Podcast

Episode 157

May 1, 2018

Diana Thompson joins the podcast to talk about her career, working with clients and pain, and how massage therapists can bring massage therapy into integrative healthcare.

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EPISODE 157

Diana Thompson joins the podcast to talk about her career, working with clients and pain, and how massage therapists can bring massage therapy into integrative healthcare.

Resources mentioned:

This episode is sponsored by:

PS- To get a little better at talking about pain, check out PainScience.com

Transcript:

Sponsor message This episode is sponsored by Hands Heal Electronic Health Records. We know massage can alleviate stress, reduce pain, and improve function. Now prove it with Hands Heal EHR, an online, client-centered, recordkeeping system that can help you grow your practice, save time, and chart meaningful results. Hands Heal EHR is committed to helping all types of massage therapists create a meaningful record of all massage sessions — wellness and treatment — quickly and easily. Choose between a detailed SOAP note format for documenting treatment sessions or a basic format for wellness sessions. Identify tangible results of your massage to keep clients coming back and referrals coming in. Simplify your recordkeeping with a secure, HIPAA compliant, cloud-based system that can be maintained from any web-connected mobile device. You can learn more at handhealehr.com. That’s handshealehr.com.

Allissa Haines Hello, everyone. Welcome to the Massage Business Blueprint podcast, where we discuss the business side of massage therapy. I am Allissa Haines. And I am here, super excited, and a little nervous, to have our very special guest today, Diana Thompson. Hi, Diana.

Diana Thompson Hi, Allissa. It’s great to be here with you.

AH Thank you. Everyone, I want to tell you a little bit about Diana. And I feel like this bio is just absurdly shortened because Diana has done so many cool things that, in order to give a bio, we would need a whole hour unto itself. But, let me give you a really brief overview. Diana has been a licensed massage therapist for over 30 years, which kind of makes her one of my heroes. She has a private practice in Seattle, Washington, treating acute and chronic pain disorders. Diana lectures at massage, acupuncture, midwifery, chiropractic, physical, and physical therapy conferences internationally, and is a consultant for massage therapy research with the Research Institute at Group Health Cooperative in Seattle. Her newest endeavor, and we’re going to talk about it more specifically later, is hands Heal Electronic Health Records, a patient-centered, web-based EHR for massage therapists. She has a new book, Integrative Pain Management: Massage, Movement, and Mindfulness Based Approaches, and she’s also the author of Hands Heal: Communication, Documentation, and Insurance Billing for Manual Therapists, which is now in it’s fourth edition and is, probably, one of the books I most recommend for massage therapists. Diana is a recipient of many national awards including the president’s award for AMTA, massage therapist of the year, ONE Concept humanitarian of the year from Performance Health. And weren’t you the president of the Massage Therapy Foundation at one point, too, Diana?

DT Yes.

AH Yeah, I thought so. I thought that one was left out of there. But let’s turn it over to Diana to tell us a little bit more about her journey though massage, which has become the favorite part of these interview podcasts for me. Diana, how did you get into massage more than 30 years ago?

DT Well, it started in high school, if you could imagine. I used to line up all my friends in the rec room at the apartment building that I was living in — line them all up on the floor face down, and I’d go form back to back to back massaging everyone in the complex. Kind of crazy.

AH How did you even know what massage was at that point? As a teenager, had you received massage or just seen —

DT No. No. You know, I have no idea. There was someone that said, “Hey would you rub my back?” and it was so much fun that I just started doing everyone. And someone would tell someone, and then they would show up. And soon as I got home from school, word got out, and they were all lined up waiting for me.

AH Nice. So where’d you go from there?

DT Well, in college, I worked in the gym handing out towels. That was my official job. The athletic training room was right next door to the cage where the towels were and the laundry was done. And the athletic trainer would bring me in to massage people. I was learning how to tape people, but I was still tearing the tape with my teeth, and so he wouldn’t let me tape anyone. So I was just doing the massages and having a good time. And I was pretty well known in the athletic training room because I played rugby, so I was injured all the time.

