Conventional business models for medical spas leave something to be desired—at least they do in the view of Raleigh, NC, aesthetic plastic surgeon Michael Law, MD.

“In a typical arrangement, you’ll have a physician who invests in a medical spa venture set up and run by outside interests, leaving him excluded from any of the decision-making with regard to mission, philosophy, and technology,” Law says. “For a physician to be in this kind of situation is potentially disastrous for him or her.”

Physician risk would be lower, Law suggests, if physicians stopped treating medical spas as mere afterthoughts and, instead, started seeing them as vital ventures that can and should be seamlessly woven into the fabric of practice. That’s how Law has structured his own medical spa—Blue Water Spa—which garnered Best Medical Spa awards in 2006 from American Spa and Skin Incmagazines.

“In my opinion, a true medical spa is a place that offers pampering therapy with medical-grade skin care treatments and products that provide visible results, all fully integrated into the medical practice,” he explains. “The advantage of this approach is that an individual’s entire list of aesthetic needs can be met in one location, drawing as needed on the combined expertise of the surgeon, nursing staff, and medical aestheticians. In other words, the practice–spa integration model allows me to provide a wider range of aesthetic treatment to virtually everyone who walks in through my doors.”

Efficiency Strategy
Law’s Raleigh practice and Blue Water Spa opened in 2003. The freestanding building that houses both affords some 5,000 square feet of floor space between them. However, because they are integrated, there isn’t a distinct section devoted to plastic surgery and another to the spa.

Law elaborates, “Whether you’re coming in to see me for surgery and follow-up or you’re coming in for spa treatments, you’re greeted by the same concierge, you’re seated in a common waiting area, and the same rooms I use to see and treat patients are also used by the spa staff for facial work and other services. So, in this office, you’re always in the medical practice and the spa at the same time, wherever you go.”

Law does not believe that plastic surgery alone is the answer to every patient’s needs. As a result, he usually is not the first to meet with newcomers seeking an initial consultation. Responsibility for that is delegated to the office’s clinical staff, according to Law’s wife and business partner, Kile Law, a noted authority on spa design and operations.

“Not everyone who thinks they need a facelift actually does,” she says. “Our approach allows us to explore with the patient other ways to achieve a particular set of aesthetic objectives.

“For example, it might turn out that a laser treatment, or perhaps a filler, is the most appropriate choice for the patient. In any event, it’s an approach that makes things more efficient for my husband. Since he isn’t tasked with providing a consult for each and every seeker of aesthetic services, his time is freed up so that he can focus more of his attention on those who need his particular set of skills.”

This arrangement results in remarkably high levels of satisfaction among patients, Michael Law reports. Consequently, he has been able to achieve business success faster than might otherwise have been possible. “In a very short time I’ve developed a plastic surgery practice that is now based primarily upon referrals from satisfied patients,” he enthuses.

Further contributing to satisfaction is the fact that, once they arrive at the office, patients spend little time in the waiting room. Efficiencies built into the operation of the facility permit this.

Kile Law says, “One thing we’ve done is make sure we have a sufficiently good ratio of staff to patients. That way, patients can be taken care of more quickly. Another thing we’ve done is to provide an adequate number of treatment and consultation rooms for our volume of patients.”

The refinements the practice has made over the years to its scheduling rationale have also been important. “We factor into each appointment what we feel are the right number of minutes for patient preparation and room turnover,” Michael Law says. “Doing so reduces some of the potential for progressively falling further behind schedule as the day unfolds.”

Trained for Success
Law entered practice in 1998, the same year he completed his plastic surgery residency and fellowship training at the University of Southern California in Los Angeles.

“Medicine was all I ever seriously considered doing,” says Law, the son of a Raleigh pastor. “As a kid, I had a microscope, a chemistry set, and a telescope—I was the archetypical science geek.”

Kile Law on Employee Satisfaction
Because the majority of consumers of aesthetic services are women, it behooves a plastic surgery practice to fill the ranks of its staff with women who have affinity for other women, says Kile Law, wife and business partner of aesthetic plastic surgeon Michael Law, MD.

“You want employees who will be emotionally supportive of the women coming to see you,” she says. “The staff should be of the frame of mind that they’re cheerleaders for the patients.”

