Common business ethical issues in massage therapy

COMMON BUSINESS ETHICAL
ISSUES IN MASSAGE THERAPY
Prepared by:
MANNY P. DALEON
Trainer

Common Business Ethical IssuesCommon Business Ethical Issues
1. Scope of Practice
2. General Finances
3. Fee Structure
4. Barter
5. Gift Certificates
6. Tips
7. Taxes
8. Recordkeeping
9. Independent Contractor Status
10.Product Sales
8/3/2012 2Prepared by: Manny P. Daleon-Trainer

Common Business Ethical IssuesCommon Business Ethical Issues
11.Referrals
12.Marketing Materials
13.Complying with Local, State & Federal Laws
14.Slander & Libel
15.Copyright
16.Contracts
17.Insurance Billing
18.Dual Relationships
19.Confidentiality
20.Case Management

Suze Orman, author of
The 9 Steps to Financial Freedom says--
“Before we can get control of our
finances, we must get control of our
attitudes about money, feelings
that were shaped by our earliest
experiences with it. Opening
ourselves to abundance—not only
of the pocketbook but also of the
heart—is what’s necessary for true
balance and freedom.”

Four MajorFour Major Fee-SettingFee-Setting StrategiesStrategies
1.High-end rate:
2.Industry standard rate:
3.Low-end rate:
4.Time-limited introductory
rate:

Four MajorFour Major Fee-SettingFee-Setting StrategiesStrategies
High-end rate:
Set rate significantly higher than industry standard rate
to target a small percentage of the population. This
usually only works if your service is innovative, in
demand and has no competition.
Industry standard rate:
Determine the industry standard rate and align with it.
Low-end rate:
Set rate significantly lower than the industry standard
rate to attract a larger market share.
Time-limited introductory rate:
Offer introductory rates for a limited time or package
deals reflecting.

Potential EthicalPotential Ethical Issues with TipsIssues with Tips
1. Problems inherent with transference.
2. Clients not certain when or how much to
give.
3. Clients concerned that practitioner will
expect the same amount (or more) each
time.
4. Clients worry that they won’t receive the
same level of service if they don’t give a tip.

Work Smarter with BarterWork Smarter with Barter
Barter is a cashless exchange of goods and
services.
Barter income is taxable, like any other income.
Approximately 3,000,000 companies in North
America belong to an organized barter exchange.
Those businesses transact approximately $4
billion in sales annually.
Barter affords you a simple, legal method to
conserve cash outlays.
Bartering is also an excellent method for
expanding your client base.

BarteringBartering TipsTips
1. Treat barter as cash.
2. Issue gift certificates or scrip to keep
track of trades.
3. Carefully evaluate barter prices.
4. Realistically assess your barter
commitments.
5. Set good boundaries.
6. Join a barter exchange.

GiftGiftCertificateCertificate BenefitsBenefits
1.1. ServeServe asas aa marketingmarketing tooltool toto generategenerate
newnew clients.clients.
2.2. ProvideProvide aa surgesurge ofof incomeincome intointo youryour
practice.practice.
3.3. OfferOffer anan easyeasy wayway forfor clientsclients toto shareshare
youryour services.services.
4.4. FacilitateFacilitate goodwillgoodwill promotionpromotion whenwhen
givengiven asas presentspresents oror donateddonated toto
charities.charities.

GiftGiftCertificateCertificate ConcernsConcerns
Expiration Dates
Non-redemption
Increase in Value if not
Redeemed Promptly
Aggressive Marketing

GiftGiftCertificatesCertificates
In the amount of:_________________________
To: ____________________________________
From:__________________________________
BlueBlue
LagoonLagoon
FloatingFloating
MassageMassage
Authorized Signature: __________________________
Certificate Number:____________________________

Remember:
• While gift certificate sales are
excellent tools for increasing
revenue, keep in mind that the true
profit is generated not from the sale
of the certificate but from the
subsequent sessions that the new
client books.

GiftGiftCertificateCertificate RegisterRegister
Date
Sold
Amt
Paid
Purchased
by
Phone
Number
Issued
to
Phone
Number
Services Products Amount Date
Redeemed

Unethical Tax PracticesUnethical Tax Practices
Concealing Income
–Cash Payments
–Barter
–Tips
Exaggerating Expenses
Not Collecting/Remitting Sales Tax
Not Filing Appropriate Tax Forms

EthicalEthical ProductProductSalesSales
The major focus is to enhance your clients’ health
and well-being.
Keep in mind the effect of the Power Differential.
Educate clients on the product’s benefits and
disadvantages.
Be well-informed about any product you sell.
Only sell products that you know are reliable.
Only sell products that are suitable for use by your
clients.
Only sell products that are a natural extension of
your business.
Only sell products that are in your scope of practice.

Referral ConcernsReferral Concerns
The gesture can be misconstrued.
Possible conflict of interest.
“Kickbacks” are often illegal.

UnethicalUnethical MarketingMarketing
 Exaggerated Claims
 Misleading Ploys
 Inappropriate Images
 Ignoring Business Regulations
 Misrepresenting Credentials

LegalLegal IssuesIssues
 Comply with local, state and federal laws.
 Maintain appropriate and adequate insurance
coverage.
 Avoid slander (verbal) and libel (written) defamation.
 Respect copyright rules.
 Create written contracts.
 Avoid civil lawsuits.
 Don’t designate someone as an independent
contractor if s/he is really an employee.
 Before hiring a practitioner, set clear agreements
about the custody of client files if that practitioner
leaves.

