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Taking Your Medical Spa To The Next Level

October 2004

When I talk to physicians about medical spas, I often encounter a puzzled look. Because dermatologists and plastic surgeons are leading this movement, they tend to be familiar with medical spas. Not all physicians, however, are familiar with the concept, and some mistakenly think medi-spas are nothing more than glorified fitness centers. Nothing could be farther from the truth. Medical spas are undergoing rapid growth in this country, and for good reason. They occupy a void in a healthcare system that focuses too much attention on illness and not enough on healthy living. Medical spas also provide the service and attention that most Americans are hard-pressed to find in the healthcare system around them. Where else, after all, can patients have blood drawn to analyze their chemistry and vitamin levels, then receive nutritional and diet counseling, fitness training, life coaching and skincare products, all from one place and one set of providers? Medical spas, however, are more than just a collection of convenient services for patients. They are poised to play such a vital role in U.S. healthcare system because of the way they can help transform patients’ view of health. A Not-So-New Idea The notion of medical spas has strong roots in the not-so-distant past, when American physicians focused largely on preventing — not merely treating — illness. In the early 1900s, when medical spas were first becoming popular in the United States, physicians often served as their medical directors. The predecessors of today’s medical spas strived to prevent illness by encouraging healthy lifestyles. As mainstream American medicine slowly shifted its focus from the prevention to the treatment of chronic disease, however, the medical profession gradually lost interest in the concept of spas — and the contribution they can make to healthy lifestyles. Today, however, medicine is coming full circle, and patients are rediscovering the importance of not just treating, but preventing, disease. And for many patients, medical spas provide exactly the emphasis they’re looking for. As the nation’s health declines year after year, many Americans are simply losing faith in mainstream medicine. Poor nutrition, lack of regular exercise, increasing levels of stress and mounting environmental pollution are all taking their toll. While the “diet” industry has exploded within America, we as a nation are consuming more calories, growing more obese, and suffering greater rates of heart disease, hypertension and diabetes. Consider one of the biggest health stories of the year: the rise of obesity among U.S. adults and children. The Centers for Disease Control and Prevention recently announced that a startling 31% of adults are obese, and that 15% of children and teenagers are overweight. Simply put, we need a revolution. We must find ways to prevent, not just treat, these diseases. In part, that means reversing lifestyle in nutrition, fitness, the practice of medicine and overall wellness. Full-Service Spas Medical spas address at least some of consumers’ demands by offering the traditional medical services in a more relaxed environment. Clients can make an appointment for a medical problem and be seen by a physician in a more classical sense, but they can also take advantage of more aesthetic procedures and treatments offered. But even more significant than medical spas’ flexible environment is the huge array of services they offer. At WellSprings Institute, the medical spa that is part of my dermatology practice in Paducah, KY, we offer four basic types of services: medical dermatology, cosmetic dermatology, spa services and wellness services. Cosmetic dermatology services include collagen laser, chemical peels, microdermabrasion and spider vein treatments, to name a few. Our spa services include facials, massage therapy, manicure, pedicure and other standard amenities found at spas. Our wellness services include nutritional counseling, body-fat analysis, weight-loss programs, personalized menus and fitness training. We recently hosted a 12-week wellness program where we mentored clients on how to develop and maintain a healthy lifestyle. Services included fitness training, nutritional counseling, healthy weight loss and eating programs, along with personality profiling, life coaching and routine bloodwork. These types of services encourage our patients and clients to view health care in a more comprehensive manner. Their focus gradually turns from treating problems to preventing them. Wanted: Integrated Services How did I become interested in medical spas? When I started my practice 11 years ago, I realized that patients needed advice on skincare products, facials and make-up. They wanted solid information about how to take care of their skin, and they were starved for information on the skincare products that were flooding the market. I initially hired an aesthetician to help answer many of these questions. This allowed me to address patients’ skincare concerns while still focusing on other areas of medical care. Slowly, my practice began to offer physician-strength skincare products and offer chemical peels, facials and skincare consults. As patient demand grew, I eventually opened a spa that offered facials, massage, microdermabrasion, manicures, pedicures, make-up and skin care. While this new business allowed me to meet more and more of my patients’ demands, I quickly realized a major disadvantage: The spa was physically separate from my dermatology