As many of us know, the educated consumer will prefer quality services and products. In most cases, they will also prefer a facility, that can meet their needs, with or without medical spa in the title. For those of you who own a skin care facility there is a way to offer more services to your client base and create a well-rounded practice. For those of you who already offer physician referrals and in-house injection clinics, there is a way you can do better.

Build a Well-Rounded Practice
The art of aesthetics has been practiced by aestheticians for decades. From the basic European facial to mild exfoliation treatments, massage and makeup artistry, the aesthetician takes great pride in his/her practice. But let’s face it! Clients want more for themselves in skin care and either look to their aesthetician to supply them with an outlet, or seek the outlet on their own. This “outlet” can be basic Botox® or filler injections or become as grand as full body or facial reconstruction. Any of these services requires a trained medical doctor and in no way can be performed by any aesthetician. Within the past eight to 10 years, this increased client demand for more aggressive skin care treatments has led to the creation of the medical spa. But this influx of medical spa has many people questioning the legitimacy and value.
The true definition of a medical spa is a skin care facility that has both presence and involvement of a physician with his/her patients. From skin care treatments to minor and major medical treatments, the physician should be there to monitor progress and pick up the phone if necessary. If a facility is touting a medical spa title and plastering a physician’s name that is not on premises, it is not a medical spa. If it is offering hair, nail, and light peel treatments with the occasional Botox® or filler injection, it is not a medical spa. A true medical spa facility is best characterized by the physician and the alternative wellness treatments they offer that can range from skin care and massage to nutrition and yoga. Granted, there are many spa’s that offer the same types of wellness treatments, but they cannot offer medical treatments or evaluations, laser skin resurfacing, or laser hair removal treatments, to name a few.
Many medical spas that offer enhanced skin care do so by hiring nurses, aestheticians, and/or technicians. There is a difference between each title and one should not be confused with the other. For starters, nurses can be a Vocational/Practical Nurse, Registered Nurse, or Nurse Practitioner depending on their education levels and licenses. It is important to realize that the title “Nurse” has been used very loosely in the aesthetic industry. Overall, Registered Nurses and Nurse Practitioners can safely perform injection treatments; laser and IPL light therapy treatments, in addition to assisting in surgical procedures. Nurse Practitioners can take these responsibilities further by diagnosing conditions, prescribing medications, and can run their own medical facility. Aestheticians are thoroughly trained in skin care and beauty and can offer effective client care via face and body treatments by performing mild chemical peels and extractions, waxing, and product recommendations that can help maintain and improve results. Technicians can be trained to perform specific treatments that include laser hair removal and microdermabrasion, but may not effectively meet the total needs of the client.
Understanding the proper meaning and practice of a medical spa only assists part of the population of aestheticians and physicians. Many spa owners and aestheticians that have been in the industry for many years are seeking a means to offer minor medical procedures to their senior client base that simply desire more enhanced results. The needs of these clients can be met in two ways. First and probably the most important, always keep a list of practicing physicians in your contact books. Prime physicians for clients of aestheticians include a Plastic Surgeon, Dermatologist, Ophthalmologist, and OB/Gyn. It is advisable to know more than one specialized physician as clients may have specific desires or tastes in what they look for in their professionals. The second way to offer more services to your clients is to bring the physician to your facility. Have them perform Botox® and filler injections on site in a sterile room and offer consultation for alternative medical procedures. One major concern with this tactic lies with your liability insurance provider. Always be sure that you carry protection for injection clinics as the procedure is being held on your premises. Physicians are covered by malpractice and cannot be pursued in many cases, so the likely alternative to meet the needs of damaged individuals will be the facility in which the procedure was performed. Keep in mind that the physician should receive payment directly from the client and always maintain clear and effective communication with your insurance provider.
Providing well-rounded client care by inviting and referring physicians has many benefits to the skin care facility. The increased perception of services offered enhances the visibility and client referrals to the facility, helping to increase revenue. With the enhancement of services offered, the spa can market and advertise the injection clinics to bring more business. In addition to an increased perceived value on the clients’ behalf, a mutually beneficial relationship between the spa and physician may develop. Aesthetic training and expertise is in beauty and skin care. Aestheticians created skin care services that have been used for decades to rejuvenate the skin. These include facial treatments that range from chemical peels to light extractions, makeup artistry to cover skin imperfections, massage techniques and muscle relaxation, and lymphatic drainage. Pre- and post-operative plastics patients can greatly benefit from aesthetic services, consultations, and recommendations. The physician benefits by knowing that his/her client is in good hands and that they will be alerted on the healing process. Moreover, the physicians do not have to concern themselves with staffing their own facility and they get increased business from the referral process. So why does a skin care facility and aesthetician feel the need to sellout and become a medical spa when the basic concept is at their fingertips?

Go Medical without Selling Out Guidelines
Because medical spa’s have essentially been in existence for nearly 10 years, some of you have probably been working as a “Well-Rounded Facility” for quite some time. Well, for those of you willing to go out on a limb and feel the breeze in your hair, there is always more opportunity to go medical without selling out. First ask yourself what treatments you want to offer that you currently cannot provide. Answering this question will give insight into how far you need to go to get your physician, how to bring them in, and the insurance coverage needed to protect the business. There are some treatments that can be considered semi-medical in that state-to-state licensing varies per what the aesthetician can use. In some cases it is not the state that governs these treatments, but the insurance companies.
Configuring treatments and how to bring them in legally is only part of the process that involves offering medical treatments. Choosing the right physician to meet the needs of the clients and contribute to the success of the facility is of great importance. There are essentially two separate roles that the physician may take. First, he/she can essentially lease out part of the facility and practice non-invasive procedures in house and major medical procedures in the hospital. Second, the physician may be hired on as a Medical Director to help train and oversee client progress for aggressive peel or laser hair removal treatments, while offering consultations, Botox, and filler injections on the side. Either role that is chosen requires a possible remodeling of the facility to uphold all Federal and state medical requirements for sanitation and sterilization.
When treatment outlines and a physician choice have been made, and all insurance and legalities have been figured (much easier said than done), the limitations of the aestheticians must be defined. The aesthetic staff can work on a referral basis or they can be trained to perform advanced aesthetic treatments and possible laser hair removal, to name a couple. Again, this is where maintaining a practice within your liability insurance parameters plays a key role. Unless the physician takes on the staff as his/her own, none of the practices are covered under malpractice and lawsuits may be made against the facility.
Overall, there is no need to sell out to become a medical spa. Aestheticians and physicians can work hand-in-hand to provide the highest quality services to their clients. Whether you decide to offer in-house clinics, work off of a referral basis, hire a Medical Director, or rent out part of your facility, each is a viable option for increasing client care and retention. After all, if you fail to provide them with the services they desire, clients will move on to someone who can. As a skin care provider, it is your responsibility to see that your clients succeed in their skin care goals. They may see a physician for advanced medical treatments, but will always come back to you for skin care and maintenance.

With over 20 years as a practicing aesthetician, Spa Owner, and National Educator, Tina Zillmann has experienced many changes in the industry, many of which young inexperienced aestheticians will never be able to encounter. Her experience and assistance with medical procedures and her extensive practice of pre- and post-operative plastics patients’ care has led her to advanced skin treatments and made her one of the top aesthetic educators in the U.S. Zillmann currently acts as the Vice President of Skin Rejuvenation Clinique, Inc, Active Partner and Director of Advanced Rejuvenating Concepts skin care manufacturer and distributor, President of the Aesthetics International Association, and Certified CEU Educator.