn’t too concerned. I continued to receive revenue through writing articles, business-growth coaching, investments in other practices, and teaching continuing education. Once you’ve put a few revenue streams in place, you can generate substantial income from incorporating one or more of these adjunct arms into your business. To help you get started, here are six not-so-run-of-the-mill suggestions to generate revenue that don’t require any manual therapy.

How are you at web and text stuff?

So many practitioners are in desperate need of someone who can create or update their website, Facebook business page, LinkedIn profile, and the rest of their online presence. If you are skilled with a mouse and have the know-how to create effective web assets, there is a strong demand for your services.

Are you an experienced copywriter or pay-per-click expert?

Do you have a strong background in marketing and sales? Many therapists are extremely competent clinical practitioners but are not so great at expressing their ideas through the written word. If you can help them with their marketing, you could be hired to bring in clients for their practice.

Are you handy with a sewing machine or a jigsaw, or do you excel at interior design?

As you know, therapists will probably be required to wear protective clothing and retrofit their practices. Not everyone has the ability to envision how their new treatment room, front desk, or reception area may look or function. If you have the skills to look at photographs of an office space and suggest design ideas—or have material manufactured to complete the plexiglass desk shield, design plastic chair covers, or oversee adding required space between therapy tables—you could command a very nice income for your skills, knowledge, and expertise.
How are your managerial, speaking, and writing skills?

With new changes from COVID-19, small practices will need to update their operation manuals and employee handbooks. You can also submit articles to professional publications (like Massage & Bodywork), local and national media outlets, or be a guest contributor for blog posts and podcasts.

Do you think it could be fun to organize your own event?

Now is your chance to gather a group of continuing education educators or private practice owners and create your own online educational summit or entertainment production. You can charge a fee to attend or allow people to register for free, and then sell the recordings to bring in revenue as the producer of these events.

Are you great with numbers?

Data analysis and accounting principles are scary, if not completely lost on many providers; however, bookkeeping, tax paying, and keeping on top of business stats still need an owner’s focus. If you have a head for numbers, experience in tax preparation, or know how to analyze profit-and-loss statements or flow charts, there are many practitioners looking for you.

To begin, I suggest you choose one revenue stream that best fits your current skill set—and there’s no reason to go back to school or get additional training. Now might just be the time to go back and revisit any past career you’ve had and dust off those skills.

Even when COVID-19 is just a small dot in the rearview mirror, I encourage you to see how valuable it can be to continue incorporating additional revenue streams. We never know when some other negative event may interrupt our practice (like an injury, surgery, natural disaster, or another virus), and we are once again required to shelter in place. Or, your business plan may change due to a positive occurrence, like your desire to live a “laptop lifestyle“ traveling the world, living in other areas, or a life change, such as the birth of a baby.

I trust you now see the value in diversification so you can be more adaptable to any and all situations, both positive and negative. It’s smart not to have all our eggs in one basket, should the basket break.

I’m extremely proud of those of you who already have multiple revenue streams in place, and I encourage the rest of you to start considering how to add at least one additional service, based on your skills and professional preferences.

Irene Diamond was featured in our sixth episode of The ABMP Podcast series “Conversations in Quarantine.” To listen, visit www.abmp.com/podcasts.

For more information on how to structure virtual visits, join Irene Diamond’s free Facebook group at www.facebook.com/groups/preciseprivatepracticesuccess. To download a training for teaching “12 Additional Revenue Streams,” go to www.irenediamond.com/12-revenue-streams.

Irene Diamond is the developer of Active Modulation Therapy and Active Muscle Massage—The Diamond Method. Diamond is a business consultant, a continuing education instructor, a Massage Therapy Hall of Fame inductee, and practices as a pain relief specialist in her San Francisco Wellness Center. Diamond is working on her first book, Building a Profitable Precise Private Practice, due in October 2020.