Do not turn away the person who is paying the bills. Do not hurt someone's feelings--they are more aware than you think. The therapist chose this industry--not everyone who walks through the door will be a "10." But everyone represents humanity.

Find something good to say. Let them know they are valued. Their eyes will light up. This will make their day (perhaps even their week.) But be honest. A client can weigh 400 pounds yet have very nice skin. Say the good.

Shape does not matter. There are all kinds of bodies. But the body is not all of the person. When the therapist acknowledges the full person, then real touching begins.

Clients may be protected by law against discrimination. The New York State Education Department, for example, says, "Massage therapists do not discriminate in providing services to patients/clients based upon culture, ethnicity, age, gender, belief, or sexual orientation." The Office of Civil Rights of the federal Department of Health and Human Services held that the city of Los Angeles had to license an HIV-positive therapist. It is probable some jurisdictions have applied the same protection to clients.

Disabled persons may be protected under state or federal law. Massage establishments may need to comply with the public accommodations portion of the Americans with Disabilities Act (ADA). Information is available at http://www.usdoj.gov/crt/ada/adahom1.htm or by calling 800-514-0301.The 1990 Act has engendered considerable litigation. Not even the state of Tennessee was immune. In 2004, the United States Supreme Court in a 5-4 decision ruled George Lane could sue the state of Tennessee for failing to provide an elevator in a courthouse. Mr. Lane appeared in court by crawling up the steps. On a second occasion, he refused to crawl again. Court employees indicated he refused their offers of assistance. He was subsequently arrested for failing to appear. Remodeling raises greater diligence issues but there is no grandfather clause--even existing buildings must comply to some extent. Tenants are as responsible as landlords for conforming to the Act.

Do not put down other modalities of therapy. One client asked a technician with little experience not to press on an old injury in the back. The therapist said, "Oh, those doctors don't know what they're talking about. I can fix that." Without permission, the therapist began doing hard manipulation. The client had to return to the doctor and was in pain for several weeks. Not only did the therapist never see the client again but may have given the impression the industry is full of flakes.

There is still tension between therapists and other health professionals. The gap is just beginning to be transcended. To continue coming together, therapists need to respect the medical profession. While therapists may have their own opinions, it is better to use diplomacy.