A look at the present and future growth of the medical-spa industry

The medical-spa industry has certainly evolved quickly into a lucrative area for practitioners, and it has surpassed even the most cynical concern that this is just another passing trend. Change is in the air for the traditional spa, and consumers are wanting and paying homage to this new breed of spa. However, as with any new trend, understanding its origin and its potential is essential before jumping on the bandwagon. In this article, we will discuss the present and future growth of the medical-spa industry.

A medical spa offers a broad spectrum of noninvasive procedures intended to improve the aesthetic appearance of the skin, in a spa-like environment. What differentiates it from a traditional or day spa is its menu of services, which spans beyond the simple, expected aesthetic feel- and look-good treatments and into the arena of new fillers, botulinum toxin Type A, and other age-management services. 

Bernard Shuster, MD, a Florida-based plastic surgeon, says, “I took note of my patients’ growing interest in aesthetic-enhancement procedures that went well beyond my typical practice. My desire to meet and exceed their needs was the impetus for expanding my plastic surgery practice into the new and potential-filled world of the medical spa.”

Shuster is not alone in his desire to embrace the growing number of re­quests from pa­tients to receive more than a feel-good facial. According to the American Society of Plastic Surgeons, the top five procedures performed in 2005 were botulinum toxin Type A injections, chemical peels, microdermabrasion, laser hair removal, and sclerotherapy. There were 8.4 million noninvasive procedures performed in 2005, an increase of 13% over 2004.

From Yesterday to Today
To best understand the evolution of today’s medical spa, it is noteworthy to consider that the very first medical spas and skin care centers were outgrowths of or additions to existing dermatology and plastic surgery practices. Physicians in these practices were already seeing patients who would be natural candidates for such procedures as those offered at a medical spa. However, these procedures were not covered by traditional health care insurance.

In most cases, a separate business had to be organized around these aesthetic procedures. The patient would be asked to pay cash for the procedure, and this triggered the desire to create a separate environment that was perhaps less medical and more spa-like.

While medical spas were not full-scale day spas, they incorporated some of the same features that discriminating consumers have come to expect when paying cash for their ageless beauty treatments. Recognizing the need to separate the medical-treatment areas from the aesthetic-enhancement procedure area, the physician would create a separate entrance for these “well” patients and provide additional pampering and soothing attention.

The growth in this field has prompted the stand-alone medical spa. During the past 5 years, many physicians in specialties not related to skin disease or aesthetic ap­pearance—such as emergency medicine, in­ternal medicine, neurology, or obstetrics and gynecology—have opened freestanding medical spas or “laser centers” to create their own brand of medical spa.

Because the medical-spa industry began without clear regulatory guidelines, a physician was not even required to be on-site at these laser centers. Gradually, most states have clarified the laws about the practice of medicine as they relate to medical-spa procedures and the use of lasers for skin procedures, which put an end to this phase of growth in the industry.

Changes Are Coming
Change is inevitable for the medical-spa industry, with regulations coming soon to a state near you. Florida is the first state that has defined the practice of medicine in a medical spa in such a way that only a plastic surgeon or a dermatologist may actually operate a medical spa. In Florida, a surgeon can be the medical director of only two medical spas, and a physician is required to be on-site or nearby. 

According to Hannelore Leavy, executive director of the International Medical Spa Association (IMSA), “Many state medical boards are instituting or planning to institute restrictions about who can operate a medical spa and what licenses and training are required, both by the doctors (not necessarily dermatologists and plastic surgeons) and from their staff.”

She explains that therapists are being restricted in many states to RNs, PAs, and aestheticians with medical training. Medical-spa owners and operators are advised to check with their state medical boards and their cosmetology boards with regard to their licensing requirements and to monitor their legislative bodies for any upcoming changes. IMSA encourages and invites the medical-spa industry to keep it informed about any upcoming bills before the boards so that it can alert the industry and possibly influence any unfair restrictions that are being opposed.

Similar regulations will undoubtedly spread to other states and may fan out na­tion­wide. As a result, we will see the birth of the next generation of medical spas. 

