Massage Therapy – is the customer always right? (Part 2)

June 2, 2009 by whymassagetherapy
Filed under Career

As a follow up to my post a few days ago – “Massage Therapy – Health Profession or Customer Service? “, I’m pretty sure that you know where I’m going with this.

At the forefront of my thoughts when talking about massage therapists and customer service (as in “is the customer always right?”) is that ultimately because the health and well-being of our clients is our responsibility during treatment, it supersedes the customer service aspect of the profession.

That being said, for the most part therapists will very seldom encounter situations where they have to pull out their “health professional first” hat and decline a customer request. Ultimately, if what you do as a massage therapist during treatment presents a risk of harm to the client, then you need to stick to your decision if you decide to refuse or alter a treatment. Cases where this might happen:

1) Your client refuses to fill out a health history form.

This is pretty basic – I won’t treat a client if I don’t know what is going on with his or her health. End of story. The client may say “my health is fine”, but really, what does fine mean? “Fine” is different between members of the general public and health professionals, and most people, as previously discussed, don’t have the knowledge to have any kind of discernment when it comes to therapeutic techniques. Can you imagine getting a severe diabetic client who wants scar tissue work done, or a client with a history of TIA (transient ischemic attack) or stroke who wants to “work the kinks out” of his or her neck. These are two conditions which require precaution when treating, and for which certain techniques are contraindicated.

How to approach this? Tell your client that there are often conditions which require a treatment to be modified, or that treatment may even be unsuitable. You as a therapist are unable to plan and deliver the best treatment possible without this health information. You can also remind them that the health history is fully confidential and their information will not be disclosed. If they are really sticky, you can quite simply say that you are not willing to be liable for any injury caused because you weren’t informed, and that you will not treat them. (

*Any time you have this type of conversation with a client, you need to keep an incident report of it, even if you didn’t end up treating them. This will cover all of your bases in the event that the client feels like accusing you of being unprofessional. (Personally, I haven’t ever heard of this, but it’s better to be safe than sorry))

2) Your (new) client is adamant about getting “really deep pressure”.

This is actually quite common, and I have had to finesse my way around this several times. John (or Jane) Doe may say “My therapist uses really deep pressure, it’s the only thing that works for me.” and you start treating and suddenly your client finds your moderate pressure too much. Why is this? It’s because everything is relative and subjective – what is deep to one person is too light for another, or too much. What feels good to one client may be excruciatingly painful to another. Your colleague’s pressure might be considered deep, but relative to whom? This is a situation where being creative and flexible really comes in handy.

The fact of the matter is that it is always better to use the first appointment as a trial run, so to speak. I’m not saying to just put oil or gel on your client and spread it around so that he or she gets no benefit – that would just be annoying and I can pretty much guarantee they wouldn’t rebook. What I’m suggesting is that you use moderate pressure (I love that word) and check in frequently – and don’t forget to advise your client that he or she may feel a bit sore the next day (informed verbal consent should have done even before getting them on the table anyway).

How to approach this? You can say to your client “Since I haven’t seen you before, I’m not sure how you are going to react to the treatment, or my pressure. What I usually do is use moderate but firm pressure during the first appointment, and then if you react well to the treatment, I’ll use more pressure next time. This is to prevent you from getting really sore in case I use too much pressure – you might not realize this until it’s too late, and you could be sore for days.” This is usually sufficient, but if the client argues further, I will say that I rarely have complaints about my pressure being too light, or my clients being too sore (but this my experience, you’ll have to figure out your own explanation )

3) Your client shows up with a bad cough, fever or chills

Many clients will show up when they are getting ill with acute bronchitis or flu-like symptoms because “everything hurts” and they think that a massage will make them feel better. At this point you should ask them if you can call a cab for them and rebook when they are feeling better. Don’t take “no” for an answer. Seriously.

It’s not just that treating someone with an acute or systemic infection will be really bad for them (after all, they body is already trying to fight off a virus or bacteria – increasing circulation won’t help them at this point) – you are also putting yourself, other clients and your clinic at risk of infection. Remember the SARS epidemic (Sudden Acute Respiratory Syndrome) in Ontario, Canada in 2003? It was absolute chaos for a while, and massage therapists all over Ontario received guidelines from the CMTO concerning protocol in preventing the spread of infection. The last thing you need is to be remembered as the therapist or clinic that was an incubator for infection – even if it wasn’t your fault.

What I would suggest that you say to a client in these or similar events is something like this “Since you are not feeling well, I believe that it is in your best interest to go home and rest until you get better, the massage won’t help you and may make you worse. Let your body deal with the infection, and then call me in a week or so to rebook.

The bottom line is this, a client will 99% of the time appreciate that you are making his or her health as a priority. If a client cannot see reason in your commitment to her health or well-being, then you may risk losing her business. But, in my experience, I would rather have 20 clients who respected my knowledge and professional judgement than 40 who did not.

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