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<div id="articles1"> <h2>The Employment Quandary</h2> by Cherie Sohnen-MoeOver the years I've heard a tremendous amount of grousing about the working environment for massage therapists. Employers lament over the lack of reliable help and therapists complain about their bosses, low pay, and poor working conditions. The time has come to shift from complaining to finding solutions. In my quest to for the core issues behind this problem and to develop an employment model that is satisfying for all parties I interviewed numerous therapists and employers.<h3>On the One Hand. . .</h3>The majority of therapists I interviewed were unhappy with their employment situations and viewed them as adjuncts to their private practices or as temporary positions until they built their practices (similar to the vast number of actors marking time as food service employees). One massage therapist I interviewed has been in practice for more than five years. She worked at a center as an independent contractor for two years. Her two main reasons for taking this job were to gain experience and have a regular schedule. She originally anticipated it as a long-term arrangement, but was unwilling to stay due to the problems and built her private practice.The therapists that were pleased with their employment arrangements either worked in environments where the business owners had excellent communication skills and demonstrated respect for the therapists, or worked in busy spas (where they didn't have to worry about sitting around and not getting paid), that paid them well, and had reasonable working conditions.The most often cited benefit was not having to do laundry. Therapists working in spas expressed enjoying working with clients from a variety of backgrounds and therapists in clinics or centers stated they liked the opportunity to work with the same clients on a regular basis.Spas are the largest employers of massage therapists. Spas provide a luxurious atmosphere. The clients are usually easy-going and appreciative. Spas often provide significant training benefits and cross training. The equipment tends to be first rate and products are of high quality. The average therapist can't afford the amenities that a spa provides. Indeed, working in this environment can be fun for therapists. Plus the spa handles marketing, bookings, and financial transactions.The major disadvantages to working in spas include: lack of control over the scheduling (such as being required to work several 50-minute sessions without a break); having to perform services other than massage (e.g., hydrotherapy, wraps, and paraffin treatments); no discretion about clientele; and a reduced session fee. One therapist shares, "The general sensation I experience is that I exist to fill out 'packages' of services for which I receive a reduced rate of commission and then the session is rushed by the manager because the client needs to be ready for her pedicures or whatever. Not that the clients want to rush, they'd be happy to get a full hour. . ."Most spas now hire therapists as employees. Over the past few years government agencies have forced many spas to reclassify their therapists from independent contractors to employees. Therapists have also successfully initiated lawsuits for reasons such as employment misclassification and age discrimination. Another instance of therapists taking action is currently occuring at the Spa Claremont at the Hotel Claremont in Berkeley, California. The therapists are attempting to bring the spa employees into the Hotel Employees and Restaurant Employees Union, so that the spa will be required to respond to their employment problems.The concerns expressed by the massage therapists all had a similar base: they felt taken for granted. One therapist remarked, "the invitation to work for companies was always very inviting and promising. . . but in the end always turned out to have a totally different set of (their) rules and/or regulations."The therapists also resented being required to sell products about which they weren't properly trained such as aromatherapy, tinctures, vitamins, nutritional supplements, and skin care products. Another cause for dissention was doing management or receptionist duties during a full massage shift.Staff meetings are often unproductive. Instead of being a forum for professional growth, discussing client issues, sharing techniques, and networking, therapists complained that the majority of meetings focused on increasing revenue.Inconsistency is also a major concern. Owners often don't uphold standards and agreements. For instance many therapists shared that even though everyone was supposed to participate in promotional endeavors such as open houses, charity events, and sporting events, it seemed that it was always the same few people doing all the work.Giving certain clients preferential treatment can cause morale problems as well as a loss of clients. One therapist stated that she would see the owners apply different standards and business practices depending on how much they liked a client. One example of this is the cancellation policy. If the owners liked the client, they'd extend professional courtesy. If not, they would bill the client or take it off the client's pre-paid package. This same center highly discouraged the client/therapist bond. The owners didn't want the