InsuranceInsurance CoverageCoverage
 Liability Insurance
 General Liability Insurance
 Small Business Insurance
 Malpractice Liability Insurance
 Product Liability
 Automobile Insurance
 Fire and Theft Insurance
 Business Interruption Insurance
 Personal Disability Insurance
 Medical Health Insurance
 Worker’s Compensation Insurance
 Partnership Insurance

HighHigh RiskRisk ClientsClients
 the sexually provocative client.
 the professional plaintiff client.
 the client with unrealistic expectations.
 the client who idolizes the practitioner.

FormalFormal Client ComplaintsClient Complaints
 Notification to State Licensing Board

Notification to Professional Organizations
 Civil Lawsuit
 Criminal Lawsuit

CivilCivilLawsuitLawsuit DiscoveryDiscovery ProcessProcess
Interrogatories
Depositions
Request for Production of Documents
Request for Medical or Psychiatric
Examinations

MalpracticeMalpractice ActionsActions
The elements that a client must prove by a
preponderance of the evidence are:
1.A duty of care owed by the practitioner to the
client.
2.A breach of that duty.
3.A causal relationship between the breach.
4.Damage to the client.
Healthcare practitioners are “held to the standard
of care and skill of the average member of the
profession.”

AvoidAvoid aa MalpracticeMalpractice
LawsuitLawsuit Gather and complete an accurate medical history from
each new client.
 Obtain as much information as possible from the other
members of the client’s healthcare team.
 Have the client sign an Informed Consent sheet and
other HIPAA paperwork.
 Use common language when talking with clients.
 Be courteous and professional.
 Document every interaction (including phone calls)
with a client.
 If a problem occurs during a session, immediately
discuss it with the client (and family, if appropriate),
and do not have the client pay for further sessions.

CopyrightCopyright GuidelinesGuidelines
1. Copying works for client education violates
copyright law.
2. If it looks copyrighted, assume it is.
3. Copyright protects an author’s right to obtain
commercial benefit from valuable work.
4. Copyright preserves the author’s right to control
how a work is used.
5. Copyright law is mostly civil law.
6. Obtain permission to use the work from the
copyright owner and always give proper credit.

Copyright Fair Use FactorsCopyright Fair Use Factors
1. The purpose and character of the use. This
includes whether such use is of a commercial
nature or non- profit educational purposes.
2. The nature of the copyrighted work.
3. The amount and substantiality of the copied
portion in relation to the copyrighted work as
a whole.
4. The effect of the use upon the potential
market for, or value of, the copyrighted
work.8/3/2012 27Prepared by: Manny P. Daleon-Trainer

ContractContract ChecklistChecklist
Names and addresses of all parties involved
A short description and mission statements
Summarization of contracted party’s desired
role
A classification of the business relationship
A description of what each party is to provide
A timetable
Location of where work is to be performed

ContractContract ChecklistChecklist (cont’d)(cont’d)
 The duration of the contract
 Payment method and schedule
 Fringe benefits
 Opportunities for increases in financial
increases
 Insurance coverage provided
 Insurance coverage required
 Guarantees
 Financial obligations of the contracted party

ContractContract ChecklistChecklist (cont’d)(cont’d)
Conditions for termination of the agreement
 Guidelines for transfer of the contract
 Who retains custody of the client
 Arbitration
 Who is responsible for contract breach legal
fees
 Contract communication contact information
 Signature lines and date the contract is signed

DisputeDisputeResolutionResolution
The Seven Steps:
1) Adopt an attitude of resolution.
2) Listen carefully to each party’s stories.
3) Allow a preliminary vision to arise with all parties.
4) Allow people to express their disappointment and then
bring everyone into the current moment.
5) Agree (at least in principle) to create a new vision.
6) Design the new agreement.
7) Acknowledge resolution.
Adapted from the work of Stewart Levine, Getting to
Resolution: Turning Conflict into Collaboration

NegotiatingNegotiatingTipsTips
Logistics Count
 Prepare
 Negotiating Styles and Personality Dynamics
 Use Active Listening Skills
 Walk Away for Awhile
 Set Time Limits for Complex Negotiations
 Pause and Reflect

IndependentIndependentContractorContractor StatusStatus II
Primary Characteristics of an Employer
Employee Relationship:
An employer has the right to discharge an
employee.
 An employer supplies the employee with
tools and a place to work.

IRS 20-PointIRS 20-Point ChecklistChecklist
An individual is likely to be considered an employee if he or she:
1. Is required to comply with company instructions about when,
where and how to work.
2. Has been trained by the company to perform services in a
particular manner.
3. Has her services integrated into the company’s operations
because the services are critical to the success of the
business.
4. Must render services personally.
5. Utilizes assistants provided by the company.
6. Has an ongoing, continuing relationship with the company.
7. Has set work hours established by the employer.
8. Is required to work the equivalent of full time.
9. Works on the company’s designated premises.

IRS 20-PointIRS 20-Point ChecklistChecklist
An individual is likely to be considered an employee if he or she:
10.Must perform services in the order or sequence determined by the
employer.
11.Must submit regular progress reports.
12.Is paid in regular intervals, such as by the hour, week or month.
13.Is reimbursed for all business and travel expenses.
14.Uses tools and materials furnished by the employer.
15.Has no significant investment in the facilities that are used.
16.Has no risk of loss.
17.Works for only one person or company.
18.Does not offer services to the general public.
19.Can be discharged by the company.
20.Can terminate the relationship without incurring liability..

REFERENCE:
• Sohnen-Moe Associates, Inc.
• www.sohnen-moe.com

NEXT TOPIC
• MASSAGE MARKETING
8/3/2012 Prepared by: Manny P. Daleon-Trainer 37

Common business ethical issues in massage therapy

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