The migration to medical spas

March 1, 2006

Virginia Beach, Va. ? While the rapid growth of medical spas gives dermatologists a promising path for expansion, these businesses ? if not run properly ? also can create challenges including price competition and patient complications, an expert tells Dermatology Times.

"The medical spa concept is very exciting and innovative. It's going to become a great asset for both patients and dermatology. It's a new platform for dermatologists to continue their role as skincare experts and advocates for patients," says David H. McDaniel, M.D., assistant professor of clinical dermatology and plastic surgery, Eastern Virginia Medical School, Norfolk, Va., and medical director, Laser Skin & Vein Center of Virginia and Skin Concepts Medical Spa.

Med spa strategies

"But for a few, their main job is directing the medical spa. They might do some Botox (Allergan) and Restylane (Q-Med), but a small minority of practitioners run a medical spa as a business," possibly without traditional medical services, he explains.

"That trend is growing rapidly. In some of those cases, businesspeople own the spas and hire a medical director," a practice which raises concerns because the physicians hired often lack the training to provide skin diagnoses and therapy or cosmetic surgery and procedures, Dr. McDaniel says.

Expertise, training - or lack thereof

"In some cases, the level of expertise behind those types of medical spas is a bit disturbing. The training of the staff might be limited to training provided by companies who sell the creams, peels or lasers. Or the physician might not be as experienced as the staff he or she is supervising," he adds.

In some cases, Dr. McDaniel notes, the physician is little more than a figurehead who may not even be on-site. He says that it's possible for nonspecialists to become experts in providing cosmetic treatments.

"But what I don't see happening very often in this country is people leaving a noncosmetic specialty and spending perhaps a year or two in a fellowship or mini-residency" before setting up a medical spa, Dr. McDaniel says.

"Entering the medical spa business without proper training is not good for our patients or our profession," he says.

No less dangerous are medical spas in some states that offer procedures performed by personnel who are inexperienced, untrained and/or unsupervised, Dr. McDaniel adds. "There are many problems attendant with that, and we're seeing them. Most minimally invasive procedures are not yet risk-free procedures," he says.

Marketing dilemmas

As for competitive issues created by medical spas, Dr. McDaniel says those run with a marketing orientation might pose problems for dermatologists whose main expertise is in the clinic, not in business or marketing.