clients to get "hooked" on a specific therapist. The therapist I interviewed was very skilled and had a high rate of client retention so the owners tended to give her the new clients. Unfortunately, they did not honor her "regular" clients. Often when a regular would call and specifically request her, that client would be told that she wasn't working that shift (even though she was) and would be booked with another therapist. Imagine the bad will that was generated when that client showed up for an appointment with a different therapist and saw the therapist she had requested. Yet if it was a favorite client of the owners, they would let the client book with the requested therapist. Also, whenever a favorite client would call for a massage, they would schedule it with one of their "better" therapists (even if that therapist was already scheduled to work with a client who had specifically requested that therapist) and would bump the "non-favorite" client.When asked what would inspire them to continue working for a company, the responses were mainly: better pay, benefits; allowed to keep regular clients; improved communication; and sharing the "yuck" shifts. One therapist put it quite succinctly: "A constant stream of well-tipping clients scheduled according to my needs."The therapists' advice to employers is: utilize excellent communication skills; be very clear on business ethics; don't expect more than what you pay for; set and enforce standards; compensate therapists for office duties and business building activities; provide training; pay fair wages including raises and bonuses; provide benefits; and demonstrate respect for all clients.Their recommendations for therapists who are considering hiring on as an employee or independent contractor are: be clear about your boundaries; clarify roles and expectations; and make friends with the receptionist.(I interviewed many employers and therapists who work as employees and independent contractors. It is interesting to note that almost every individual practitioner wished to remain anonymous, while the employers were quite willing to publicly share their stories.)<h3>On the Other Hand. . .</h3>The employers profiled in this article represent a variety of management styles and the environments ranging from a 5-person on-site chair massage business to a center with 33 therapists. All the employers interviewed stressed the importance of good communication and mutual respect. It would have been interesting to interview the employers of the unhappy therapists. I imagine they are probably not cognizant of the problems or place the blame on the therapists' attitudes.Finding qualified, reliable help is a major concern, but most of the owners seem to have developed effective methods to recruit, interview, train, and retain staff.All of these employers have the desire to build businesses where everyone thrives and it's a joy to show up for work. Their expectations of the therapists are rather basic: likes people and is friendly; shows up on time; loves massage and gives great massages; communicates well with clients and co-workers; takes initiative; respects boundaries; is cooperative and compassionate; keeps good personal hygiene; takes on-going classes and workshops; and is trustworthy.<a href="#seniortouch">Sharon Long (see profile below)</a> states the ideal employee is "Someone who is as interested in making your business as much of a success as you envision it. Someone who has pride in his or her work and is willing to follow your suggestions to make the people your company serves return time and time again. Someone who wants to learn." She also advises employers, "Your employees reflect you and your company. Make them be the best they can be. . . it's that simple.<h3>Employer Profiles</h3><a href="mailto:pegabel@hotmail.com">Peter W. Gabel</a> American Therapeutic Massage 29930 W 12 Mile Rd Farmington Hills, MI 48334 248-851-3700The massage therapists at American Therapeutic Massage are at-will employees. Gabel has been in business for more than 10 years and currently has 25 employees in two locations, although he always seems to be one or two therapists short staffed. His company advertises extensively in the major massage publications and through local massage school placement programs. Their hiring process includes an 1.5-hour interview followed by three, one-hour audition massages. Gabel says, "We receive a large number of inquiries, yet most of the inquirers do not persist through our selection process. Many therapists choose to drop out after learning about the job requirements, such as signing a non-compete contract, not having visible tattoos or excessive piercings, or working weekends and evenings. Of those that complete the selection process, we find that many lack very basic hands-on or people skills. Many are not able to do much deep work. Some have very poor work histories. Others are scared off upon learning about the additional training that we require and provide."Of those therapists he hires, less than half last more than six months of employment. Many of the employees that are recent graduates discover they don't like the work or find that it's too strenuous. Some don't want to comply with their training requirements; particularly the in-depth, 10-hour training in the areas of client communications and helping the clients make a commitment to receiving massage on a