It went from there to on my breaks home from college, my mom would send me off to some type of massage class. I got certified in Touch for Health while I was in college and then after I graduated, I went straight to Seattle and was walking along Broadway and saw one of those little signs that had the tear-off phone numbers at the bottom. I don’t know if you really remember —

AH Like an old-school flyer?

DT It was so old-school flyer because there was no internet. Nobody had cell phones. You would tear off this phone number and take it home with you to make a phone call. And it was for a massage clinic. So I went to massage school in 1983 and got licensed. So that was the beginning of my official career.

AH So you got licensed, and what was your first gig in massage?

DT I was working at a massage clinic in the university district that had beads in the doorway kind of thing, and a clothing-optional sauna downstairs, and it was very hippy, very New Age. It was not at all suspicious sexually, but it was a very, very New Age-y sort of clinic. I was there for a year and, meanwhile, I would work on the weekends doing sporting gigs. So softball teams, rugby teams, sailing team. I had a professional track athlete that I worked on. So that was just the beginning. And then in 1985, I started my own clinic.

AH Wow. So did you start your own clinic, straight up by yourself?

DT Well, there was a chiropractor downstairs, and she and I became very good friends. I had been in a couple terrible car accidents where, one, I went partially through the windshield, and the second one, I just shattered the windshield with my head because it was also in the day, way back when, there were no seatbelts in cars.

AH Yeah, I remember those days.

DT Yeah, right?

AH You’d just all bounce around the back seat. Whatevs. It’s fine. You can ride in the back of the wagon with your face pressed against the back of the glass window.

DT Exactly.

AH It’s good times.

DT Yeah, yeah. So anyway, that’s what got me in to see a chiropractor, and she got me doing massage in her storage room. And then the upstairs came available, and I rented the whole upstairs from her clinic. And in 3 years, I had 17 massage therapists working for me.

AH Wow, so you ended up running a really big place.

DT I did. And we did nothing but injury massage. So we worked mostly with acute traumatic stuff. I didn’t really get into chronic pain until much later.

AH What was it like working in injury care then? Were you dealing with insurance reimbursements at that point or did that come later?

DT The first time I could bill insurance was in 1986. We were doing car accident billing and worker’s comp, and we didn’t start billing major medical until 1988.

AH Wow.

DT But yeah, we were billing insurance for years. Year and years and years up here. So it’s a common thing for us, and we’re pretty dedicated to it because access is everything.

AH So at what point did you get more into chronic pain stuff and research and more of the stuff that you’re doing now?

DT Well, I wasn’t getting older, but my clients were. So things were happening that just really took me in that direction. They were getting knee replacements and hip replacements and all kinds of orthopedic stuff. Down the street, there was a really big cancer treatment center that got built, and so we were getting a lot more post-surgical work with cancer. So the shift went two different directions. The acute part went toward post-surgical work, and the chronic part went to orthopedic surgeries with older adults.

AH That is so — it is a story I hear a lot. I feel like so much our work starts out in a general way and then we follow — our education and what we do follows what I consider, the clients that I most adore, what they need and that guides my training and where I go next, which is what led me to some oncology massage training and some other things like that. But that is such a common thing to hear, and it’s heartening and it speaks to the caregiving aspect that we feel in the field.

DT And also, I think, speaks to the flexibility of our profession.

AH Yeah, you can go anywhere and do anything with this and you can find some way to help anyone on your table with skilled massage. Whole other podcast episode we just piloted right there, Diana. So tell us a little bit more about what you’re doing now. And if I interrupted you a little bit more about how you got there if you want.

DT No, no. That’s the problem with asking someone who’s been doing this forever where that comes from because it’s a long story.

AH I bet.