practice. While I felt we were doing a great job of addressing the outer wellness of a person, we were doing little to address these peoples’ inner wellness through preventive care. It became clear that to truly serve the needs of my patients and make the spa successful, we needed a more integrated approach. Changing the Culture At about the same time, I struggled through a personal illness and began to look into nutrition, fitness, stress management and other wellness services that complemented what we already offered at the spa. Because these types of topics are not taught in traditional medical schools, most physicians are very leery of learning how these areas affect true health. My personal journey awakened a passion in me to help both my dermatology patients and spa clients develop a lifestyle of healthy living, one that is not encouraged in America’s healthcare system. If you think about it, 61% of Americans are trapped in a prison in which they are malnourished and overweight. About 27% of Americans are clinically obese, and they feel like they have no hope and no way out. They are so malnourished that they live with constant headaches, body pain, stomach distress, heartburn, fatigue, arthritis, and hundreds of other ailments. As patients, we are told to accept these ailments as part of getting older. Part of the problem is that the messages about eating well we receive are complicated. Exhortations about healthy eating are regularly overwhelmed by the hundreds of billions of dollars spent on advertising for junk foods. As fast food chains compete with one another by increasing portion sizes, our waistlines continue to grow. Clearly, the low-fat recommendations of the 1990s didn’t work. The food industry’s massive advertising campaigns didn’t tell consumers that low fat and nonfat products had extremely high levels of sugar and carbohydrates that turn to fat once ingested into the body. And no one mentioned that these foods often contain addictive chemicals that make them worse in the long run than the fattening products they replaced. All of this adds up to one conclusion: It’s time to move from a disease-care system to a healthcare system in which prevention is at the forefront of wellness. We need to expand the role of medical spas, and physicians should be at the forefront of the movement. Mission and Values How do we move in that direction? In my case, the progression to a medical spa was an evolution from basic spa services to a more integrated, holistic facility. The notion of integrating services is critical. Unhealthy lifestyles are so entrenched among Americans that most people need both education and resources to change their ways. This philosophy is what led me to build the WellSprings Institute Dermatology and Spa. The Institute is a single business located in the Livingwell Centre, which houses both a spa and my dermatology practice. The Livingwell Centre also has a gym with personal fitness trainers, a rehabilitation facility and a chiropractic facility. While I firmly believe in the potential of medical spas, I also realize that their success depends on a few key factors. For example, medi-spas must start with core values and a mission. At WellSprings Institute, for example, our five core values are encourage, educate, excellence, empower and equip. Our mission calls on use to do the following: 1. Encourage and educate others towards excellence in wellness and inner/outer beauty for the glory of God, thereby equipping and empowering them to impact the lives of others. Our staff understands this goal, and we review it regularly to remind ourselves of why we are here. 2. Address the needs of patients and clients in a relaxing, comfortable, well-equipped environment. Because fitness is such a key part of a healthy lifestyle, we need a gym with personal trainers, either in-house or nearby. 3. We must have well-trained staff who truly understand our mission and culture. Here is a brief overview of some of the types of staff we use: • Aestheticians or cosmetologists are needed for the spa services as well as the skin care. • A registered dietician is critical because nutrition is so misunderstood in America. This person can be responsible for nutritional assessments, weight loss programs, nutritional supplements, body fat analysis, fitness nutrition and even pantry and shopping trips. • While massage therapists are trained in multiple areas of massage, they often need additional training for more advanced or newer services such as stone therapy. • General medical personnel are usually well trained for medical aspects of practice, but they typically need education on the need and purpose of the wellness aspect. 4. Our products and services must be well-researched and represent the best available. Consumers are flooded with information on skincare products, make-up, lotion and nutritional supplements in the media. We must strive to give them the highest quality products available. 