regular and frequent basis. (This training includes demonstrations and written tests to assure the material has been learned.)Still he is pleased with his staff and says, "More than half of the therapists have been with me between three and eight years, and are quite capable, dedicated, and effective. We have to look hard for the right people, but they are out there and they stay with us."His company offers benefits including: health insurance; vacation and holiday pay; free massage; dental insurance; and retirement contributions.The therapists work a fixed schedule. Receptionists book appointments according to client preferences for time and if there is a gender consideration or request for a specific therapist. Therapists receive an hourly rate, plus commissions for massage sessions given. They also receive bonuses for rebooking clients and gratuities.His key advice to anyone who is considering hiring massage therapists is, "Take responsibility by embracing the employee status, not independent contractors. Provide clear expectations and reward good performance."<a name="seniortouch"></a><a href="mailto:mslong@hotmail.com">Sharon Long</a> SeniorTouch, <acronym title="Limited Liability Company">LLC</acronym> 443 Whitfield Rd Baltimore, MD 21228 410-869-0908SeniorTouch, <acronym title="Limited Liability Company">LLC</acronym>, was formed over a year ago when Sharon Long partnered with an <acronym title="Health Maintenance Organization">HMO</acronym> that wanted to provide massage therapy to its members as part of a benefits package. According to Long this <acronym title="Health Maintenance Organization">HMO</acronym> serves elderly residents in about 22 nursing sites in Maryland and the DC area and her entity provides the therapist(s) for each site. Each practitioner is "credentialed" both by the <acronym title="Health Maintenance Organization">HMO</acronym> for the site where he or she is to work and also by an independent credentialing company. Long states, "This places the practitioner on the same level as other health care and clinical personnel, and also subjects them to the same state and federal regulations and laws that govern nursing homes and other clinical areas. I do background checks on all my practitioners before I actually place them at a site."Long currently has 18 massage therapists working with her and is about to hire more. The therapists in this program are all independently contracted and each one also has jobs in other areas of massage therapy. She stresses the importance of finding qualified, reliable, and sensitive therapists who want to work in hospice and nursing home environments. The work may not be physically demanding but it's emotionally taxing, and requires knowledge of clinical practices and routines. She started her search for practitioners who were interested in working with this specific population by contacting the two local massage schools in MD and DC, (one in particular was teaching medical massage and also coursework on how to work with the frail and elderly). She placed advertisements on the AMTA's web site and also contacted colleagues for referrals. Many of the applicants were referred by one massage instructor who knew which students would be specifically suited for this work.She s sought legal advice about how to start this business because the liability issues were numerous. According to Long, "I constructed a work agreement by using an example I found in one of the booklets the AMTA put together to help massage therapists start, develop, and maintain a practice. My attorney tweaked it a little to suit the needs of this program."She originally contracted about 25 massage therapists. Eight dropped out because they didn't like the work. Seventeen of her original crew are still with her after a year. She credits the longevity with providing the independence therapists seem to value, "Not being tied down to a 9-5 job is what they prefer. Most massage therapists on my team want a schedule that's flexible but had to resort to choosing their own permanent times to work within a set schedule. It is often better to work in the nursing homes between 1 and 5pm because the mornings are busy with medical appointments, baths, etc, and after dinner the bedtime rituals are in full swing. SeniorTouch massage therapists work between 1 and 5pm any day of the week. The therapists are a devoted group of independent people who are willing to work in a structured program because of their intense interest in nursing home massage."Each therapist wears a lab jacket and SeniorTouch badge with their name and the words "Nationally Certified Massage Therapist" printed on the badge. Long states, "One thing I insist on is that they look like professionals whenever they are working at a site, and that they think of themselves as part of a team that is doing some very unique work."She makes it very clear to all the people she interviews that they won't last more than two months if they are doing this for the money, "There is a lot more to working in a depressing environment with people who are so sick, helpless, and so very old, that you must think long and hard as to your intentions for wanting to do this type of massage."She made certain that each practitioner knew exactly what was expected of them in regards to federal and state regulations governing clinical areas, and what the consequences would be if they