DT These days, I have been working on this electronic health record thing that. After choosing to write a book in that, who would have thought that I would write a book on charting. But that happened in the 90s. And then in the 2000s, adding insurance into it and more communications stuff and how to do expert witness testimony and all kinds of things made that more and more interesting and complex, for me anyway. And then the government started shifted and started thinking about how to be more transparent in healthcare and how to communicate more broadly because there was a lot of expense in just re-doing care. And electronic health records became the way to do that.

And my goal has always been, bring massage therapy into integrative healthcare. We’ve got to move in that direction professionally so we can have more access to patients, patients can have more access to us, we can be more of service like we know we can be, and we don’t have to lose our individuality and our ability to take care of people from a wellness perspective. That will always be there. But it’s nice to have options. In order to do that, we have to communicate the same way that other healthcare providers do. It was time for us to move into the electronic recordkeeping era. So that’s how I’ve been spending my time for probably 5 years now.

AH And you’re still seeing hands on massage clients, right?

DT Yes. I’ve kind of shoved them into 2 days. So I see 6 people a day; so 12 a week.

AH And are you still seeing them in an independent — is it your clinic? What is your massage practice look like now?

DT I moved into a clinic that a friend of mine owns, Mayo Therapy and Associates. It’s — she’s got like 17 massage therapists — of course, that might be my number — 13 massage therapists working for her. But I got the nice room in the back, and I just pay rent, and I get this beautiful waiting room and lots of company, lots of nice massage therapists that I get to hang out with. I’m not alone, which is nice, and I’m independent, which is ideal for me.

AH Yeah. So what is your — this is our final interview-y question before we get to jump in to hear a little more about Hands Heal and then also about how to connect with pain care practitioners. What is your fantasy job/location/training like? If someone handed you a blank check today, what would you do with that?

DT You know, I — from a selfish perspective, I would start making jewelry.

AH Yeah?

DT Yeah.

AH All right.

DT I love jewelry. I don’t wear a lot of it, but I love beading. I would love to do metalwork or welding. I would totally get into welding some big sculpture-type things and maybe putting some semiprecious crystals, you know, big ones, in the sculptures. I would just love to work with my hands and metal.

AH That’s awesome. I have a nephew who is just about to complete his vocational training for welding, and I want him to show me things. That sounds really, really cool.

DT Yeah. I took a little intro class and totally fell in love with it. It’s very kinesthetic and intuitive in that, you put that big mask on and you can’t see anything. You can’t see what you’re working on. It’s too dark and you just have this big, bright light in front of you, and I just found that it was really easy to go from people to metal. [laughs]

AH [laughs] I have to say, you’re the first person who has just completely surprised me with your answer. So thank you for that. [laughs]

DT Hey, you’re welcome.

AH Okay, we’re going to bounce into our halftime sponsor, which y’all probably already know is Hands Heal EHR, which is an online, client-centered, recordkeeping system that can help you grow your practice, save time, and chart meaningful results. Hands Heal Electronic Record System is easy to use. It’s comprehensive, and you have an option: you can use simple wellness notes or more detailed treatment notes, whatever’s going to work best for your and your practice. You can track progress with pre- and post-session pain, function, and mood scales. You can eliminate paper files and file cabinets from your office. You can store images and range of motion videos too. It is accessible on any internet-connected device. You can link it to scheduling and payment systems. It is secure and HIPAA compliant. I think that HIPAA compliancy is probably the second or third most common question we get when we start talking about these kinds of systems and any kind of system. It is only $25 a month. If you want to learn more about it, you can go visit handshealehr.com.

But, Diana, since we’ve got you and since you created this, I’m guessing out of your own necessity, kind of already mentioned that — tell me a little bit about what I missed and what you really want people to know about this system.

DT Well, the thing that I think is the coolest about it is that clients log on before and after their sessions to complete these scales. So we know to track pain, we could do a 0-10 scale, whatever, but really function is the most important thing. People will do whatever they can before they hit their threshold of pain. So if we just track pain, it’s going to look like it’s the same every time we see the person. But if we track function, maybe getting dressed and driving to work gets them to their pain threshold. And then maybe it’s playing catch with the kids in the backyard, and then maybe it’s starting to go back to exercise where they hit their threshold of pain. So there’s all these levels of progress that we could be noting.