5. We can educate the public through creative seminars. At my practice, for example, our Web site publishes a monthly e-mail newsletter for our spa clients and patients. We provide information about wellness in general and profile our products and services. In addition, we sponsor a monthly wellness seminar. We also use an electronic medical record system in conjunction with the Canfield Photography System to document our findings. That helps us track information for physicians. Changing the Culture Patient education is critical. Because many of our patients turn to the media and the Internet for much of their information, they aren’t always well-informed. Making matters worse, many physicians lack good information on these topics because most medical schools still don’t teach these topics. While our mission is challenging, we can take heart in the knowledge that our patients are hungry for this information. Consider, for example, that the number of visits to alternative medicine practitioners exceeded visits to primary care physicians in 1990. The most frequently cited reason patients gave for seeking this avenue of care was their disappointment with conventional medicine. In some ways, this is good news for those of us interested in medical spas as an alternative form of health care. These patients are looking for a holistic focus, more time with their healthcare providers, and a greater role in the healing process. More than ever, educated and resourceful patients are looking to their physician to guide them in this area. We as physicians need to be educated about their options. We must work to overcome a bureaucratic, insurance-dictated medical environment that has not responded to patients’ demands. A departure from this disease care model mandates a change in the environment where wellness services are delivered, with education at the forefront and government involvement in providing the resources to patients/clients to be able to afford this type of care. Recognizing that prevention and wellness costs the government and consumer less, we are beginning to see the first wave of attempts to give Americans a newfound freedom through medical spending accounts, flexible benefits, health savings accounts, corporate health programs and health vouchers. We as physicians need to get involved. Incorporating the values and beliefs into the development of a medical spa is a great start to equipping people for living truly healthier lives. That takes the medical spa to a new level. Dr. Jones is in private practice in Paducah, KY.

When I talk to physicians about medical spas, I often encounter a puzzled look. Because dermatologists and plastic surgeons are leading this movement, they tend to be familiar with medical spas. Not all physicians, however, are familiar with the concept, and some mistakenly think medi-spas are nothing more than glorified fitness centers. Nothing could be farther from the truth. Medical spas are undergoing rapid growth in this country, and for good reason. They occupy a void in a healthcare system that focuses too much attention on illness and not enough on healthy living. Medical spas also provide the service and attention that most Americans are hard-pressed to find in the healthcare system around them. Where else, after all, can patients have blood drawn to analyze their chemistry and vitamin levels, then receive nutritional and diet counseling, fitness training, life coaching and skincare products, all from one place and one set of providers? Medical spas, however, are more than just a collection of convenient services for patients. They are poised to play such a vital role in U.S. healthcare system because of the way they can help transform patients’ view of health. A Not-So-New Idea The notion of medical spas has strong roots in the not-so-distant past, when American physicians focused largely on preventing — not merely treating — illness. In the early 1900s, when medical spas were first becoming popular in the United States, physicians often served as their medical directors. The predecessors of today’s medical spas strived to prevent illness by encouraging healthy lifestyles. As mainstream American medicine slowly shifted its focus from the prevention to the treatment of chronic disease, however, the medical profession gradually lost interest in the concept of spas — and the contribution they can make to healthy lifestyles. Today, however, medicine is coming full circle, and patients are rediscovering the importance of not just treating, but preventing, disease. And for many patients, medical spas provide exactly the emphasis they’re looking for. As the nation’s health declines year after year, many Americans are simply losing faith in mainstream medicine. Poor nutrition, lack of regular exercise, increasing levels of stress and mounting environmental pollution are all taking their toll. While the “diet” industry has exploded within America, we as a nation are consuming more calories, growing more obese, and suffering greater rates of heart disease, hypertension and diabetes. Consider one of the biggest health stories of the year: the rise of obesity among U.S. adults and children. The Centers for Disease Control and Prevention recently announced that a startling 31% of adults are obese, and that 15% of children and teenagers are overweight. Simply put, we need a revolution. We must find ways to prevent, not just treat, these diseases. In part, that means reversing lifestyle in nutrition, fitness, the practice of medicine and overall wellness. Full-Service Spas Medical spas address at least some of consumers’ demands by offering the traditional medical services in a more relaxed environment. Clients can make an appointment for a medical problem and be seen by a physician in a more classical sense, but they can also take advantage of more aesthetic procedures and treatments offered. But even more significant than medical spas’ flexible environment is the huge array of services they offer. At WellSprings Institute, the medical spa that is part of my dermatology practice in Paducah, KY, we offer four basic types of services: medical dermatology, cosmetic dermatology, spa services and wellness services. Cosmetic dermatology