medical spaThe interrelationship between massage, spa and medicine in the U.S. dates back to the origin of health spas and curative waters.

Massage was an important component in the early days of the American health spa, while therapeutic touch as part of the medical spa movement has taken massage to a new level in spa.

A medical, or med, spa offers spa services, but is first and foremost a medical facility. As such, a medical spa offers challenging and rewarding opportunities to the massage therapists employed there.

While early medical spas had a much more clinical feel to them, most medical spas today have adopted best practices from the hospitality and day spa environment to create a relaxing and supportive environment for guests.

Massage services can play an important role in creating and maintaining a hospitality-driven experience while also providing therapeutic benefit.

The Med Spa Movement

The growth in the popularity of medical spa treatments and procedures is not a trend; it is a movement.

It is estimated that there are more than 4,200 medical spas in the U.S. generating 3.97 billion dollars annually, according to the American Med Spa Association’s report, Medical Spa Industry Overview, 2017.

Today’s medical spa guest is seeking a one-stop facility that can deliver classic spa services as well as effective medical spa services and wellness programs.

This return to a blend of traditional spa services such as massage along with medical treatments offers the savvy physician or medical spa owner an opportunity to expand or enhance their present menu of services.

For the massage therapist this provides a unique employment opportunity that offers the best of both the spa and the medical setting.

Physician’s assistant Lauren Olson, PA-C, owner of Radiance Advanced Skin & Body Care in The Woodlands, Texas, has integrated massage therapy services into her medical spa for more than a dozen years.

“We have offered massage from the beginning,” Olson said. “We do know that massage has many health benefits and is a natural extension of a wellness setting.”

Olson’s massage therapist has been on staff for 11 years and as the medical spa practice and services have grown, so has her role.

In addition to massage, she has become certified in detox body wraps, micro current treatments for the body and other medical spa treatments.

What is a Medical Spa?

There is little consensus about both what a medical spa really is; additionally, the regulations and guidelines related to medical spas vary greatly from state to state.

The most significant difference between a day spa and a medical spa is that a med spa is first a medical facility.

By definition, this means the services delivered are considered medical services and must be provided or overseen by a physician or other licensed medical professional such as a nurse practitioner or physician’s assistant.

Only one state, Tennessee, has a registry requirement for medical spas; however, med spas in every state (and the District of Columbia) are guided by their state medical board guidelines.

These guidelines define what is and is not a medical service, and who can provide, supervise or delegate the service, as well as other requirements.

Because a medical spa is a doctor’s office, additional federal guidelines regarding referral practices, confidentiality of guest records, OSHA requirements, and other policies and procedures can differ significantly from other spa or massage therapy establishments.

If you are considering employment in this type of setting, you will need to familiarize yourself with these additional requirements.

In most states, even a medical office must obtain a massage facility license in order to offer massage therapy to guests, for example.

The Med-Spa Guest

It would be a mistake to presume that everyone who seeks medical spa services is older; in fact, recent trends indicate that younger millennials are seeking these and other medical spa services to prevent rather than treat the visible signs of aging, as reported by Jennifer Neid in “Why Millennials Choose Botox,” in American Spa magazine.

Medical spas are attracting growing numbers of men as well.

In its 2016 Plastic Surgery Statistics report, the American Society for Plastic Surgery estimated that in 2016, 8 percent of all cosmetic minimally invasive procedures were performed on men. This is an increase of 28 percent from 2000.

Medical spa services have grown across all age groups, gender and ethnicity sub groups.

This trend shows no sign of slowing, with an 8 percent projected growth for medical spas, according to the American Med Spa Association.

In fact, the guest-mix at a medical spa may look very similar to the target market you currently work with.

Additionally, many fitness and wellness facilities have added onsite medical spa services to their program offerings, allowing members to obtain a full range of medical aesthetic services in addition to a workout.

Massage in the Spa

If you search for “massage therapist medical spa” on Google or any of the popular job-search sites, you will see a number of opportunities ranging from independent contractor positions to room rentals to hourly or salaried positions in a variety of medical spa settings.

