Private Practice
vs Employment

Private Practice

Running a private practice is very different from working in a clinic or spa. You still have to perform the basic practice management activities, though in a different manner for each arrangement. At some point in their careers most massage practitioners work alone, either in a private office, home or out-call. A private practice provides freedom and flexibility (e.g., you choose the attire, clients, environment, music, modalities, fees and scheduling), and you can essentially do anything you want as long as it’s legal, ethical and moral. In addition to the general practice management activities, the sole practitioner must contend with other issues as follows:

Autonomy Along with the freedom of being on your own is the potential for loneliness and isolation. You are the one responsible for making certain everything is done, which often means YOU get to do it all—until you can afford to hire an assistant.

Finances When you are the only source of revenue in your business, you may not have the cash flow to purchase items when you want them. Often you need to delay financial expenditures such as expensive equipment (e.g., an office copier, computer or hydraulic table).

Marketing When you are in private practice, you are responsible for all the marketing activities to get new clients as well as retain your current clients.

Safety Safety is a concern for any business owner, but even more so for the person in private practice. You don’t always know who the clients are the first time they come to your office or the neighborhood you’ll be entering if you do out-calls or on-site services.

Benefits The only “employment benefits” you receive are the ones you pay for yourself (which kind of defeats the whole concept of “perks”). As a sole practitioner there are no true paid vacations, holidays or sick days.

Employment

Some people kick-start their careers by working at a spa or clinic, others take part-time jobs to augment their private practices, and there are those who prefer to only work for others. Spas are the number-one employers of massage therapists, followed by clinics. Working as an employee provides many benefits such as the possibility of walking into a full practice with little marketing; the ability to provide a larger scope of services for your clients’ well-being; starting out with a ready-made professional image; being part of a team with clear and established boundaries; reduced paperwork (there’s usually an office manager); the ability to focus on hands-on work; access to better and more varied equipment and supplies; an excellent built-in referral base; support staff to do the scheduling, place confirmation calls and handle financial transactions. Working in these settings also requires conforming to a set image, policies and procedures. You might need to alter your style and scope of practice to align with the company’s vision and schedule.

Client Contact You may be required to alter your treatments in terms of style, modalities and length. In a clinic setting the time you spend with clients and the actual work you do may be determined by the lead primary care provider. The most often cited complaint from spa therapists is the lack of control over the scheduling, such as being required to work several 50-minute sessions without a break. Another concern is receptionists booking a specific service even if it isn’t clear that the practitioner on duty is proficient in that technique or if contraindications are present.

You rarely get to choose your clients. In spas there is little chance to mark progress or make lasting connections because clients don’t return very often. Some spas also require massage therapists to perform other services when not doing their primary service. They often expect practitioners to promote services and products to their clients regardless of whether the practitioners like them.

Finances Some spas hire therapists as employees and others as independent contractors. Compensation varies greatly. If the spa isn’t well-known with a high guest count, there might not be a lot of work available for the practitioners—meaning your shift would not be filled. Spas often base salaries and preferential scheduling on seniority.

Working in these settings does avail certain perquisites. You can receive discounts on services and products. If you work at a spa, you usually can use the facilities and get free or low-cost meals. When hired as an employee, benefits can include health insurance, paid vacations, paid sick days, pension plans, profit sharing and reimbursement for continuing education.

Logistics Most spas have staff for the day-to-day activities of running the business (e.g., preparing the office for clients, stocking supplies, cleaning), but in some spas (and many clinics) these activities are shared by everyone. You need to know what’s expected of you when you’re not directly working with clients (e.g., paperwork, janitorial chores, clerical duties, assisting the other practitioners, providing treatments for staff and marketing). Whether you get paid for these activities depends upon your employment status.

You usually have to share the treatment room with other practitioners. This can be challenging if the layout doesn’t suit you well. The rooms may not be adequately sized or insulated, and the equipment may vary from room to room.

Marketing In a destination spa, you don’t have to do the marketing or scheduling of clients, but there is no guarantee that your work hours will be filled. Successful spa therapists excel at marketing to current guests for repeat sessions. Many practitioners (particularly in clinics and day spas) discover to their dismay that to increase their client flow they need to market their services actively.