didn't adhere to those regulations. She included this information in the contract and provided written guidelines on everything they should and shouldn't do in the nursing homes. She also holds team meetings to clear up any questions or problems the practitioners may have, "I listen to their suggestions. . . they are doing the work and their suggestions are often quite helpful."Her major staffing problem is when therapists get sick. She can't place another practitioner at that site unless that practitioner is credentialed for that particular site. She says, "I value the very dependable massage therapist. I have had some experience with indifference on the therapist's part about adhering to the rules set up for clinical areas. I think some feel they aren't nurses or doctors so they can't be held responsible or prosecuted for breaking rules. I often hear 'We're Massage Therapists, we don't hurt anyone.'"The only other problems she has encountered center around session documentation. Each session is supposed to be documented directly after the work is done. Long contends, "Some practitioners get behind or don't want to look for the documentation form so they skip the documentation and just do the massage. This will be noticed usually by the staff when they meet once per week to review the patient's record with the family and <acronym title="Health Maintenance Organization">HMO</acronym> people. I hear about the error through the <acronym title="Health Maintenance Organization">HMO</acronym> and I will call the Nurse practitioner to find out firsthand exactly what the problem is. I contact the therapist to discuss this with him/her (the staff usually has spoken to the therapist as well). If this happens again I replace the therapist at the site with another therapist. Occasionally I will have someone fail to show up to complete their allotment of residents. They are replaced if the work is not completed within the month."Long often includes compliments and feedback to the SeniorTouch practitioners along with their paychecks to give them a good feeling about the work they do. They also have meetings to celebrate, review potential problems, brainstorm for new ways to improve their services, and share great stories and experiences they've had with the residents.Other employment opportunities are offered to SeniorTouch massage therapists who want to work outside the elder area. Her entity partners with pharmaceutical representatives in area hospitals where they offer chair massage in the NICU and critical care areas. Long states, "I believe in treating those who represent my company with dignity and respect. Sending them out well-prepared is the key to keeping quality therapists. I am available to them, I return all calls and take immediate action to solve problems so that I don't have any frustrated people on my team. This keeps the <acronym title="Health Maintenance Organization">HMO</acronym> folks happy too. No one is perfect and things do happen. I spell out everything in black and white as to what I expect of them and back it up in writing so they know where they stand. I am careful to explain the difference between being independent and being a representative of a company--there are still rules to follow. If they aren't comfortable with this then they need to leave my group and go on to something else. SeniorTouch is managed with structure and discipline but I pair that with being very considerate and appreciative of the time and the devotion that the massage therapists spend sharing their gift of touch."Long coordinates the schedules and payroll of all the massage therapists. She also files a <acronym title="Health Care Financing Administration">HCFA</acronym> 1500 insurance form for every resident worked on each month. Even though she has a computer program to process these forms, it's still a nightmare considering she averages more than 500 claims each month. She is responsible for keeping up communication with the <acronym title="Health Maintenance Organization">HMO</acronym> staff and the nursing home staffs as well. The massage therapists are grateful that they don't have to do this work!When asked about her advice for those thinking of employing a massage therapist, Long says, "Review what you really value about your practice or business and the clientele you serve, then train and prepare that therapist to represent your entity the way you envision it for yourself. Take time to find out where to locate quality therapists. Networking is a very important aspect in finding good people for specific work. Where you advertise for help is key too. You should be very specific as to what you expect and put it in writing. Make sure the therapist is willing to work according to your guidance and not as their own boss while working for you. Be on top of things...check and recheck. Most people will create their own rules if you don't have any for them to follow. If you aren't sure that you've covered all the bases then seek legal advice. Spending a few bucks for legal advice will save you a bankroll of heartaches in the long run."