Insights on MedSpas With Dr Will Kirby

William Kirby, DO, is a board-certified dermatologist and the chief medical officer at LaserAway. He is also an associate clinical professor of dermatology and the cosmetic director for the Accreditation Council for Graduate Medical Education accredited Prime West Consortium/Western Dermatology Residency. Dr Kirby is the health and beauty reporter for Life & Style Magazine and a member of the editorial advisory board for Dermatology Times, The Dermatologist, and The Journal of Clinical and Aesthetic Dermatology. In this recent interview, Dr Kirby discussed his insights into MedSpas and their impact in dermatologic aesthetic practices.

To start, what is a MedSpa?
There is not a one-size-fits-all, universally accepted definition of “MedSpa,” but we can break down the word to better understand it. The “Med” in “MedSpa” refers to elective, minimally invasive aesthetic treatments that are implemented by a clinician—a physician (MD/DO), a registered nurse, a physician assistant, or a nurse practitioner. Based on the regulatory environment of a specific state, rarely will a minimally invasive aesthetic treatment be conducted by an aesthetician or technician. In this context, “minimally invasive” usually means that we are targeting the dermis or hypodermis.

The “Spa” in “MedSpa” references nonprescriptive, noninvasive, elective treatments that are almost never implemented by clinicians and target the epidermis but never go deeper. Like all aesthetic health care practices, MedSpas offer well-regulated “med” treatments but may or may not offer “spa” treatments.

For example, a large, comprehensive, physician-owned, dermatology or plastic surgery practice that mainly offers laser treatments, but also offers microdermabrasion, implements “spa” treatments by definition. Thus, one could argue the practice is a “MedSpa.” Conversely, a small, free-standing clinic owned by a nurse practitioner that offers laser hair removal and neuromodulator injections but does not offer noninvasive aesthetic treatments would not be categorized as a “MedSpa,” rather it would be an “aesthetic practice.”

What role do MedSpas play in the aesthetics/dermatology space?
Well, again, we cannot really agree on a definition of a “Med- Spa,” so it is a challenge to specifically discuss their role. We can agree that MedSpas are just like some wellness centers, dermatology practices, and some plastic surgery clinics in that they offer prescriptive, elective, aesthetic treatments. And some, but not all, also offer spa treatments. Again, the bottom line is, at least in my personal opinion, that the quality of the practice and the treatment providers will be the determinant of success, not a practice classification.

What are the primary medical spa techniques typically administered? How do you determine which technique is appropriate for a specific individual?
The most common noninvasive, nonprescriptive, “spa” treatments offered are HydraFacials, DiamondGlow, microdermabrasion, light chemical peels, and facials. You could also group topical skin care preparations into this category. The most common minimally invasive, aesthetic medical or “med” treatments offered are neuromodulators, fillers, laser hair removal, laser tattoo removal, skin rejuvenation and revitalization via laser, radio frequency or ultrasound, body contouring, and prescription- grade skin care products. The actual treatment implemented is determined by the specific clinical need of the patient.

One might contend that every medical specialty in the world, from neurology to pediatrics and emergency medicine to gastroenterology, is predicated on the health care provider making an initial diagnosis, explaining that diagnosis to the patient, and then offering different treatment options with one exception: aesthetics. Aesthetics is the only specialty where the patient makes the initial diagnosis, explains it to the health care provider, and then asks for different treatment options. This tiny, yet fundamental, difference is what sets our profession apart from all other fields.

Why should physicians consider using MedSpas in combination with standard cosmetic treatments?
Many physicians already operate “MedSpas,” whether they realize it or not! Again, these are just minor, varying definitions that do not shape the final outcome of the treatments provided. Dermatologists and plastic surgeons reading this may just be realizing that their own practice employs an aesthetician who is doing extractions or microdermabrasion and that their practice can be, by definition, considered a “MedSpa.”

The only way an aesthetic practice cannot be considered a “MedSpa” is if they do not offer any spa services and do not employ unlicensed technicians or aestheticians.

The bottom line is that you can categorize a practice that offers aesthetic services in a number of different ways, but it is really up to the operators to select the treatments that best serve their specific client (spa) or patient (med) populations, then hire and train a clinical staff who can provide those services, noninvasive or minimally invasive, in a safe and effective manner.

Is there anything else you would like to share regarding MedSpas?
It is my strong, unwavering contention that degree diversity and inclusion represent the natural evolution of the aesthetic industry. Patients already seek out all types of health care providers who deliver excellent clinical outcomes regardless of the categorization of their practices, and there is no reason to believe that movement will change. For anyone currently in or soon entering the aesthetic space, regardless of their professional designation, the future is very bright!