Michael Law’s Raleigh, NC, practice—which seamlessly incorporates a medical spa—employs a staff of 25. Many of the workers are present on only a part-time basis because that’s the way they prefer it. “The shorter hours gives them the flexibility to raise a family as well as have a career,” says Kile Law, herself a part-timer for that very reason.

When it comes to retaining good employees, Kile Law believes the key is making sure the staff members are satisfied with their jobs. “Pay good employees at least what they are worth, then add enough perks to keep them around,” she says. “Also, consider giving them performance- and responsibility-based raises.

“Some employees are motivated primarily by their compensation; others are motivated by working in an environment that fosters and values a sense of camaraderie. Still others respond the most to being appreciated—for themselves as individuals, for their own personal skills or talents, or for their contributions to the success of the business. Some employees place the greatest value on having the opportunity to perform the specific task or tasks for which they have trained.”

Kile Law also recommends providing cross-training for employees. “Employees,” she notes, “usually value the opportunity to expand their knowledge base and update their skills so that they can be at the cutting edge of aesthetic science and technology.” —RS

His college education began in 1980 at the University of North Carolina, Chapel Hill. He graduated with honors 4 years later, the holder of a degree in science and membership in the Phi Beta Kappa honor society. From there, he went to Emory University in Atlanta. He emerged in 1988 as a newly minted doctor of medicine (he graduated magna cum laude and was ranked second in his class).

While in medical school, Law acquired a keen fascination for the intricacies of human anatomy and physiology, which led him to choose surgery as his field of specialization. He then undertook general surgery training at the University of California, Los Angeles (class of 1995), and during his residency he became interested in plastic surgery.

“I really liked that plastic surgery allowed for more interventional possibilities than general surgery,” he recalls. “With plastic surgery, in almost any given case, there are going to be a variety of potential solutions from which you can choose. This is not typically true of general surgery.”

Law transitioned directly from school to solo private practice. He chose to hang his shingle in the most crowded and competitive plastic surgery market on the face of the Earth: Beverly Hills.

“I had a very specific vision for the kind of practice and the kind of business that I wanted to build,” he says. “I felt that the quickest route to fulfilling my goals and dreams was to be making the decisions myself, which I could only do if I were in solo practice. I also felt I could succeed in Beverly Hills because of the excellent training I received and the strong set of skills I possessed.”

Return to Raleigh
Indeed, his practice grew steadily during the handful of years he was in California. Then, in 2002, he pulled up stakes and relocated his practice to North Carolina.

“I thoroughly enjoyed California—I enjoyed training there, I enjoyed practicing there, and it had a lot to offer,” Law relates. “Being that Southern California was so vital a center of aesthetic surgery made me a better surgeon. But I wanted to be back in Raleigh, back with my family; that’s where my heart really was.”

Law was confident that he could transplant most of the elements of his Golden State practice to more conservative North Carolina. This was a move he began to plot not long after he established himself in Beverly Hills. Law took his time, though, in setting a date for his eastbound departure.

“I didn’t want to be premature,” he explains. “Raleigh and the region around it were growing at a rapid rate, becoming more and more affluent and cosmopolitan, and attracting a huge influx of people from all parts of the country and around the world. But I didn’t want to be in Raleigh until the city had become big enough to support my practice.”

It was during the wait for that right time to arrive that Law found love in the arms of the former Kile Lee, a medical-products clinical trainer and spa consultant from Newport Beach, Calif, who earlier had served on the State of California’s Laser Hair Removal Task Force. The couple met when she paid a visit to his office to discuss clinical training for a product she was promoting: an injectable filler.

“I had a rule that my professional life and personal life were separate, and for that reason I never dated physicians,” Kile Law recounts, adding that her rule fell by the wayside after getting to know Law. “He called me some time later and asked if I’d like to go out with him. I told him I would.” Wedding bells tolled for the pair in March 2002.

Michael Law on New Technology
Michael Law, MD, says that he is continually watchful for innovative devices, systems, and products, but adds that he approaches anything new with a healthy degree of skepticism.