services include collagen laser, chemical peels, microdermabrasion and spider vein treatments, to name a few. Our spa services include facials, massage therapy, manicure, pedicure and other standard amenities found at spas. Our wellness services include nutritional counseling, body-fat analysis, weight-loss programs, personalized menus and fitness training. We recently hosted a 12-week wellness program where we mentored clients on how to develop and maintain a healthy lifestyle. Services included fitness training, nutritional counseling, healthy weight loss and eating programs, along with personality profiling, life coaching and routine bloodwork. These types of services encourage our patients and clients to view health care in a more comprehensive manner. Their focus gradually turns from treating problems to preventing them. Wanted: Integrated Services How did I become interested in medical spas? When I started my practice 11 years ago, I realized that patients needed advice on skincare products, facials and make-up. They wanted solid information about how to take care of their skin, and they were starved for information on the skincare products that were flooding the market. I initially hired an aesthetician to help answer many of these questions. This allowed me to address patients’ skincare concerns while still focusing on other areas of medical care. Slowly, my practice began to offer physician-strength skincare products and offer chemical peels, facials and skincare consults. As patient demand grew, I eventually opened a spa that offered facials, massage, microdermabrasion, manicures, pedicures, make-up and skin care. While this new business allowed me to meet more and more of my patients’ demands, I quickly realized a major disadvantage: The spa was physically separate from my dermatology practice. While I felt we were doing a great job of addressing the outer wellness of a person, we were doing little to address these peoples’ inner wellness through preventive care. It became clear that to truly serve the needs of my patients and make the spa successful, we needed a more integrated approach. Changing the Culture At about the same time, I struggled through a personal illness and began to look into nutrition, fitness, stress management and other wellness services that complemented what we already offered at the spa. Because these types of topics are not taught in traditional medical schools, most physicians are very leery of learning how these areas affect true health. My personal journey awakened a passion in me to help both my dermatology patients and spa clients develop a lifestyle of healthy living, one that is not encouraged in America’s healthcare system. If you think about it, 61% of Americans are trapped in a prison in which they are malnourished and overweight. About 27% of Americans are clinically obese, and they feel like they have no hope and no way out. They are so malnourished that they live with constant headaches, body pain, stomach distress, heartburn, fatigue, arthritis, and hundreds of other ailments. As patients, we are told to accept these ailments as part of getting older. Part of the problem is that the messages about eating well we receive are complicated. Exhortations about healthy eating are regularly overwhelmed by the hundreds of billions of dollars spent on advertising for junk foods. As fast food chains compete with one another by increasing portion sizes, our waistlines continue to grow. Clearly, the low-fat recommendations of the 1990s didn’t work. The food industry’s massive advertising campaigns didn’t tell consumers that low fat and nonfat products had extremely high levels of sugar and carbohydrates that turn to fat once ingested into the body. And no one mentioned that these foods often contain addictive chemicals that make them worse in the long run than the fattening products they replaced. All of this adds up to one conclusion: It’s time to move from a disease-care system to a healthcare system in which prevention is at the forefront of wellness. We need to expand the role of medical spas, and physicians should be at the forefront of the movement. Mission and Values How do we move in that direction? In my case, the progression to a medical spa was an evolution from basic spa services to a more integrated, holistic facility. The notion of integrating services is critical. Unhealthy lifestyles are so entrenched among Americans that most people need both education and resources to change their ways. This philosophy is what led me to build the WellSprings Institute Dermatology and Spa. The Institute is a single business located in the Livingwell Centre, which houses both a spa and my dermatology practice. The Livingwell Centre also has a gym with personal fitness trainers, a rehabilitation facility and a chiropractic facility. While I firmly believe in the potential of medical spas, I also realize that their success depends on a few key factors. For example, medi-spas must start with core values and a mission. At WellSprings Institute, for example, our five core values are encourage, educate, excellence, empower and equip. Our mission calls on use to do the following: 1. Encourage and educate others towards excellence in wellness and inner/outer beauty for the glory of God, thereby equipping and empowering them to impact the lives of others. Our staff understands this goal, and we review it regularly to remind ourselves of why we are here. 2. Address the needs of patients and clients in a relaxing, comfortable, well-equipped environment. Because fitness is such a key part of a healthy lifestyle, we need a gym with personal trainers, either in-house or nearby. 