Massage therapists can create career pathways in multiple environments and in multiple business models, one of those being the massage job.

Massage therapists can create career pathways in multiple environments and in multiple business models, one of those being the massage job.

Most health professionals have a straight-line career path working within a medical environment as employees and are not self-employed. Not so with massage therapy. Until the early 2000s, a vast majority of massage therapists were self-employed, meaning they were both the massage therapist and the business owner, handling two distinct roles.

Now and into the future, massage therapists have a choice: They can have a career focused on massage therapy practice as the only role, with their employer handling all the business responsibilities, facility management, marketing, business licenses and other non-massage-related tasks.

How does a massage therapist choose their career pathway? There are pros and cons to both an independent practice and employment. The decision needs to be made based on accurate information about employment versus self-employment, and honest self-reflection. As a self-employed massage therapist for 40-plus years, a massage therapy school owner and primary educator and owner of a massage therapy franchise, I feel confident providing guidance for making these types of career decisions. Following are some important considerations.

Being a business owner is a full-time responsibility. There is specialized knowledge required to navigate business responsibilities successfully. Right out of massage therapy school it can be overwhelming to practice as a novice massage therapist and a business owner. Choosing employment can be the better option.

There is also an interesting trend where self-employed massage therapists are weary of essentially working two distinct jobs—massage therapist and business owner. Shifting the career model to employment is now a viable option that allows them to practice massage therapy without the business responsibilities.

Work-Life Balance

The concept of a work-life balance is influencing career pathway decisions. People want time for experiences other than work. The self-employment business model would seem to allow for flexible scheduling until the reality sets in of having two distinct jobs as massage therapist and business owner, both of which are time-consuming.

Full time as an employee is 20 to 25 hours of massage in a 30-hour work period. The same for self-employed is 20 to 25 hours providing massage plus 15 to 20 hours managing business responsibilities. Most employers will work with the massage therapist to create a work schedule, from part-time to full-time, supporting work-life balance with essentially the same bottom line income.

The decision to be employed versus self-employed should be made on many other factors other than income potential. It is a misconception that a massage therapist will make more money when self-employed. When comparing income, it is necessary to compare figures used to calculate income taxes. It is inaccurate to compare self-employed business gross to employment wages.

Unfortunately, in the massage therapy business world, many people do not understand the financial end of business management and think massage therapists are undercompensated as employees. This is really not accurate—but may influence whether a massage therapist decides to become an employee or self-employed. If an individual feels they are being paid unfairly they will not be satisfied as an employee.

To understand how employee wages are calculated, it is necessary to understand the financial responsibilities of the employer.

 Based on business economics, what is paid in wages in the service sector should not exceed 35% of gross income. Additionally, the employer must pay payroll taxes, unemployment and Workers Compensation insurance, adding about 10%—for a total wage burden of 45% of business gross. Business overhead is typically 50% of gross income, leaving 5% profit to the business owner. (Source: Second Wind Consulting.)

Let’s break this down into a single massage allocation. Understanding this financial breakdown is critical for an employee to be satisfied with their income:

Employment Wages

• The massage therapy session fee (gross business income) is $75.

 • 35% of $75 is $26.25 allocated for wages and an additional 10%—$7.50—allotted for payroll taxes and other payroll expenses, resulting in a $33.75 wage expense.

• It is important to understand that the wage allocation of $26.25 and the 10% payroll expenses and taxes not only compensate the massage therapist, but also support all staff, such as reception. Fifteen percent of wage allocation is typically designated for support staff, or about $4 of every massage session.

• In this example, $22.25 ($26.25 minus $4.00) per massage session is the maximum that can be paid to a massage therapist.

• Also remember, overhead allocation is $37.50 of the $75.00 fee. Finally, a profit of $3.75 per massage session goes to the business owner. The low profit to the business owner surprises many people, since it is common to think that the business owner is making a lot of money while paying the massage therapist low wages.

