The Medical Spa: The Next generation of the Spa Industry 

by Alexis Ufland   

Until recently, Western Medicine has failed to recognize the healing benefits of the Spa and Fitness Industry. With the arrival of the latest trend, the Medical Spa, the two fields have converged and caused a veritable explosion, making this new trend the wave of the future. As defined by the International SPA Association, a Medical Spa is an institution whose primary purpose is to provide comprehensive medical and wellness care in an environment, which integrates spa services as well as conventional and complimentary therapies and treatments. Dermatologists and Plastic Surgeons have been jumping on the bandwagon joining Day Spas and even expanding their practices to offer ‘higher level’ Spa services and care. As a consultant for the development of Medical and Day Spas, Fitness Centers and Hair Salons, I can attest that this is a welcome change to the industry.

Like a Day Spa, the Medical Spa enforces the importance of a relaxing atmosphere. Attention to detail is essential - from the color of the walls to the fabric of the robes. A soothing, comforting ambiance helps to put the client at ease for even the most uncomfortable medical procedures. However, the Medical Spa differs from a Day Spa in the following two regards. As a Medical Spa houses both a Medical and Esthetic staff under one roof, both medical and cosmetic treatments are offered within the center. Depending on the doctor(s) present, these services may range anywhere from Botox injections to Lipo-suction. Therefore, one role of the Medical Spa is a comprehensive approach to caring for the client before, during and after these procedures take place. The second distinction is, again with the presence of Western Medicine, the Medical Spa is able to use a higher-grade product and, therefore, the Spa services show greater results. A Medical Spa is the perfect balance between clinical and luxury. 

The first step in creating a Medical Spa is the concept design and menu of service. With the Doctor holding the reigns, the developmental stage must include their involvement. The Doctors support of all Spa services and products is crucial to a Medical Spa’s success. The difficulty lies in creating a menu of service that is synergistic with the doctor’s way of thinking, yet still a marketable product. Doctors often feel divided with regard to the benefits of certain Spa services. This attitude differs from Doctor to Doctor. It has been my experience that some Dermatologists promote Topical Collagen Facials while others are ambivalent towards its results. Some are staunch proponents of ‘Oxygen’ facials; others are hesitant about their benefit. Some Doctors refuse to use the word ‘toxins’ and ‘detoxify’ in their vocabulary (a difficult adjustment for Spa therapists!). A happy medium must be reached in order to ensure smooth operations. It is wise to present thorough research and sound medical proof of Spa services so that the Doctor can recommend and support the menu without compromising his/her integrity. Procuring Medical endorsements will afford you many options, if you are creatively inclined. For example, it is always a safe bet to begin your menu with Vitamin C and Glycolic Peels. Doctors advocate these treatments due to their efficacy and proven results. Vitamin C and Glycolic Peels can be parlayed into both face and body treatments. A full body Glycolic peel followed by an Anti-Oxidant body mask is a sure hit at a Medical Spa. A creative treatment menu can be both luxurious and medically sound. 

Along with service selection, finding the correct ranges of products is a vital part in development of the Medical Spa concept. Pharmaceutical companies have just begun designing products solely for Medical Spas. Dermatological pharmaceutical representatives allow these new products to be offered in your spa as long as there is a Doctor on staff. Custom facial design is necessary, though, as pharmaceutical product ranges do not impart technique. 

Coverage for both General and Professional Liability differ from state to state and need much research prior to opening. Depending on the services offered the Spa could be an extension of the Doctors practice or its own entity, each having its own method of protection. The owner of a Medical Spa has two choices, the Doctors practice and the Spa can be covered under one medical malpractice policy or they can separate themselves and be covered by two policies, a malpractice and a basic spa/salon policy. Although all practices and therapies are under one roof and panels may be formed to diagnosis and treat patients, the reality is that each individual practice or class of services should protect themselves. With the increase of Esthetic services offered within the Doctors office, there are now medical coverage firms, such as PRI, that are beginning to cover a wide array of spa services ranging from Intense Pulsed Light Hair Removal to Bikini Waxing. However, these firms avoid covering such therapies as Massage, Acupuncture, Ayurveda etc. Therefore, if the doctor were to place the Spa under their malpractice policy these practitioners would have to cover themselves independently. On the flip side, the doctor can cover their practice separately from the Spa and hold two policies. This would allow coverage for a wider range of spa services. Unfortunately there is not only one standard answer for everyone, research needs to be done to find the policy and method that suits their facility, the type of services they expect to offer and the budget that they can afford. On the subject of protection, Doctors within Medical Spas should not only separate their practice by liability coverage but also have contracts that include a 'No Hold Harmless' clause. In the case that a problem does occur, neither Practice nor Spa will be held responsible for someone else’s actions. Research into state medical 'referral' laws are also very important, practices may need specific disclaimers to recommend patients to visit the Spa.  