The other thing that’s really important is to track mood. I think we start to get a little worried if we say anxiety or depression or even stress. But mood really kind of captures how is this pain making somebody feel? How is is affecting their daily life and how they feel about themselves? Although we can’t therapize someone, we can certainly track how it’s affecting them emotionally. There’s more research on how massage influences anxiety and depression even than pain. So those are important things to track. Clients can go in and do it, and then the sessions over and they can go back in and say how much better they feel afterwards, or not, and leave you some feedback, and it cuts down on your charting, which is awesome.

AH I love this concept of bringing the client in to be part of their recordkeeping too. What a — I didn’t — I’ve looked into the system a little bit. I’m going to do the trial thing and really dive into it. But I had no idea it did that and how — man, we’re always trying so hard to find ways to make clients part of their care and more responsible for their care and more collaborative in their care. To take people who really want to feel better and give them a tool to record that and help us is brilliant. I had no idea that was in there.

DT Yeah, and I think it’s easier than having them write a journal.

AH Absolutely.

DT Because it takes 2 minutes for them to do it before and after, and yet it will make such a difference. And it gets them really committed to their wellness.

AH Sweet. And, again, everyone, you can learn more at handshealehr.com. And of course, we’ll have a link to that in our podcast notes. So let’s transition into the real, full topic that brought you here today, which is how to connect with pain clinics and other practitioners treating people with pain. So what advice do you have for us on making those connections and nurturing those relationships?

DT Well, I kind of want to start with how big the news is right now, how prominent the news is displaying this opioid epidemic: that it’s really a big thing, and it’s a problem. And I don’t know if you know this, but the opioid epidemic grew out of the 1990s when pharma decided that they would start marketing opioids to healthcare providers.

AH I’m just going to jump in. I actually did know that because I worked in pharmacy from 1997 —

DT No way.

AH — I was a pharmacy technician right out of college. I ended up in a pharmacy. I was in pharmacy from ’97 to 2006. And holy moly that era of marketing directly — I can’t tell you how many pharmaceutical reps bought me pizza over those 10 years and doughnuts. They just fed us all constantly. They fed the techs and educated the pharmacists. But it was insane. But I interrupted you.

DT And they even told you it wasn’t addictive, didn’t they?

AH Oh, they absolutely did. It was just — I accompanied a few pharmacists here and there to some of the fancier dinners because I had a real interest in the pharmacy end versus just the computer-y insurance billing the technicians did a lot of. So I went to a few of the fancy dinners and heard a lot of their shticks and their lectures and, oh, they absolutely said it wasn’t addictive.

DT Yeah.

AH And things like “this is not addictive, and it helps your patients stay ahead of the pain.” Which when you’re heading into some procedure and you’re fearing the pain of it, that was — they taught pharmacists these lines, and we believed them in a lot of ways. Yeah, but validating that and it’s so nice to hear someone say that out loud. But I’ll let you get back to your background.

DT Yeah. Well, and thank you for validating that. I mean, I read this stuff. I’m reading the research on opioids all the time because I’m fascinated, and I’m just shocked that they would say that. So just to give you the numbers: 11.5 million people annually misuse prescription opioid medication. Million. And 42,000 die every year from opioid overdoses. And the craziest statistic I have for you today is that only 54% of opioid overdoes are unintentional.

AH Oof.

DT Yeah. Yeah. It’s difficult to document suicides with overdose because it could go either way. But what they’re saying is that there’s a huge percentage of people who cannot live with this addiction and they don’t know what else to do, and so they take their lives. So whatever you think about drug users, these are our grandmothers, our mothers, our kids. People who get hooked on pain medication because of some trauma or illness or accident, some injury, and they end up committing suicide with overdoses. It’s horrific.