<a href="mailto:doctorhands@hotmail.com">Rich Haslam</a> The Massage Corner 815 W Los Olas Blvd Fort Lauderdale, FL 33312 954-234-5144The therapists at Rich Haslam's company only do chair massage at Whole Foods Markets. He is branching out to convention centers and expanding his business to include other wellness practitioners. He originally began providing massage services at the Whole Foods Market in San Antonio in 1995. Currently he has five therapists all working as part-time independent contractors. He attempts to allot each therapist only two five-hour shifts per week.He originally hired therapists as employees, but in 1998 he switched them to independent contractors. Haslam states, "I think it's much better for the employer to have an independent contractor, particularly when wanting to terminate a contract versus firing an employee. The independent contractor status is also better for part-time therapists since they receive more money for their services. Even as employees, part-timers are usually not eligible for many benefits. Although if I had a clinic situation, I would switch to employee status once I had a core group."He developed his own contract that states what the therapists will do for "offer and consideration."The contract is four pages long and details the relationship of the parties, waivers, severability, expected appearance, and prohibited attire. It also details commission splits, performance expectations, insurance requirements, liability waivers of both parties, termination procedure, and a non-compete section.According to Haslam, good therapists are difficult to find, but not impossible, "I have had many excellent therapist work for me in the past. I've also had some pretty bad ones too." Reliability has been the most persistent problem. Many massage therapists don't have the discipline necessary to be competitive and often display unprofessional behavior such astardiness. He isn't too concerned about attitude problems because they are usually easy to spot in the initial interview.One of his concerns is that the therapists seem a little too casual with first-time clients, "l thought it's desirable to have a relaxed attitude, some see this as an open door to be too relaxed thus saying inappropriate things or crossing personal boundaries."Offering massage in health food stores is great for visibility of the profession, but it has its pitfalls. The biggest one being that the majority of clients are walk-ins. Some appointments are made with the individual therapist for the day that they are scheduled, yet most of the times the therapists have to "recruit" clients on the spot. Unfortunately, many therapists don't have the outgoing personality to get people in their chairs.Given that the therapists are independent contractors, Haslam can't provide benefits per se although there are advantages, "Since the therapists are working on people who are either just discovering massage or have received massage before but not from them, there is the opportunity of encouraging those clients to become full-body massage clients."His advice to both therapists who are looking for jobs and employers is to put everything in writing, "If you are an employer, put everything in writing and explain it thoroughly. Then give gentle reminders from time to time." For individual therapists, Haslam states, "Get it in writing! No exceptions. If you are a contractor, run, don't walk, away from any deal that does not have a written, detailed contract. This also applies to partnerships or even sharing an office."<a href="mailto:bevmay@attbi.com">Beverly May</a> <a href="http://www.redwoodmassage.com">Redwood Massage & Sauna</a> 797 Arguello St Redwood City, CA 94603 650-365-5240Beverly May is the owner of Redwood Massage & Sauna. Three years ago May expanded her sole practice into one with four rooms. She originally took over this business because she wanted to work in a nice environment that has showers and saunas. Her original concept was to develop her business into a cooperative where instead of a percentage, each massage therapist would pay a flat rate for rent and common expenses such as utilities and supplies. May says, "I thought this structure would attract and retain the most qualified and committed massage therapists, who would not need to leave to make more money. I thought by sharing management they would feel it's truly their business and would only leave if they had a burning desire to start their own place from scratch, which isn't easy due to local laws and the high cost of rent in Silicon Valley. Much to my surprise, I find that most of the massage therapists who have come here to work prefer to stay on a per massage basis, even if it costs them more. I don't see the commitment to the profession or to at least my location that I had expected."There are currently 10 other therapists, although only two nearly full time. May is there five days a week. The massage therapists are independent contractors. Actually, the way her contract is written, they are tenants paying rent on a per hour basis. The contract was prepared by an attorney and they also sign the Procedural Policies which covers the day-to-day rules such as being on time and not parking in the lot. According to May, "This creative approach allows me to have a little more control than if they were true independent contractors. A mall that rents shop space can tell the shops what time to open and close, and impose other rules on them."Since each therapist is independent, they collect their own money and pay May each day. Credit cards and checks are run through the business as pre-payment of rent. If there's anything left over, she gives the therapists the difference so