Nora Brunner MA, APR
ABMP PR Specialist
303-679-7647, 800-458-2267, ext. 647
nora@abmp.com

Explosive Growth Rate for Massage Training Begins to Flatten
One of the dramatic trends in the profession is the explosive growth rate for new students entering massage training and the variety and number of established educational institutions that have branched into massage therapy or new organizations that have sprung up as independent schools to meet the demand. ABMP surveys showed explosive growth (107.1 percent from 1998 to 2004) in enrollment and graduation numbers, but an early 2007 analysis showed the first (slight) decline in that indicator since ABMP school surveys began in 1998. ABMP’s school database peaked at 1,582 schools in 2006, but early survey results leveled off at 1,571 schools.

Enrollment has declined 9.8 percent from 73,933 entrants in 2004 to 66,653 in 2006, the analysis showed. Graduates from massage therapy programs in 2006 totaled 62,784, versus 71,272 graduates in 2004, a decline of slightly less than 12 percent.

While on the surface these census results may appear troubling to some in the massage community, ABMP considers this a healthy market correction. The massage training universe may have overreacted to the growing consumer demand. (Click here to read more.)

The massage school industry pie is being divided into more pieces. Massage training institutions, formerly the province of stand-alone proprietary schools, are now facing increasing competition from less-specialized entities. Primarily these are career (vocational) schools, public community colleges and public technical schools. An ABMP 2007 survey of state-approved massage schools reveals the following:


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New Training Entities Get Into the Act

• The number of state-approved schools has increased 122.8 percent between 1998 and 1,571 as of May, 2007.



• Larger schools dominate the field — one-fourth of schools account for more than 70 percent of graduates. Half the schools account for 90.5 percent of all graduates.



• Despite their domination of the field, the top 125 largest schools continue to lose overall enrollment market share. Rankings are fluid — in the four surveys conducted between 1998 and 2004, only 38 schools have remained in the top 125 for all four surveys. Similarly, just 26 have ranked in the top 125 in numbers of graduates.

Challenges for Schools, Students, Graduates
Dearth of Qualified Instructors
One problem schools are facing is an insufficient number of qualified, experienced teachers to meet student demand. Explosive growth of 122.8 percent in schools and 107.1 percent in enrollment since 1998 has inevitably required the hiring of a disproportionate number of rookie instructors.

Graduate Expectations and Income
The part-time nature of most massage practices is a dynamic that dramatically shapes the profession. The median number of client contact hours for ABMP members is 13 (average 15.4) — 68 percent say they wish they had more clients.

As in any business, the 13 hours a week does not mean the other 27 hours of the 40-hour business week are free. Just as a pilot’s work is not defined solely by flight hours, the independent massage professional spends many additional hours weekly maintaining the massage room, ordering supplies, returning phone calls, keeping books and promoting the practice (2005 ABMP Member Survey).

Nearly half of the respondents (45 percent) report supplementing their income with another job, a job at which they spend a median number of 25 hours per week. The top five secondary occupations include: office/secretary/clerks; sales/retail; teacher/education; massage instructor; and esthetician/skin care professional (2005 ABMP Member Survey). For most, this pattern reflects a conscious choice to balance massage work, with its strenuous physical demands, with work responsibilities stressing different skills.

Income
Average massage-related income for massage therapists in 2005 was $18,950, with a median income of $14,500 (2005 ABMP Member Survey). An American Massage Therapy Association (AMTA) fact sheet erroneously asserts that massage therapists earn an annual income “comparable to other healthcare support workers,” on the basis of misleading numbers supplied by the U.S. Department of Labor, Bureau of Labor Statistics (BLS), exacerbated by an AMTA further assumption.

The bureau reports average annual income for massage therapists to be $29,250, including gratuities (U.S. Department of Labor, Bureau of Labor Statistics, Occupational Employment and Wages, November 2003).

• The bureau derived this number by gathering data showing a mean hourly wage of $16.83 for massage therapists, then “multiplying the hourly mean wage rate by a ‘year-round, full-time’ hours figure of 2,080 hours.”



• AMTA obviously failed to consider the BLS footnote. Their purported “2005 Massage Industry Fact Sheet” states, “The average annual income for a massage therapist (including tips) who provides 15 hours of massage per week is $29,250” (emphasis added). The BLS mean annual wage by contrast is based on 40 hours per week. It can reasonably be assumed that BLS data includes all hours devoted to one’s massage practice, not just client contact hours. A rough estimate is perhaps half an hour of support time (for bookkeeping, marketing the practice, continuing education, taking client histories, laundry, linen changes and other room preparation before and after a session) for each hour of hands-on work. Those assumptions, coupled with a further assumption that massage therapists take three weeks vacation each year, would produce a mean annual wage of $18,555 from massage — close to ABMP’s $18,950 survey data.