So one thing that I like to say is it’s not an opioid epidemic; the epidemic is pain. So what’s going on that so many people are in pain, because they’re even having difficulties with NSAIDs. So a hundred thousand people in the United States went to the ER because of NSAIDs. So ibuprofen — Tylenol is not an NSAID; it’s in a different family, but Tylenol also. And there were 16.5 thousand deaths from non-prescription pain killers.

AH Oof.

DT So 1 in 10 people in the United States and globally have chronic pain, and it costs the United States $635 billion a year. So just all of that to kind of say this is a big problem, and this is completely in our wheelhouse. This is what we do. We work with people in pain. What I think is really important if you want to start marketing yourself to pain doctors and pain clinics is to understand chronic pain. Understand what it is and how to work with it. So I just want to help you understand it a little bit before I talk about how to market yourself. Because that level of knowledge goes a long way —

AH Excellent.

DT — when you’re talking with doctors.

AH And I think that’s a really big stumbling block for a lot of us. I know that it is for me. Feeling completely not confident in expressing to another healthcare professional what I know about pain and how massage can help with that. So I am excited about this background.

DT Yeah, thanks. They have found that people with severe pain have worse health. It’s not a leap to go there, but their stress is worse, their posture is terrible, their ability to function in daily life is decreased, and then it leads to — and this is something I don’t think we always think about — fear of movement and isolation.

Chronic pain is really a bio-psycho-social issue. It’s a very complex condition. It’s not just the physical. We’re dealing with mental issues. The fear of movement is a big one. The physical issues, of course, but also the social issues. Once you start to not want to do things or move or you start to isolate yourself, you don’t go out, you lose contact with your friends, sometimes your family, and then you’re getting out less and less and less, and you’re moving less and less and less. We really want to think holistically, and we want to address more problems than just the original source of the pain. I think we’re really good at finding out where it hurts and working on that spot. But we have to remember that we’ve got a whole person in front of us. There was a very interesting study that I worked on several years ago where they compared wellness massage, full body, relaxation-type massage to site-specific treatment massage. And you might remember — what were the results?

AH I have no memory of this. [laughs]

DT Right. It was a little bit ago. I think it was 2008, maybe. They were the same. Same results. In fact, the full body massage did a little bit better. It wasn’t statistically significant, but it was slightly better than the site-specific treatment massage. And I promise you, because I interviewed all the massage therapists that worked on that study, they were good. I hand-picked them, and it wasn’t like we picked massage therapists that didn’t really know how to do treatment massage. Because we’re in Washington, we’ve been billing insurance for decades. People get trained in massage school to work on treatment. They were good. And yet.

It just reminds me that there’s a whole person on the table. Their neurobiology has been completely rewired, so things are not as they appear in the nervous system, and we have to think about the pain being stimulated by any other part of the body. You get this neuroplastic pathway in your system where something just repeatedly irritates one spot. You could stub your toe and your low back would hurt. You could overstretch your shoulders or neck and your low back would hurt. Because that’s what’s wired to get stimulated no matter what you do. We just have to remember don’t cause pain, treat the entire body, and be multi-dimensional in your approach. Just don’t do massage, but make sure you’re doing awareness training or some relaxation training or you’re recommending some sort of meditation or some sort of relaxation program at home. Homework is really important — and that you’re doing some really gentle movements. We have to re-train the nervous system to bypass that overstimulated area and start to stimulate or create new pathways, new patterns in movement elsewhere. Because I also think we start compensating, and we get into this compensational pattern that we need to break. So be holistic and be multi-dimensional.

The buzzword that you’ll want to use with doctors is “bio-psycho-social.” You tell them massage therapists have been bio-psycho-social therapists for decades, forever, hundreds of years. That’s who we are; that’s how we work with people. And they’ll be impressed because they don’t quite know how to approach people that way, how to have their treatments all be diverse enough, holistic enough. So we can add something to the team that they don’t already have.