they are paid each day. They use My Receptionist� appointment booking service to schedule appointments when they are in session. An extra dollar per massage is paid to May for the receptionist service and she subsidizes the rest. The therapists also pay her for the credit card transaction fees.The major problems she encounters seem to be founded on commitment: to the profession; to showing up for work reliably; and attitude. According to May, "It took me a while to interview for staff who understand that the flexibility of being a self-employed massage therapist does not mean that you can call in on a moment's notice because you don't feel like working, the energy isn't right, or something else came up. For many of the newer graduates it's far different from when I entered the field in the early 70's, when massage was a calling and a lifestyle. I have learned to interview very differently now, looking more for a desire to serve and caring personality. In the past I have run into massage therapists who are looking for easy money with little stress or responsibility, and expect that they can be successful with taking only take the nicest clients with the easiest bodies, the most appreciation and biggest tips. They have little patience for the more physically or emotionally challenging clients. They expect to be fully booked immediately with loyal regular clients who will not mind waiting when they are late or having to reschedule every other week when the massage therapist takes off. They also seem to miss that a peaceful environment is very important to the clients and so let their personal differences interfere with any hope of teamwork."She has had to change her expectations and accept limited commitments. "Having been self-employed almost my entire working life requires that I am reliable, committed, and have initiative. The hardest thing for me to learn is that not everyone is quite like that, and those who work in others' businesses may do so because they don't want the responsibilities or commitment of their own business."May has learned the hard way that if she doesn't manage consistently, the staff tries to manage each other and more than likely the results are disastrous, "What's even stranger for me is that if I ask them to renew their insurance or permit, be on time, etc., they may not do it. If I instruct them in unambiguous terms, they not only comply, but have thanked me for giving them deadlines. Recently, the working environment has vastly improved. May states, "Having now realized that my weak management skills probably contributed to most of the frustrations I and the staff have experienced, we all seem happier with clearer leadership and boundaries."<a href="mailto:destinyduo@aol.com">John Vito</a> Body Mind & Spirit Massage Therapy Center 6206 Claremont Ave Oakland, CA 94618 510-547-6716John Vito is the owner of Body, Mind, Spirit Massage Therapy Center in Oakland, California. He began his career as a massage therapist in 1985 working in a health club and a chiropractor's office. His background also includes teaching at the National Holistic Institute, a massage school in Oakland, and he is a certified Neurolinguistic Programming (NLP) practitioner.His dream business evolved in response to being mistreated. Neither the health club nor the chiropractic office truly supported the massage services. They didn't allot money for items to enhance the environment (e.g., music, bolsters, flannel sheets). The therapists weren't encouraged to market themselves since they didn't receive a bonus or higher percentage by bringing in private clients. The companies didn't want to bend any of their rules. The club where he worked originally classified the therapists as independent contractors and then forced them into employee status. Overnight he went from making $30 per hour down to $24. About the same time, the chiropractor pulled something similar and Vito's wage plummeted from $33 to $15. Also instead of doing hour-long massages, his job shifted to helping the chiropractor and doing piecework, such as triggerpoint therapy.Out of that frustration he had a vision of a place where massage would be treated for the sacred practice that it is and where people would work out of collaboration. He wanted a business that would provide quality service for clients, be a good environment for therapists, and use fair business practices.In 1992, just two weeks after having this vision during a workshop he was leading called "Create Your Own Future," he went for a massage at a massage and skin care center and discovered it was for sale. After research and negotiation he bought the center.The first four years all the therapists were independent contractors. While on vacation in Bali, he had a few disconcerting thought about the independent contractor relationships. He stated, "There was this grayness about the independent contractor status and I wanted to make sure that nothing could take away my business. Plus the therapists were overly independent: not invested in the business; not integrated; stealing clients; not showing up; rooms left in a sloppy condition; and just generally not helping out." The therapists seemed to have the attitude of "I did my massage and that's it."According to Vito the major pitfalls of classifying the therapists as independent contractors are the lack of control of standards and he couldn't require the therapists