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Submitted By Anonymous

A regular female client of mine is a very nice lady, but she is, in a word, obese. Any massage therapist knows how layers of adipose tissue make accurate assessment and treatment difficult. I have two hourly rates reflecting complexity and demands of the treatments, with one being $10 higher than the other. This client originally saw a coworker of mine in an office we shared, and then she quit doing massage therapy. I originally charged this lady the lower rate, but realized this was not sensible, particularly since I often apply kinesio tape and/or used advanced techniques. If she were to question the higher rate, I would tell her that my rates are based on advanced training and skills; I draw upon for individual cases. (Working on an obese person requires extra finesse and energy, to say the least.)

If you were confronted with the same situation again, how might you handle things differently?

Response from Anonymous

I would handle the same situation in the same way.

Response from Institute for Integrative Healthcare Studies

Charging differently for a client who is obese walks a very fine line of inappropriateness. It is illegal to discriminate based on physical characteristics. Would you charge less for an extremely skinny or short person or more for an extremely muscular or tall person? Would the fee be different for a person with Parkinson’s disease, or a person confined to a wheelchair? An hour-massage should be charged the same no matter who the client is, what they weigh, what they look like or what their disability might be. If the client signs up for a 90-minute massage, then yes, of course the charge would reflect that.

You may charge differently for various types of massage, and using kinesio tapes can justify this in some cases, as long as you do the same for ALL the clients you use the tape on. Just basing your rate on advanced training is not a reason for increased charges, unless you charge the increase across the board.

Individuals who are considered obese already experience a lot of prejudice and discrimination based solely on their weight. Who is the one to determine at what point obesity becomes so problematic that a massage therapist must increase the fee? Is it by sight evaluation alone, or is the client weighed. If a bodybuilder came in and weighed the same would he or she also be charged because of the extra pounds, or since they are more “fit,” would they be excluded? Is a pregnant woman charged extra during her third trimester because of her weight increase?

All these questions need to be asked in justifying the increase of price for one client over another. As massage therapists we need to ask ourselves if we are being fair and just to our clients, and are we obeying the law with regard to setting prices.

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