Opportunity and Challenge
demand for massage therapy is higher than ever before, and the rapidly
growing spa industry is playing an important role in that. Many
of today's regular massage clients received their first massage
at a spa - and many new therapists are starting their careers at
spas. As the massage and spa industries increasingly overlap, it's
essential that each group understand how best to work together in
the wellness arena of the future.
you stop and think about it, the term "medispa" is redundant:
The spa experience has always been about healing, especially in
Europe. But in the crowded, fast-growing North American spa scene,
there are categories of spas and they all need names. A medispa
is a spa that is affiliated with physicians - most often dermatologists
and plastic surgeons - who work with an integrated staff of estheticians,
massage therapists and other wellness professionals under one roof.
It's a logical and convenient evolution in health care that brings
together services that promote total well-being.
should not be confused with holistic clinics or centers in hospitals,
where massage, aromatherapy, acupuncture and other alternative healing
modalities are increasingly being used to complement Western medicine.
Those programs are also booming, and they, too, offer massage therapists
the possibility of working in a medically integrated environment.
But the medical scope of integrative centers is much broader than
that of medispas.
the clinical services available in medispas are mostly focused on
anti-aging and appearance, which in addition to medical procedures
that target these areas, includes stress reduction, skin care and
other preventive health measures. These services can range from
botox injections and tummy tucks, to salt scrubs and deep-tissue
massage. Medispas are the opening wedge for a new type of health
care that addresses the whole person's state of being, using whatever
therapies work best. Even now, at this early stage of their evolution,
many medispas offer medical care in a comforting, non-clinical environment,
and complementary therapies in the reassuring context of Western
are one of the fastest growing segments of our industry: Entrepreneur.com
recently calculated their growth at 23 percent a year, and named
medispas one of the top five business opportunities of 2003. The
International Spa Association’s 2002 Spa Industry Survey pegs
the average annual growth of medispas at 18 percent since 2000,
and their cumulative growth at 143 percent since 1997.
not surprising that this good idea is catching on. People love one-stop
health and beauty shopping, and the fusion of the credibility of
a medical office with the comfort, services and personal attention
of a day spa is very appealing. Medispas are now being initiated
by both the medical and spa ends of the business: Some dermatologists
and plastic surgeons are expanding their practices by hiring estheticians
and massage therapists and adding spa-like services, while some
day spas are expanding into medispas by recruiting physicians and
other medical professionals.
no end in sight for this fusion. People who can afford it are increasingly
willing to pay for the care they want; at the same time, insurance
plans are beginning to pick up the bill for massage, lymphatic drainage
and some forms of touch when prescribed by a physician. Individual
consumers and, to a lesser degree, physicians, are increasingly
aware of the healing value of touch therapies. Medispas are, I strongly
believe, our first glimpse of a new holistic model of health care
in this country.
this means for us
Obviously, medispas offer terrific opportunities for massage therapists.
They also offer challenges that our profession may not be fully
equipped, at this time, to meet. Differences in perception of our
profession run the gamut in the medical world, and if touch therapies
are to become an indispensable part of any medispa, that has to
first challenge we face is a general lack of respect for and understanding
of our profession. Clearly, this is something that's improving.
But there are still hurdles to overcome among medical professionals,
many of whom regard massage therapy as a feel-good treatment that
can be performed by anyone with a modicum of training.
Shelton, M.D., a dermatologist and co-owner of the New York Aesthetic
Center, is excited about offering touch therapies to his clients,
but doesn’t have a massage therapist on staff. Instead, the
esthetician in his office sometimes performs basic massage on patients.
When asked why he doesn't hire a professional massage therapist,
he said that New Yorkers are in a hurry and want to get in and out
quickly; they don't have time for a 60-minute massage.
are my questions for our profession: Why is the assumption out there
that in order to have a therapeutic massage experience, you have
to lie down for an hour" At Shelton’s office, an esthetician
performs foot massage on patients, and apparently it’s very
successful. Yet Shelton doesn’t perceive enough demand to
hire a massage therapist to join his team. Is this due to a lack
of understanding of the therapeutic value of professional massage
therapy" Or is it due to the economics of hiring massage therapists,
and the perceived income per hour they expect" I think it's
I don't think an esthetician giving foot massage is an ideal situation.