So enough background. What I also want to talk to you about is what you need to know. I did a survey when I wrote the pain book. I did a couple of surveys. We had 23 authors in the book and each writing about a different discipline, a different massage movement or mindfulness-based approach to treating pain. I gave them all this survey, and they were to hand them out to the healthcare providers that referred to them and to the patients that came to see them. And one of the questions that we asked was Why do you refer your patients to this massage therapist or this yoga teacher or whatever? And what stops you from referring to anyone else? Why is it this person and not other people? Two crazy answers. Well, one made sense, but the other one was totally crazy. The reason they send them to that person was because they got a massage from them and that made them feel comfortable. And I just think that’s a little crazy because they don’t do that with cancer patients. They don’t do that with somebody who’s got irritable bowel syndrome. Hey, go see this gastroenterologist that I went to. He’s great. They do it based on respect and reputation, and they don’t do that with us. And the reason why is because there isn’t enough research. And yet, there’s only — what do they say? — only 17-20% of medial treatments are research based? True.

AH Huh.

DT I know. And yet they keep saying, well, it’s not evidence-based; it’s not evidence-based. But if you think about it, the reason I said it kind of makes sense is we had little to none research 20 years ago. But in the last 20 years, we’ve got a lot more research. In fact, the Massage Therapy Foundation petitioned to have — petitioned; that’s not the right word — went to the Samueli Institute and asked for a systematic review to be done on pain. When they started investigating it, they found so much research they did three systematic reviews. And they were able to do two meta-analyses along with those systematic reviews. That’s huge. That says a lot. So know those three systematic reviews. You could do nothing else but take those three with you when you start asking for referrals. So read them, understand them; they’re available on the Massage Therapy Foundation website. They also have a database of the 100 research articles that those systematic reviews are based on in the meta-analyses.

AH And we’ll totally have a link to this in the podcast notes as well, everyone.

DT Right on. Because it’s money. Right there it’s gold for you. The other thing you have to do is document. Document, document, document. If it isn’t written down, it didn’t happen. You’ve got to have some evidence, some clinical evidence to show that what you’re doing is effective. You; not everybody else, but what you’re doing is effective. And they’re not just looking at pain. They’re looking at function, and they’re looking at mood because that’s where the research is.

So you’ll want to get a system, number one, that’s electronic; number two, that does measurement scales. And it’s really handy if it automatically fills a graph because then you just show them a graph, and they can see the progress over time, and your clients can see it and be really impressed with the progress that you’re getting with them.

Number three is to learn to communicate. You’ve got to find a common language. When you communicate — this is my big bugaboo — you don’t want to make crazy claims. Even if you think you know that they’re true. Like massage reduces lactic acid or massage increases blood flow or circulation. Whatever it is, don’t say it because the mechanistic research is not there to support it. Even if we all think it’s true. Which some of that is not very not true. So talk about results, not claims. Talk about the fact that they can now exercise. Talk about the fact that they’re sleeping better and say how much better. Talk about the fact that they’re driving again, walking again, having sex again, that they’re able to be independent again. So all of those things are really, really, really positive results that make a big difference. So there’s no need to make claims that you can’t substantiate.

Those are my three big pieces of advice: know the research, document your outcomes, and find a common language to communicate with, which is results.

AH We get a question pretty frequently, which is massage therapists who feel really overwhelmed by all of the new pain science, and they may have participated in conversations online that have been super aggressive one way or the other regarding evidence-informed practice and charting and pain science and feel completely scared to say anything and feel really unprepared to talk to clients, never mind other healthcare practitioners, about claims and results. Where do you sent someone to start? Let’s say you’ve got a new therapist out of school and their school didn’t provide this kind of background, which most don’t and that’s a whole other episode. Sorry, I almost tangented there. Or even a practitioner like me who — I’ve been around a while, but I haven’t done — I don’t feel like I’ll know enough to be able to speak in an educated manner. Where do you send me to start?