• The only way the business income for an owner becomes sustaining is to have multiple massage therapists providing multiple massage sessions to generate business.

Self-Employed Income

• A self-employed massage therapist, doing all the work required of the business, should pay themselves equivalent in wages, or $33.75 (massage and support staff), and receive the $3.75 profit, for an income of $37.50 per massage session.

• But when calculated per hour based on the employee working 30 hours compared to the self-employed therapist working 50 hours, or 30 hours as the massage therapist and 20 hours as the business owner—the per-hour income rate is the same: $15 per hour.

• The business owner needs five massage therapists working to see a profit per session similar to the massage therapist income. Understandably, we want massage therapists to make a sustainable income, and the $15 per hour entry-level average seems low—but it is comparable to other health professions with similar education.

• Also, in the service sector gratuities can add to income more for employees than they do for self-employed massage therapists or massage therapists employed in the medical setting.

Benefits of a Massage Job

If income is similar, then what would be the advantage of being an employee? Obviously, all the business obligations are managed so you can concentrate on being the best massage therapist you can be.

Also, there are typically multiple massage therapists in a work environment, so there can be peer support. (This can also be a disadvantage if there are difficult people working in the environment, but a quality employer should resolve those types of situations.)

Employees are eligible for unemployment, which came to light during the pandemic closedowns. Employees are protected by U.S. Department of Labor laws and regulations that the employer must follow.

There may be support staff to help with laundry, room turnover and cleaning as well as handling front-desk types of activities such as check-in and checkout, reminder calls and so forth. Because of support staff, you may actually be able to perform more massage sessions and therefore increase your income.

Choose Your Employer Carefully

As an employee, it is important to carefully choose your employer. You can expect your employer to do the following:

• Be open to feedback that is professionally provided

• Listen attentively to you

• Investigate your concerns

• Consider your suggestions and be open to ideas

• Provide ongoing updates about the business status

• Clearly communicate expectations and rules, and enforce fairly

• Maintain flexibility and adapt when possible

• Respect your work-life balance needs

• Create a team-based environment, and willingly help with business tasks if needed

• Create and maintain a great employee experience, including the provision of up-to-date and ergonomically supportive treatment rooms, equipment and needed supplies, and a healthy work environment

• Effectively manage workplace conflict and deal effi­ciently with nonproductive staff behavior.

• Continually support business success and plan for the future

To be successful in an employee career pathway you need to be an excellent employee with the following qualities, in addition to being an excellent massage therapist:

• Have a strong work ethic

• Be dependable and on time

• Consistently follow through with workplace tasks

• Avoid workplace drama and gossip

• Be appropriately assertive without being demanding, overbearing or abrasive

• Be self-motivated and work effectively with little direction

• Be team-oriented and support collaboration

• Maintain perspective and avoid catastrophizing

• Manage conflict directly and effectively by focusing on issues

• Be able to keep from getting upset or offended by the things other people say and do

• Be flexible; be able to adapt in a meaningful way

• Be open to feedback without defensiveness

• Support and help implement positive change

• Be a problem-solver

• Help others

• Be kind

• Do what is needed without being told; function beyond the job description

• Understand that they succeed when the business and everyone involved is successful


Finally, and pragmatically, if you are continually unsatisfied as an employee, especially when working for an excellent employer, then it is likely that you are better suited to self-employment, with all the risks and obligations involved.

Sandy Fritz

About the Author

Sandy Fritz is a founding member of the Alliance for Massage Therapy Education and the author of massage textbooks including “Mosby’s Fundamentals of Therapeutic Massage”; “Mosby’s Essential Sciences for Therapeutic Massage: Anatomy, Physiology, Biomechanics, and Pathology”; and “Sports & Exercise Massage: Comprehensive Care for Athletics, Fitness, & Rehabilitation.” Her articles for MASSAGE Magazine include “Old Myths Die Hard: The Truth About Toxins,” and “The Massage Profession Needs to Face the Future—United.