3. We must have well-trained staff who truly understand our mission and culture. Here is a brief overview of some of the types of staff we use: • Aestheticians or cosmetologists are needed for the spa services as well as the skin care. • A registered dietician is critical because nutrition is so misunderstood in America. This person can be responsible for nutritional assessments, weight loss programs, nutritional supplements, body fat analysis, fitness nutrition and even pantry and shopping trips. • While massage therapists are trained in multiple areas of massage, they often need additional training for more advanced or newer services such as stone therapy. • General medical personnel are usually well trained for medical aspects of practice, but they typically need education on the need and purpose of the wellness aspect. 4. Our products and services must be well-researched and represent the best available. Consumers are flooded with information on skincare products, make-up, lotion and nutritional supplements in the media. We must strive to give them the highest quality products available. 5. We can educate the public through creative seminars. At my practice, for example, our Web site publishes a monthly e-mail newsletter for our spa clients and patients. We provide information about wellness in general and profile our products and services. In addition, we sponsor a monthly wellness seminar. We also use an electronic medical record system in conjunction with the Canfield Photography System to document our findings. That helps us track information for physicians. Changing the Culture Patient education is critical. Because many of our patients turn to the media and the Internet for much of their information, they aren’t always well-informed. Making matters worse, many physicians lack good information on these topics because most medical schools still don’t teach these topics. While our mission is challenging, we can take heart in the knowledge that our patients are hungry for this information. Consider, for example, that the number of visits to alternative medicine practitioners exceeded visits to primary care physicians in 1990. The most frequently cited reason patients gave for seeking this avenue of care was their disappointment with conventional medicine. In some ways, this is good news for those of us interested in medical spas as an alternative form of health care. These patients are looking for a holistic focus, more time with their healthcare providers, and a greater role in the healing process. More than ever, educated and resourceful patients are looking to their physician to guide them in this area. We as physicians need to be educated about their options. We must work to overcome a bureaucratic, insurance-dictated medical environment that has not responded to patients’ demands. A departure from this disease care model mandates a change in the environment where wellness services are delivered, with education at the forefront and government involvement in providing the resources to patients/clients to be able to afford this type of care. Recognizing that prevention and wellness costs the government and consumer less, we are beginning to see the first wave of attempts to give Americans a newfound freedom through medical spending accounts, flexible benefits, health savings accounts, corporate health programs and health vouchers. We as physicians need to get involved. Incorporating the values and beliefs into the development of a medical spa is a great start to equipping people for living truly healthier lives. That takes the medical spa to a new level. Dr. Jones is in private practice in Paducah, KY.

When I talk to physicians about medical spas, I often encounter a puzzled look. Because dermatologists and plastic surgeons are leading this movement, they tend to be familiar with medical spas. Not all physicians, however, are familiar with the concept, and some mistakenly think medi-spas are nothing more than glorified fitness centers. Nothing could be farther from the truth. Medical spas are undergoing rapid growth in this country, and for good reason. They occupy a void in a healthcare system that focuses too much attention on illness and not enough on healthy living. Medical spas also provide the service and attention that most Americans are hard-pressed to find in the healthcare system around them. Where else, after all, can patients have blood drawn to analyze their chemistry and vitamin levels, then receive nutritional and diet counseling, fitness training, life coaching and skincare products, all from one place and one set of providers? Medical spas, however, are more than just a collection of convenient services for patients. They are poised to play such a vital role in U.S. healthcare system because of the way they can help transform patients’ view of health. A Not-So-New Idea The notion of medical spas has strong roots in the not-so-distant past, when American physicians focused largely on preventing — not merely treating — illness. In the early 1900s, when medical spas were first becoming popular in the United States, physicians often served as their medical directors. The predecessors of today’s medical spas strived to prevent illness by encouraging healthy lifestyles. As mainstream American medicine slowly shifted its focus from the prevention to the treatment of chronic disease, however, the medical profession gradually lost interest in the concept of spas — and the contribution they can make to healthy lifestyles. Today, however, medicine