A medispa or med-spa is perhaps the natural extension of a dermatologists practice. In order to become a dermatologist or plastic surgeon, one must spend four years in medical school, match to a very competitive residency, and then complete four to seven more years of training. A massage therapist or aesthetician needs very little training by comparison. Despite this difference, physicians recognized that hundreds of millions of dollars were being spent on spa treatments each year. In order to capture some of these out-of-pocket dollars, physicians began offering their medical services along with non-medical services. Thus a patient could have a dermal filler injection along with her microdermabrasion and deep tissue massage.
Unfortunately, when physicians started getting into the business of spa treatments, they created a bit of confusion among patients seeking cosmetic services. The average patient did not know what procedures needed to be performed by a doctor and which could be performed by a well-trained, but possibly unlicensed, staff member. In order to compete with the new medispa, traditional day spas would hire physicians to be their medical directors or physician liaisons. The doctor would receive compensation, the day spa would change to a med-spa and the services would remain the same (but the prices would go up). Even worse, with the physician to “direct” the medispa, some facilities performed procedures that were at the boundaries set up by medical licensure boards.
In other words, the term medical spa is pretty loosely applied. The International Medical Spa Association defines a medical spa as
“a facility that operates under the full-time, on-site supervision of a licensed health care professional. The facility operates within the scope of practices of its staff, and offers traditional, complementary, and alternative health practices and treatments in a spa-like setting. Practitioners working within a medical spa will be governed by their appropriate licensing board, if licensure is required.”
However each state (or province in Canada) is free to define how a physician may supervise a medical spa and free to regulate who can perform which spa treatments. The problem is that the rules vary by state and are not always rigorously enforced. With cosmetic procedures, the lines are blurred even further.
What does this mean for you? Know who is doing your procedure, what their training is, and how many procedures they have done before yours. This is good advice for those interviewing anyone from a plastic surgeon to someone doing a facial. If your skin will be cut, it should be done by a plastic surgeon. If your skin is going to be broken or punctured, whether an injection or even intense laser light treatment, make sure you are being seen by a licensed physician, preferably a dermatologist or a plastic surgeon. All other aesthetic procedures, massages, and alternative spa treatment can be performed by experienced personnel that are currently licensed in your state. Remember that even your hair stylist is licensed.
Ask yourself the following questions: If I am seeing a person that is not a doctor but is licensed to perform a particular service, do I really need to be in a med-spa? Is it necessary for me to pay possibly higher costs of a medical spa if I am not receiving a medical treatment? Did my dermatologist recommend this cosmetic procedure because it will benefit me or because it is offered in his medispa? If you answer these questions to your own satisfaction, you are on the right track to finding the cosmetic services that are right for you.