• It is misleading for the bureau to report these numbers at face value (and for others to imply that the few individuals counted are representative of massage practitioners as a whole), as the Bureau of Labor Statistics' footnote mentions “self-employed” workers are not included. Two-thirds of U.S. massage therapy practitioners are self-employed. The BLS sample of 29,550 massage therapists (representing just 16 percent of all massage therapists practicing at the time the survey was conducted), may be skewed toward employees of larger establishments (likely major spas, hospitals and hotels), which are more likely to file U.S. Department of Labor reports than are small massage-practice proprietors.



• Average massage-therapist income is not in fact comparable to reported income of other healthcare support workers covered by the labor department survey. The lesser massage income largely reflects a choice by massage practitioners to devote fewer hours to the profession. Healthcare support workers in other fields may well more often devote 40 hours a week to such work.



• Total earnings by massage therapists, including their earnings from other employment, were $32,506 (2005 ABMP Member Survey).



• First-year practice average income was $9,589, reflecting the challenges of establishing a professional-service practice (2005 ABMP Member Survey).

Attrition an Ongoing Concern
Practitioner attrition continues to be cause for concern in the massage therapy profession. ABMP estimates some 50,000 massage therapists leave the profession each year. Three primary factors drive this pattern:

• As most professionals indicate they wish they had more clients, it is reasonable to conclude that at least some practitioners leave the field because of insufficient economic reward. Contributing to this may be unrealistic expectations of new graduates and a simple lack of business skill and confidence. It proves difficult for sole practitioners to reconcile their sense of higher purpose with the more mundane aspects of self-employment and the competitive realities of self-promotion.



• The physical demands of the profession can become daunting and may necessarily limit the number of clients a practitioner can manage even if greater demand is present.



• And, of course, lifestyle changes such as spouse relocation, maternity and other family changes affect an independent practice far more than simply changing jobs.

Potential for Market Saturation

• The number of massage therapists in the United States continues to rise. According to ABMP’s analysis, there were 241,058 massage therapists in the United States as of January 2006, up from 137,390 in January 1999.

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Methodology: In 39 states (including the District of Columbia) where licensure of massage therapists is in effect, state boards were contacted to obtain current licensing totals. In the other 12 states, ABMP developed the estimate through analysis of totals from primary membership organizations (ABMP and the American Massage Therapy Association), the distribution of National Certification Board for Therapeutic Massage and Bodywork certificants and state populations. General receptivity toward massage in particular regions also was factored in.

State Rankings Table

• Although there is no formula at present to define full scope for this still growing profession, the topic of market saturation is being raised more frequently by profession observers. A U.S. Department of Labor forecast for 2006–2007 projected an 18 percent to 26 percent increase in job opportunities through 2014 (Source: U.S. Department of Labor, Bureau of Labor Statistics, 2006–2007 Occupational Outlook Handbook). Some observers surmise that much of that predictable growth has already occurred. Certainly saturation will arrive much sooner in certain markets, even as massage gains greater popularity in others.



• On balance, ABMP expects demand for massage to continue to rise over the next five to seven years, but not at the same dramatic rate as has recently occurred. Already some market adjustment is occurring in the massage school universe — some schools that were attracted by the demand for classes but lacked well-thought-through plans are closing their doors. Nonetheless, spas are becoming more accepted, men are showing dramatically greater interest in receiving massage, markets previously tepid to massage therapy are showing more use, and more people are being exposed initially to massage in comfortable settings (chair massage in an office or grocery store, holiday gift certificates, etc.). Baby boom demographics and predisposition toward massage all auger well for the profession as a whole. We just don’t anticipate continued growth rates for massage school graduates or practitioners as in the past.



• Consumers in the West and Midwest are most likely to have received a massage in 2006 – 20 percent and 19 percent respectively in the Harstad survey, compared with 14 percent in the Northeast and 12 percent in the South. Each of these percentages is up from 2004 levels, with the six-percentage point gain in the Midwest the most dramatic.



• Not surprisingly, market forces result in a pattern of therapist distribution per capita largely reflecting these patterns. Massage has more quickly gained acceptance in metropolitan areas. In 2005, 13 percent of both urban and suburban residents received at least one massage, compared to just 8 percent of adults living in rural areas.



• As might be expected, the most populous state in the United States, California, also has the most massage therapists, with 33,658. Wyoming, the least populous state, also claims the fewest massage therapists at 459. Hawaii reports the greatest concentration of massage therapists, with one therapist for every 250 residents. The state with least concentration is Alabama, with one massage therapist for every 3,876 residents.



• Also of note is the regional concentration of therapists. The Southwest (Four Corners states along with Nevada), Northwest, Northeast, Florida and previously mentioned Hawaii, all report high concentrations of therapists. Excluding Florida, the Southeast region has the least concentration of therapists.

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