is coming full circle, and patients are rediscovering the importance of not just treating, but preventing, disease. And for many patients, medical spas provide exactly the emphasis they’re looking for. As the nation’s health declines year after year, many Americans are simply losing faith in mainstream medicine. Poor nutrition, lack of regular exercise, increasing levels of stress and mounting environmental pollution are all taking their toll. While the “diet” industry has exploded within America, we as a nation are consuming more calories, growing more obese, and suffering greater rates of heart disease, hypertension and diabetes. Consider one of the biggest health stories of the year: the rise of obesity among U.S. adults and children. The Centers for Disease Control and Prevention recently announced that a startling 31% of adults are obese, and that 15% of children and teenagers are overweight. Simply put, we need a revolution. We must find ways to prevent, not just treat, these diseases. In part, that means reversing lifestyle in nutrition, fitness, the practice of medicine and overall wellness. Full-Service Spas Medical spas address at least some of consumers’ demands by offering the traditional medical services in a more relaxed environment. Clients can make an appointment for a medical problem and be seen by a physician in a more classical sense, but they can also take advantage of more aesthetic procedures and treatments offered. But even more significant than medical spas’ flexible environment is the huge array of services they offer. At WellSprings Institute, the medical spa that is part of my dermatology practice in Paducah, KY, we offer four basic types of services: medical dermatology, cosmetic dermatology, spa services and wellness services. Cosmetic dermatology services include collagen laser, chemical peels, microdermabrasion and spider vein treatments, to name a few. Our spa services include facials, massage therapy, manicure, pedicure and other standard amenities found at spas. Our wellness services include nutritional counseling, body-fat analysis, weight-loss programs, personalized menus and fitness training. We recently hosted a 12-week wellness program where we mentored clients on how to develop and maintain a healthy lifestyle. Services included fitness training, nutritional counseling, healthy weight loss and eating programs, along with personality profiling, life coaching and routine bloodwork. These types of services encourage our patients and clients to view health care in a more comprehensive manner. Their focus gradually turns from treating problems to preventing them. Wanted: Integrated Services How did I become interested in medical spas? When I started my practice 11 years ago, I realized that patients needed advice on skincare products, facials and make-up. They wanted solid information about how to take care of their skin, and they were starved for information on the skincare products that were flooding the market. I initially hired an aesthetician to help answer many of these questions. This allowed me to address patients’ skincare concerns while still focusing on other areas of medical care. Slowly, my practice began to offer physician-strength skincare products and offer chemical peels, facials and skincare consults. As patient demand grew, I eventually opened a spa that offered facials, massage, microdermabrasion, manicures, pedicures, make-up and skin care. While this new business allowed me to meet more and more of my patients’ demands, I quickly realized a major disadvantage: The spa was physically separate from my dermatology practice. While I felt we were doing a great job of addressing the outer wellness of a person, we were doing little to address these peoples’ inner wellness through preventive care. It became clear that to truly serve the needs of my patients and make the spa successful, we needed a more integrated approach. Changing the Culture At about the same time, I struggled through a personal illness and began to look into nutrition, fitness, stress management and other wellness services that complemented what we already offered at the spa. Because these types of topics are not taught in traditional medical schools, most physicians are very leery of learning how these areas affect true health. My personal journey awakened a passion in me to help both my dermatology patients and spa clients develop a lifestyle of healthy living, one that is not encouraged in America’s healthcare system. If you think about it, 61% of Americans are trapped in a prison in which they are malnourished and overweight. About 27% of Americans are clinically obese, and they feel like they have no hope and no way out. They are so malnourished that they live with constant headaches, body pain, stomach distress, heartburn, fatigue, arthritis, and hundreds of other ailments. As patients, we are told to accept these ailments as part of getting older. Part of the problem is that the messages about eating well we receive are complicated. Exhortations about healthy eating are regularly overwhelmed by the hundreds of billions of dollars spent on advertising for junk foods. As fast food chains compete with one another by increasing portion sizes, our waistlines continue to grow. Clearly, the low-fat recommendations of the 1990s didn’t work. The food industry’s massive advertising campaigns didn’t tell consumers that low fat and nonfat products had extremely high levels of sugar and carbohydrates that turn to fat once ingested into the body. And no one mentioned that these foods often contain