DT Yeah, I think to start — I’ll start with the research side because that’s my most recent background. I want to tell you the different between a systematic review or meta-analysis and a case study, for example. Or even a small pilot study. With a systematic review, you’re taking lots and lots of articles, research articles that have already been published and determining how valid they are. You grade them, you give them a particular level, and then you can make broader statements about, oh, massage can help with post-surgical pain, for example. That’s one of the articles. There was general pain, post-surgical pain — what was the other one? — maybe cancer pain, I think. So if it’s a meta-analysis, that’s the highest level of critical thinking or evaluating on existing research or a systematic review, which summarizes research but also grades them, you’re standing on pretty firm ground.

So I wouldn’t look to a literature search or even look and see what’s out there and grab on to anything that you see because you’ll find as many things pro massage as you will con massage. So it just depends on what somebody is looking for, you’ll find what you’re looking for. But if you go straight to the top, the highest level of research, that’s where you want to hang your hat. The systematic reviews and the meta-analyses that the Massage Therapy Foundation funded are the place you want to go. So stick with those, really.

I think if you could just talk about the clients that you have, then you’re also in pretty safe ground. Just don’t exaggerate. So talk about what you can, but don’t leave out what’s wrong. I think that’s the other thing about those bigger research studies. They really evaluate what went wrong with the study, what possibly skewed the results so that the next researcher can do a better job. And I don’t think we always think that way. We have to be critical about what we’re doing and what we’re talking about. The more honest we can be and say well, I think they got better because they suddenly started to go to yoga class at the same time, or they got worse and I’m not taking it personally because they decided to run a half marathon for the first time in a year since their injury. Or whatever it is. Just really look at the other influences at play and be honest about it. So don’t think you have to have a huge result or say something really big to be respected.

AH That is a good start. [laughs] You’ve given me enough to start with.

DT Oh, good.

AH Anything — this has been so — I so appreciate — I need to hear these things and I need to hear them in a variety of ways and from a variety of people who guide me through it and hold my hand through it in many different ways. And I so appreciate your approach and that’s helped me absorb a lot more. I think that hearing more about how to talk about pain and how to talk about pain science and how to talk to other practitioners, I think I absorb more every time I hear it in a different way from someone else. So I very much appreciate you giving me a lot more to absorb. And I am really confident that our listeners feel the same way. Anything else? Any final thoughts you want us to end on?

DT Yeah, I think when you’re approaching doctors, whether it’s in a pain clinic or in a cancer clinic or just doctors that your patients or clients already have, ask what you can do to help them. This is not about you selling yourself first. You have to show interest in them. Let them know that you will support the patient’s self-care plans; that you’ve got all this time with the patients that you don’t, and that you’re really happy to do what you can to make sure that what the doctor wants to have happen can happen. So create teamwork opportunities. Create a need for yourself by knowing what it is that they need and don’t just have it be about you trying to look good in front of them. Make them look good and that’s, I think, going to get you a foot in the door and make you different than someone else that’s just trying to sell them something.

AH Excellent. Thank you so much, Diana. This is so much. This is an episode, I think, a lot of us are going to listen to many times so we can keep absorbing more from it.

DT Good.

AH So, everyone, again, you can check out Diana’s electronic health records system online at handshealehr.com. And again, we’ll have all the links to that on the podcast episode, and you can find that at massagebusinessblueprint.com. You click on the little podcast tab and you will see all of our 150-something podcasts up to this point, the past couple of years’ worth of podcasts. You can see all of the notes and links and resources that we’ve put there under Diana’s episode. That’s all I’m going to say. This has been enough, and I don’t want to give anyone any more information that might overfill their brains. So thank you again, Diana Thompson, for joining us.

DT Yeah, you’re welcome. Thank you for having me.

AH Thanks. And, everyone, have a really wonderful day.

DT Bye.

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