Additionally, plastic surgeons, dermatologists and many other types of doctors are actively adding a menu of massage services to their offerings.

Depending on the type of medical spa, the specialty of the physician, location and services offered, the range of massage therapy options may vary widely.

At the most basic level, massage services may be offered to medical spa guests as an add-on service designed to complement the existing menu of medical aesthetic treatments.

In this scenario, massage is generally offered as a way to help the medical spa differentiate itself in the marketplace by offering a spa experience to guests and providing a one-stop service model.

Services in this model tend to be more traditional and may include treatments such as Swedish massage, aromatherapy, sports massage or hot stone massage.

It is increasingly common to see such advanced massage and bodywork techniques as reflexology, acupressure, shiatsu, herbal body wraps and scrubs offered in the medical spa setting—and an increasing number of medical spas are beginning to offer massage therapy as an integrated service to complement and enhance the effects of medical aesthetic services.

In some facilities, massage is included as part of an overall treatment package in which the cost of the massage is included.

The positive impact for the medical spa when adding massage therapy services can be significant.

Massage can be an important vehicle for creating a conversation and a connection with a medical spa guest, for example.

Due to the clinical nature of many of the treatments and procedures offered in the medical spa setting, massage can also provide the opportunity for additional relaxation and nurturance.

This can contribute to overall guest satisfaction, retention and loyalty to the medical spa.

Here are three examples of ways massage is scheduled in a medical spa:

First, some medical spas recommend a massage prior to treatments simply to help a guest relax before their procedures.

Second, because massage can be effective in increasing lymph flow and circulation, a number of medical spas recommend a massage with manual lymphatic drainage after a treatment. In most cases this is done as a follow-up service.

Third, when individuals receive facial injectables such as Botox, Restalane or other fillers, most physicians advise a 24- to 48-hour waiting period before applying pressure to the treatment site.

While recommendations vary from injector to injector, this is fairly common and is an important contraindication for facial massage.

Exciting research is being conducted in the area of massage and body contouring, and many medical spas have added body contouring and weight-management programs to their menus.

In the case of cryolipolysis, which is an FDA-approved noninvasive treatment for the reduction of localized subcutaneous fat, a recent study concluded that manual massage was both safe and effective as a post-treatment method to enhance treatment results.

While actual clinical studies are few in number, this offers an exciting direction for massage in the medical spa setting. Medical spa guests expect effective and safe treatments.

Your New Venue

If you are considering applying for a position in a medical spa, do some research on the medical spas in your area.

Take the time for some professional self-assessment before responding to an employment ad or dropping off your résumé.

Review local and national job listings to develop a sense of which techniques, level of experience and skills are most requested.

Identify the advanced techniques or skills that you bring to the medical spa setting.

Prior work experience, volunteer activities or interest in health care settings may all be plusses.

Additional training or continuing education courses in medical terminology, advanced anatomy and physiology, or specific techniques such as manual lymphatic drainage are also valuable to your med spa career.

One growing trend in the medical spa is to hire massage therapists who are also licensed estheticians.

Helen Rapoza, owner of Helen’s Haven, a medical spa in Honolulu, Hawaii, for example, employs a number of dually licensed therapists.

“In a med-spa environment, skin is usually the focus, and that includes lasers, injections, acne treatments and other therapies,” said Rapoza. “Dual-licensed staff members are never bored, because each day is a mix of esthetics, microdermabrasion and massage.”

Rapoza said she believes massage does not have to take a back seat to esthetics.

Guests at Helen’s Haven have the opportunity to enjoy the blend of services as a way to personalize and customize their experience.

The medical spa setting can offer a new perspective on your massage practice and the opportunity to work as part of a health care team.

Medical spa settings offer an important new venue to advance your skills, abilities and knowledge.


Patti Biro is the owner of Patti Biro and Associates, a consulting firm specializing in special events, retail consulting, and education in the spa and wellness industry. She is a National Certification Board for Therapeutic Massage & Bodywork-approved CE provider, lecturer and consultant. A complete listing of upcoming events is available on her website.


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