The staffing of the Medical Spa is an essential element of a successful operation. The licensed therapists or ‘Para-Medical Estheticians’ require a working knowledge of all medical procedures performed by the Doctors. Estheticians are encouraged to spend an afternoon each month with the Doctor on staff to gain understanding of the procedures that the Doctor performs. Under the Doctors guidance and supervision, the esthetic staff should be thoroughly trained in patient preparation and contraindications for pre and post surgical treatments. When hiring staff, it is advantageous to employ Estheticians with varied medical backgrounds. Estheticians that have worked as a Dermatologists assistant, Registered Nurses and Estheticians with ‘Para-Medical’ continued education courses are definite assets. Experience in a Medical setting combined with a healing touch is of great value to an operation. Many Esthetic schools are adding both continuing education classes and courses with a medical influence to their aesthetics program. For example, The Dermal Institute offers continuing education in classes such as Microdermabrasion, Manual Lymphatic Drainage Massage and even Oriental Pressure Point Massage. Other schools such as The American Academy of Cosmetology in Danbury CT and the American Academy of Medical Aesthetics are adding entire two week to three-month postgraduate courses to further Estheticians knowledge of cosmetic surgeries, product ingredients and contraindications to specific medicines. To graduate from these programs, Estheticians must complete an internship where they spend two to four weeks working side by side a Dermotologist or Plastic Surgeon. For further training, it is advisable for the doctors to give lectures and presentations on a regular basis. This education will breed a close working relationship between doctor and Esthetician. 

With the industry’s increased recognition by Western Medicine and our clientele’s increased acceptance of Eastern Medicine, the future of the Medical Spa looks both promising and encouraging. The Medical Spa has only scratched the surface of its potential evolution. Hospitals and Health Insurance companies are taking bold new steps in the areas of ‘Alternative’ medical care and coverage. Doctors in private practices are providing ‘spa-like’ services to patients to ease and soften harsh clinical treatments. A notable example is the prominent Dentist who has now added light therapy to detract from the pain of oral surgery. We will be seeing more Medical Spas bridging its multitude of Spa services with various Medical environments.  

Dermatology, the original and currently most popular Medical practice that integrated Spa services has recognized that Cosmetic procedures tie in smoothly with anti-aging Spa treatments. Clients are more aware of Cosmetic Dermatological procedures such as Collagen, Botox and Laser resurfacing. These cosmetic procedures need before and after care as well as a maintenance program that can be performed by an Esthetician. Other services include Organic and Crystal Microdermabrasions, Laser Hair Removal and Camouflage Make-up. Dermatologists, however, are not the only Doctors that can prosper from the Medical Spa.  

With a Plastic Surgeon on board, the Medical Spa can provide for the client before, during and after surgery. Prior to surgery, patients benefit from the addition of yoga stress control and self- image counseling. During surgery, energy work with a Reiki Master may be incorporated, or an experienced Acupuncturist might even take the place of an Anesthesiologist. Post treatment may include long-term weight management programs with Nutritionists and sessions with Personal Trainers. Estheticians and Massage therapists can perform Spa treatments that will accelerate healing such as Lymphatic Drainage and Scar Management. Another way to integrate the Spa and the clinical is to design packages that include both Spa and medical services. For Example, you might upgrade a Detoxifying Seaweed Body Wrap with cellulite reducing Acupuncture and include a program of six with every Lipo-suction.  

An OB-GYN is a great asset for a Medical Spa as well as untapped market. Massage therapists and yoga instructors can guide patients through their pregnancy. Estheticians can perform facials with products that are non-toxic and safe for mother and child. Mommy Massages and Refreshing Leg Treatments that reduce swelling and water retention also comfort expectant mothers. Post care may include a Nutritionist and a Personal Trainer and Stretch Mark Management can be provided with a Tummy Micro-dermabrasion. Mothers to be need not feel excluded from the sybaritic anymore. And, do not forget about our baby boomer population; Menopausal women now have product available such as B. Kamins, which are designed strictly for their skins changing needs. 

Our clientele’s increased acceptance of Eastern Medicine opens many new doors and allows us to combine ancient Oriental and Indian Medicine with Spa services. Cosmetic Acupuncture has fantastic results when combined with a facial to increase collagen production. Acupuncture also has great results when combined with Body Treatments to reduce cellulite. Ayurveda is the oldest Medicine and yet the newest to hit the Spa scene. Purva and Pancha Karma treatments add different approaches to healing and balance. Chinese Medicine and Herbs are wonderful to incorporate in face and body treatments and are very popular when sold as supplements within your gift shop.  

A Medical Spa with an Oncologist on board can be extremely rewarding. Chemotherapy patients are often in need of skincare that is all natural and non-toxic. Detoxifying treatments, spiritual healing, energy work, scar management for post Mastectomies and Lumpectomies, as well as a trusting place to get fitted for wigs are just a few ways in which cancer patients can benefit from the Medical Spa.  

With all these possibilities abounding, we can only begin to imagine the future expansion of the Spa industry. Converging both sciences with spirit and East with West, it is a natural progression for today’s fast paced stress filled society. The Medical Spa helps the patient take the necessary time to heal and recuperate, it makes the patient feel beautiful in times of illness and it acknowledges alternative practices of medicine whether East, West, Complementary or Esthetic. The Medical Spa is the future generation to the Spa industry. 

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