But the reality is that medispas need multi-trained people, and
if they don't have them, they'll be resourceful with the staff they
do have - hopefully while following the state and local regulations
for our profession. Medispas are likely to hire estheticians first
due to their focus on the skin: Dermatologists and plastic surgeons
have direct knowledge of the value of esthetics for their patients.
At Shelton’s office, an esthetician performed massage because
in the course of her studies she learned basic massage and, quite
simply, she was there. Shelton can appreciate the therapeutic value
of a foot treatment to increase his client's comfort level, and
making clients comfortable is, of course, an overriding goal during
at the situation as an employer, I can see that this makes perfect
business sense, but as a licensed massage therapist, I'm disturbed
that an esthetician can be assumed to fulfill the same needs as
a massage therapist. However, this is likely to continue to happen.
As medispas strive to give their clients all the services they want,
they seek employees who can provide as many services as possible.
If we want to penetrate the burgeoning medispa market, I believe
it is crucial that massage therapists be flexible and help educate
physicians about what we do and how much we can contribute to their
Aqua, a thriving medispa in an upscale section of Dallas, lead therapist
Keith Manning's flexibility has enabled him to embrace the philosophies
of the doctors on staff and support the guests. He can be found
playing myriad roles at the medispa: scheduling appointments; writing
charts; explaining the medical procedures done on-site; and performing
massage and body-treatment services. Manning also recommends home-care
products that facilitate the guests' skin-care goals. He believes
in Aqua's mission, and in the medispa concept, and is willing to
do what's needed to make every guest's experience the best it can
looks for the same kind of adaptability and breadth in the therapists
he hires: "We look for people who've continued their education
after massage school and who, preferably, have some medical background,”
he says. “I'm interested in hiring the therapist who's qualified
to do more than one thing.
therapists who want to work in medispas, training and experience
in reflexology, structural integration, manual lymph drainage, Endermologie,
shiatsu, craniosacral and pregnancy massage are all pluses,”
he continues. “We also do a lot of deep-tissue massage for
pain relief. And the therapist must be comfortable reading [medical]
charts, and reading medical orders appropriate to massage, and be
comfortable in a medical atmosphere."
rewards" "Respect, definitely," says Manning. "The
clients recognize me as part of the medical team, as do the physicians,
who see the results of what I do with their clients."
for a moment an employer's ideal candidate for employment in a medispa.
I know that the person I dream of when I'm hiring is able to do
it all, from makeup to hydrotherapy. That person isn't quite a reality.
For whatever reason, a long time ago our profession segregated the
face from the body, and in doing so, developed uncoordinated systems
of competencies for each. We made the mistake of splitting the body's
needs into massage as one profession and esthetics as another, as
if muscles and skin, head and body, aren't even connected.
does this mean to you, the therapist who would like to work in a
medispa" My advice always boils down to the same thing: Get
the best education you can possibly find, and keep learning and
growing professionally once you're out of school. Flexibility may
be the key to your success. And if you find yourself frustrated,
consider going back to school to pick up new skills and certifications.
Medispas are raising the bar for our profession, and, in the end,
that will be a good thing. In speaking with owners of massage schools,
they point out that the therapist at the day spa on the corner needs
the same high level of education, the same knowledge of anatomy,
physiology, pathology and contraindications, as the therapist who
works for a physician, if only because the clientele doesn't differentiate.
The person with heart disease or high blood pressure or diabetes
doesn't say, "Oh, I have this condition, so I'll only go to
a medispa." She's going to turn up at the day spa on the corner
or at the spa in the resort, just like everybody else.
when consistent standards of practice and licensing are in place
will our profession reach its full potential. The medispa phenomenon
is going to make this even clearer, as physicians and touch therapists
work together more closely. Look at it this way: Do you ask your
physicians what medical school they went to" No, you wouldn't
even think of it. So why, when a person introduces himself or herself
to me as a massage therapist, is my first question, "Where
did you go to school"" Because inconsistencies of education
produce inconsistent standards of practice.
the need for massage therapists at medispas is an even greater opportunity
for our profession than it appears, because it will push us to become
better educated, more clearly qualified and more creative about
meeting clients' needs. It's up to us to insist on better curriculums,
better standards and more education.