addictive chemicals that make them worse in the long run than the fattening products they replaced. All of this adds up to one conclusion: It’s time to move from a disease-care system to a healthcare system in which prevention is at the forefront of wellness. We need to expand the role of medical spas, and physicians should be at the forefront of the movement. Mission and Values How do we move in that direction? In my case, the progression to a medical spa was an evolution from basic spa services to a more integrated, holistic facility. The notion of integrating services is critical. Unhealthy lifestyles are so entrenched among Americans that most people need both education and resources to change their ways. This philosophy is what led me to build the WellSprings Institute Dermatology and Spa. The Institute is a single business located in the Livingwell Centre, which houses both a spa and my dermatology practice. The Livingwell Centre also has a gym with personal fitness trainers, a rehabilitation facility and a chiropractic facility. While I firmly believe in the potential of medical spas, I also realize that their success depends on a few key factors. For example, medi-spas must start with core values and a mission. At WellSprings Institute, for example, our five core values are encourage, educate, excellence, empower and equip. Our mission calls on use to do the following: 1. Encourage and educate others towards excellence in wellness and inner/outer beauty for the glory of God, thereby equipping and empowering them to impact the lives of others. Our staff understands this goal, and we review it regularly to remind ourselves of why we are here. 2. Address the needs of patients and clients in a relaxing, comfortable, well-equipped environment. Because fitness is such a key part of a healthy lifestyle, we need a gym with personal trainers, either in-house or nearby. 3. We must have well-trained staff who truly understand our mission and culture. Here is a brief overview of some of the types of staff we use: • Aestheticians or cosmetologists are needed for the spa services as well as the skin care. • A registered dietician is critical because nutrition is so misunderstood in America. This person can be responsible for nutritional assessments, weight loss programs, nutritional supplements, body fat analysis, fitness nutrition and even pantry and shopping trips. • While massage therapists are trained in multiple areas of massage, they often need additional training for more advanced or newer services such as stone therapy. • General medical personnel are usually well trained for medical aspects of practice, but they typically need education on the need and purpose of the wellness aspect. 4. Our products and services must be well-researched and represent the best available. Consumers are flooded with information on skincare products, make-up, lotion and nutritional supplements in the media. We must strive to give them the highest quality products available. 5. We can educate the public through creative seminars. At my practice, for example, our Web site publishes a monthly e-mail newsletter for our spa clients and patients. We provide information about wellness in general and profile our products and services. In addition, we sponsor a monthly wellness seminar. We also use an electronic medical record system in conjunction with the Canfield Photography System to document our findings. That helps us track information for physicians. Changing the Culture Patient education is critical. Because many of our patients turn to the media and the Internet for much of their information, they aren’t always well-informed. Making matters worse, many physicians lack good information on these topics because most medical schools still don’t teach these topics. While our mission is challenging, we can take heart in the knowledge that our patients are hungry for this information. Consider, for example, that the number of visits to alternative medicine practitioners exceeded visits to primary care physicians in 1990. The most frequently cited reason patients gave for seeking this avenue of care was their disappointment with conventional medicine. In some ways, this is good news for those of us interested in medical spas as an alternative form of health care. These patients are looking for a holistic focus, more time with their healthcare providers, and a greater role in the healing process. More than ever, educated and resourceful patients are looking to their physician to guide them in this area. We as physicians need to be educated about their options. We must work to overcome a bureaucratic, insurance-dictated medical environment that has not responded to patients’ demands. A departure from this disease care model mandates a change in the environment where wellness services are delivered, with education at the forefront and government involvement in providing the resources to patients/clients to be able to afford this type of care. Recognizing that prevention and wellness costs the government and consumer less, we are beginning to see the first wave of attempts to give Americans a newfound freedom through medical spending accounts, flexible benefits, health savings accounts, corporate health programs and health vouchers. We as physicians need to get involved. Incorporating the values and beliefs into the development of a medical spa is a great start to equipping people for living truly healthier lives. That takes the medical spa to a new level. Dr. Jones is in private practice in Paducah, KY.

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