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Medical FACING A BRIGHT PROSPECT BY ANDREW WOLFFE Rarely has the outlook for any part of the spa industry looked better than the medical spa industry looks right now. Owners, operators and customers worldwide are taking advantage of high-quality skin treatments with proven results, increased acceptance of injectibles and the availability of safe and affordable laser technology. Not long ago, the outlook was very different. Medical spas boomed in popularity at the turn of the 21st century as dermatologists looked for new revenue streams and realized the potential of adding medical spas to their businesses. That boom became bust as the recession of 2008 hit; customers tightened their belts and some medical spas closed their doors permanently. However, improved economic stability has given the industry a shot in the arm and the current outlook for medical spas is now much brighter. In 2014 there were more than 1,700 medical spas in the U.S. alone, according to the ISPA 2014 U.S. Spa Industry Study, offering the latest technology in traditional spa settings. A wide variety of treatments often includes liposuction, laser skin treatments and body sculpting on top of nonmedical spa staples like facials, wraps and massages. 28 PULSE n July 2015
THERESIA KELLY Director of Spa Operations Aqua Medical Spa at Gulf Coast Dermatology Panama City, Florida Medical Spa Definition The ISPA definition of a medical spa is strict: A facility that has a full-time licensed health-care professional on-site, which is further defined as a health professional who has earned a degree of Doctor of Medicine (M.D.) as defined by the AMA. All applications are reviewed individually and international standards are taken into account when applicants from outside the U.S. apply for membership. That definition means that getting a medical spa up and running is not as straightforward as setting up a traditional spa, partially a result of having to find and hire a qualified staff. Upto-date equipment is also significantly more expensive than traditional basic spa necessities. Calculating the Risks Dr. Diane Wong owner and general practitioner at Glow Medi Spa in Ontario, Canada says opening a medical spa requires significant ongoing investment: Each laser costs more than a sports car. It is not just the equipment and staffing, you also have to consider liability insurance, which is a huge part of our costs. Anyone doing this sort of work without adequate medical training, supervision and insurance is taking a great risk. Many (but not all) medical spas are directly associated with dermatological practices, so as a result, usually have a mix of clients. Many clients are not dermatological patients and are paying out of their own pocket for cosmetic procedures. However, others may have been referred directly by a dermatologist to address a medical need. It is very important to appreciate different clients and realize the difference between what is considered medical and what is considered cosmetic, says Theresia Kelly, director of spa operations at Aqua Medical Spa at Gulf Coast Dermatology in Panama City, Florida. Less is More Like the traditional spa industry, the medical spa world has its fair share of treatments that move in and out of fashion. The current trend is for less invasive procedures and more topical treatments, says Kelly. Rather than having liposuction, customers want non-intrusive procedures that require no downtime, like cold sculpting. Botox is always popular but even there we see new injection products coming on to the market almost on a monthly basis. Bond Poire, spa director of Mandala Med-Spa & Yoga Shala in Sarasota, Florida, sees similar developments. It s probably the first question people ask: Is there any downtime? she says. People want to be in and out. Microdermabrasion is also in decline. It used to be the big skin treatment, but dermaplaning, which is done with a surgical-grade razor, has taken over. It is providing much better, long-term results. July 2015 n PULSE 29
In a Flash Spa customers not only want better treatment, they also want faster treatment. Among our most popular treatments are those that people can do over lunchtime, sometimes in half an hour or less, like a yoga class or express facials. They want to fit in as much as possible in as short a time as possible, Poire says. Not all treatments are automatically available to just anyone who wants them; pre-treatment consultation with a doctor is an important part of the client medical spa relationship. Medical staff should make sure that a client is suitable for and needs the treatment being discussed. Long-term efficacy is only possible if the customer is willing to adjust his/her lifestyle to suit the treatment. There are no quick fixes. We can only help customers as much as they want to help themselves, Dr. Wong says. Clean-living Choices Wider lifestyle changes and consumer demands over the last decade have also had an influence on medical spas. Take the growth in organic produce in grocery stores clients at medical spas are increasingly demanding organic products and a more holistic approach. Many of our treatments are based on traditional practices developed in Indonesia and Thailand, says Poire. And many of our products are produced organically in the same place. Kelly says that organic and holistic offerings are increasingly sought-after by spa-goers. Our mission is to fuse medical and holistic-care concepts to create a well-rounded care for our clients. This involves not only offering a softer side to the medical spa model but also offering more retail products that are wellness-focused, such as herbal neck wraps and aromatherapy. Male Factor Another trend that is being repeated across the spa industry is increased male participation. The last time we did our research, most of our clients were female with ages between 47 and 57, says Poire. But the most consistent clients are men who will often book out the whole year, show up for appointments and buy packages. Perhaps men look at it as more of a necessity, DR. DIANE WONG Owner and General Practitioner Glow Medi Spa Ontario, Canada 30 PULSE n July 2015
whereas women look at it as more of a luxury. Dr. Wong sees that trend growing and is particularly excited about the prospects for treating male-pattern baldness. If you catch the hair while it is still beginning to thin out, you can get some really good results. Once it has been gone for a longer period, it s much harder to regain. It s potentially a huge industry. Building a medical spa business is a serious investment of time, finances and personnel, but as consumers increasingly look beyond their doctor s office and pharmaceuticals for quality of life improvements, the medical spa industry is heading in a very positive direction. With the industry wellsupported by the explosive growth in medical device quality, injectibles variety and public enthusiasm, the dark days of 2008 seem an awfully long time ago. n BOND POIRE Spa Director Mandala Med-Spa & Yoga Shala Sarasota, Florida Bottom Line: Costs of Operating a Medical Spa Just what are the costs to consider in running a medical spa? Well-run medical spas can be a highly lucrative business, but they require significant investment if they are to meet the ISPA definition and are to be successful. Regulations vary from state to state and country to country, as do costs in local currency. However, the principle remains the same: the three major cost differentiators between setting up and running a medical spa and setting up and running a traditional spa are staff, equipment and insurance. Staffing means hiring suitably-qualified and registered doctors (unless you happen to be one yourself), at the very least in a part-time capacity, physician s assistants as well. None are cheap. Qualified estheticians can be hard to find, so many medical spas offer on-the-job training that usually takes three to four months, which accounts to another set of expenses. Equipment is the biggie, at least in terms of initial investment. There are not many medical spas that have much less than half a million dollars worth of equipment on-site, and most have substantially more. That initial investment isn t the end of equipment costs either. Lasers and other machinery are constantly being updated and improved, so the investment in machinery is ongoing. Liability insurance is one that could impact revenue. Most spas, but particularly medical spas, use equipment that, if used incorrectly, can result in a serious injury to a customer. Medical spas need adequate liability insurance, something that gives staff and customers alike peace of mind and financial cover in the event of an accident. It is a major cost, and one that must be factored into any investment into a medical spa. July 2015 n PULSE 31