“The popular media today are filled with reports of the ‘latest and greatest’ aesthetic treatments and procedures—including surgical procedures,” he says. “Some of these have tremendous marketing potential, the potential to bring a lot of patients to the practice, both for the first time and for return visits. Unfortunately, some of these turn out to be clinically ineffective, and others have an unacceptably high risk of complications. In addition, a fair number of so-called ‘new’ treatments turn out to be recycled versions of older technology.

“I don’t want to subject patients to these less-than-satisfactory treatments and procedures because, if I did, it would cause them to lose confidence in this practice. To prevent that from happening, we strive to carefully identify the treatments and procedures that are safe, effective, and appropriate. Only then do we incorporate them.” —RS

Before exchanging vows, the Laws talked about partnering not only as husband and wife, but also as business operators of a plastic surgery practice that would include an integrated medical spa. “Kile had extensive knowledge and experience in skin care, lasers, and antiaging therapy. She brought a lot to the table,” Michael Law says.

Although Kile Law has played an important role in developing Michael Law’s practice and spa, her day-to-day involvement in the business has been limited by the call of motherhood. “Our first son, Luke, who is now 4, came 9 months after our honeymoon, so I’ve worked in the office only part time,” she says. “Raising the children—there’s also our younger son, Lang, who’s 2—is my main concern at present. But that’s OK because, once we started implementing all our ideas for the integrated practice, they took on a life of their own.”

Reputation for Giving
The Laws’ business model was unconventional, and so was their approach to building awareness of the practice and Blue Water Spa. Mainly, they spread the word by cultivating good will through participation in charitable endeavors and community events—something they continue to do, only now in grander fashion. In 2004, for example, the practice and the spa together donated almost $500,000 in cash and spa treatments (mostly facials and massages that could be used as raffle prizes); in 2006, such contributions swelled to slightly more than $2 million.

Nonprofit organizations and charitable events supported by the Laws include: Prevent Blindness North Carolina, the Red Cross, Duke Children’s Classic Juvenile Diabetes Research Foundation, Raleigh City Museum, Walk for Hope, Alliance Medical Ministry, the Literacy Council of Wake County, the Cape Myrtle Festival, Raleigh School, the Holt Foundation, St Mary’s Church, and the National Multiple Sclerosis Society.

“At first, we contacted the organizations we wanted to support,” Kile Law says. “Now, as word of our reputation for community generosity has spread, we’re the ones being contacted. We don’t do any of this to be self-serving. We are frequent donors because that’s just what we believe in, that it’s the right thing to do. It’s who we are. But there’s no question that our involvement at this level with the community does benefit our business.”

On The Web
See also “Find and Keep” by Michael Law, MD, and Kile Law in the February 2006 issue of PSP. Go to and click on “Archives.”

Beyond its generosity, the Laws’ practice is widely known now throughout the area for the medical procedures it offers: facial rejuvenation, breast augmentation, breast lifts, liposuction, abdominoplasty, gynecomastia treatment, rhinoplasty, and fat grafting. The procedures are performed in hospital-based operating rooms, most frequently at WakeMed North Healthplex in Raleigh.

“I feel more peace of mind about having my cases—many of which are complex and lengthy—operated on in the hospital so that patients can have an overnight stay and be kept under observation by highly trained nurses,” Michael Law says. “That gives the patients and their families more peace of mind, too. Because of that, there is a high level of trust and confidence in my practice.”

To Franchise or Not
This preference for hospital surgeries makes it unlikely that Law will build an in-office operating room anytime soon. Besides, there are other things that require the Laws’ attention.

In 2006, for instance, Blue Water Spa began to offer consulting services to medical spas across the United States, Australia, New Zealand, and Canada. In this program, the physician and his wife offer training DVDs and manuals that deal with creating spa business plans, facility layouts, treatment protocols, marketing strategies, and more.

The Laws have considered and—initially at least—decided against offering a traditional franchise package for physicians interested in opening a medical spa. Instead, they are exploring the possibility of replicating their business model to plastic surgeons interested in adding to their practices a medical spa and aesthetic laser services.

Kile Law says, “We’re not going to offer a franchise to anyone other than a physician. There are medical spas operating with no physician on-site. We believe this is a bad thing for consumers and for the medical-spa industry.”

Rich Smith is a contributing writer for Plastic Surgery Products. For additional information, please contact [email protected].