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Inclusive Health

By: Howard Murad, MD
Posted: June 2, 2009, from the June 2009 issue of Skin Inc. magazine.
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It’s human nature to re-evaluate the way things are done. Consider fashion, food and design. These industries are constantly evolving, borrowing from what’s been done in the past, and improving methods and products for the future. It’s no different in the spa industry, where, before there were AHAs, the basic facial included just the minimum steps. It’s true that American spas got their start with methods and products from Europe; however, the changing landscape of the country, the entrepreneurship of U.S. business and the ingenuity of today’s scientific researchers have pulled the skin care and spa industry in a very different direction than from where it began. What’s certain is that where it is today will likely evolve in the years to come.

Today’s spas are largely unrecognizable from those in the 1980s. The American spa has gone from an exclusive venue where treatments were more pampering than purposeful, to an inclusive one where treatments are custom-designed and therapeutic. Along the way, therapies have come and gone, and come again—sometimes tweaked, sometimes renamed. An explosion in the number of medical spas has also been witnessed. With this, many have asked whether the holistic approach has disappeared. The answer, simply, is no—it has just evolved into an advanced, inclusive health care approach that will be the wave of the future in U.S. day spas, medical spas and medical facilities.

Where did it start?

To understand the inclusive health care approach, step back and see the pattern by which the industry has evolved. The pampering spa of the 1980s was an imported model from Europe. Treatments used French, German or Italian cosmetics, methods were less therapeutic, and the exclusive environment catered to the wealthy. Fast-forward to the 1990s—U.S. spas became holistic centers. Many owners decided to strike out on their own to venture down a path rarely taken in the Western world. The holistic movement argued that long-term solutions could never be achieved without finding and treating a root cause. This movement was in defiance of the medical world, which has its therapies based more on systemic drug therapy. Thus, there was a gradual progression down the well-being path in the 1990s—a path replete with alternative therapies and saturated with Asian philosophies.

All the while, a large portion of the industry remained ever-focused on medical esthetics. Slowly, acceptance of the spa environment and esthetic practitioners occurred in the medical world. Physicians began partnering with estheticians and body work professionals to augment waning revenues, which the decrepit U.S. health care system helped shrink. But adding skin care and holistic services to their invoices did more than just pad revenues. Clients and patients were asking for more and experiencing real results. The spa environment offered the caring service so absent from traditional medical care and holistic treatments from the alternative world and the Far East satisfied the growing natural movement. As a result of these trends, which overlapped and intermingled, the skin care and spa industry gave birth to its newest creation: the medical spa.

What changed?

Through their partnerships with spa professionals, aesthetic physicians in medical spas were introduced to a multidisciplinary strategy of treatment where each professional worked toward wellness, within the confines of their respective specialties. Often, the protocols were under the direction of a physician and—although aimed at being therapeutic—in many cases, the combinations were heavy on the medical focus. In addition, there was a lack of synergy across specialties and the left hand didn’t know what the right hand was doing. Packages were a mishmash of therapies that sometimes made no sense or could be counterproductive to the patient’s goals. Some overbearing physicians caused resentment among medical spa staff members who felt there should be more of a partnership—or yin and yang—when treating patients. All of this started to change as time went on. A shift in the physician-dominated spa model began to occur because consumers demanded less invasive or noninvasive medical procedures.