The Next Generation
What will the next-generation medical spa be like? It will incorporate antiaging modalities and therapies with medical spa treatments in the same location. (See this month’s cover story, “The Bene­factor,” on page 14.)

Several physicians or medical professionals will work from the same location. They will offer one-stop shopping for the patient who seeks higher degrees of wellness or antiaging medicine while wanting to look their best as well. Moreover, patients using these new services will be able to finance their procedures with ease and affordability.

Having a patient-financing program in your practice will help you attract more patients, convert more consultations into procedures, and increase your repeat and referral base.

According to a 2006 study conducted by Inquire Market Research, 78% of patients were more likely to schedule an appointment when a patient payment plan was offered. This same study found that 80% of patients were more likely to schedule the procedure they wanted immediately, instead of delaying treatment when they had the option to make time payments. Finally, 72% of patients were more likely to return to providers who offer a payment plan for additional services, and 77% of patients were more likely to recommend that practice to friends and family.

The new-generation medical spa will give rise to true antiaging practices, punctuated by menu offerings that may include bio-identical hormone-replacement therapy, stress management, and weight management, along with the noninvasive procedures that are time-honored and have created a loyal customer following.

These practices will also sell very high-quality nutritional supplements and skin care products. Two or three medical professionals will combine their specialties to help each patient feel and look their best, stepping out of the à la carte mentality of seeking aesthetic-enhancement procedures. Treatments will work from the inside out and the outside in.

In addition, these facilities may also offer innovative treatments for smoking cessation. Many will offer massage therapy, and some will even offer yoga or Pilates classes.

There will be a growing trend for sex-specific medical spas. In some cases, an obstetrician–gynecologist will open a medical-spa practice dedicated to treating special issues faced only by women.

In the same way, medical spas dedicated to men will emerge that deal with sexual health issues specifically faced by men, hormone therapy issues, and special facial treatments for men. More and more niche practices will launch to address specific needs.

Brad Calobrace, MD, a plastic surgeon and owner of Kentucky-based Calospa, says, “The medical-spa business is experiencing a dynamic change, and the underlying business model has shifted from a laser hair removal-centric service business to a broader base of cosmetic medical procedures and services. This trend is expected to continue with innovative and dynamic medical spas offering new and in-demand services including, but not limited to, age management, men’s health, vein treatments, and related services.”

Ethnic Specialization
The number of practices dedicated to the treatment of certain ethnic groups will also increase. Special medical spas to treat the unique skin issues of African Americans will come into existence, as will others to treat other ethnic groups.

Some medical spas may open that offer Ayurvedic treatments and holistic medicine. An Ayurvedic spa could offer signature treatments designed to reduce toxins in the body through stress reduction and increased lymphatic drainage, which is also recommended for postsurgical patients. Here again, when combined with medical spa procedures, the result is that an internal healing therapy meets aesthetic therapies, and that healing occurs from the inside out and the outside in.

Some medical spas will offer consultations in sports medicine because the patients will want to use their physical abilities to exercise or to play sports later in life. Regular exercise is still seen as a major contributor to long-term health and wellness. It promotes cardiac health while reducing the risk of diabetes or high blood pressure.

Exercise also leads to lower incidence of obesity and generally better mental health. Wellness facilities for age management will certainly devote time, and some will have on-site space, for exercise physiology and sports medicine. (See InReview on page 12 for examples of specialty medical spas.)

On The Web
See also “Plunging Into Something New” by Cheryl Whitman in the December 2006 issue of PSP. Go to PlasticSurgeryProductsOnline.com and click on “Archives.”

The medical-spa business is still in its infancy, eager to grow from experience and embrace all that has yet to be innovated in the field of aesthetic-enhancement offerings. For now, it is a work in progress, fielding change at a dynamic speed, and creating robust business models. The only thing constant is change, and it is this change that is propelling this growing industry.

Cheryl Whitman, a beauty-industry consultant for more than 20 years, is the founding board member of the Medical Spa Society and an active member of the Day Spa Association. She is the CEO of Beautiful Forever, a nationwide medical-spa consulting firm. She can be reached at (201) 541-5405 or [email protected].