to attend trainings or meetings. He consulted with several people and decided to shift his hiring classification. In mid-1996, all new therapists were hired as employees. As of January 1997, the independent contractors were reclassified as employees. Although the therapist's percentage decreased from 50% to 40% of the fee charged, he made the transition as Win/Win as possible. He gave bonuses and allowed the therapists to see the financial books.He currently has 33 therapists working for him. The therapists are commissioned employees and are paid on the following commission base: 35% for the first three months; 40% standard from the fourth month; and 50% when they get requests. Plus they have to show up on time to get that 10% bonus. When therapists bring in private clients, they only pay a room rental of $10. Vito says, "I may make less money but the peace of mind, therapist loyalty, and ease of business practices is worth it. Therapists want to work with us."Vito shares that he is inspired by how Catherine the Great would initiate changes through conversation and he encourages this philosophy in his meetings. He developed the company's policies by holding Wisdom Circles. Instead of imposing preset rules, he posed questions on how to do things better, (e.g., Why is it important to arrive 10 minutes early?) They co-created a policy and procedure manual. Vito exclaims, "The shift was amazing! Within two months, everyone was showing up on time, keeping the space clean, and the group began working together as a team." Everyone became mutually responsible. He held meetings monthly for a year until the full policy and procedure manual was complete.When people have ideas that come from themselves, they own it more. Democracy may take a long time, but down the road the alignment is worth it. When people saw that his leadership was around collaboration and collective leadership, they were more trusting and trustworthy. The level of taking care of the clients when he wasn't there was verifiable (thus he could feel free to leave). Vito states, "Ultimately besides peace of mind, it affects your bottom line. You don't get this from an autocratic environment."Now he holds staff meetings two or three times per year. Most things are handled through memos and new therapist orientation. Since the standards are embraced by all the other therapists, the new therapists join on board.Vito also requires 25 hours of continuing education each year and provides free in-house training three hours every other week. He combines the paradigms of healing and learning. For example, if one of the therapists has chronic shoulder pain, a class is held on bodywork strategies for healing the shoulder as well as techniques (exercises, lifestyle, receiving regular massage) for clients to help themselves (in this case the client is the therapist). He advocates creating an environment where the therapists can take care of themselves and learn, "a good healer takes care of themselves, but it's hard to put that into a job description."One of the standards he follows is that he doesn't really differentiate between his clients and therapists. Everything is taken care of at the front desk so that the therapists can be present, focused, and giving. The bottom line is giving a great massage. His business practices support this: to create an environment which supports the therapists to do their best work. Vito says, "It's important to honor therapist's individuality and talents, and they know when you do that. I put my values into my business. I'm blessed to be able to combine the spiritual and material world."<h3>Summary</h3>From an employer's point of view, it might seem easier and less costly to hire massage therapists as independent contractors rather than employees. Yet the independent contractor status seems to work best for businesses involving on-site work, as in the cases of SeniorTouch and Integrative Health Associates. The major problem with independent contractor status is that it fosters the concept of renegade. Most therapists working as independent contractors are attempting to establish their own private practices and thus don't have the same commitment to building someone else's company.Massage therapists need to evaluate their personality styles and skills before hiring on as an employee or independent contractor. According to May the three key questions to help determine which status best suits you are: Do you want benefits provided and revenue records kept by an employer? Do you want to keep records, pay quarterly taxes, and provide your own benefits? Do you want to be told how to work or want creative freedom in your sessions? Before hiring a therapist or taking a massage therapy job, be sure to review the company's policies and procedures and sign an Employment Agreement or Independent Contractor Agreement (see pages ???for examples).An employer/employee relationship is usually the best arrangement if you are an owner who is looking to build a company where you provide therapists with steady work, or you are a therapist who dreads marketing and bookkeeping--and simply wants to do massage.Some therapists thrive in one structure and wilt in the other. Both types of employment status can work well, as long as the therapists choose an employment status that fits their dispositions and the owners and therapists are aligned in their expectations. </div>