Medical
spas

SPA and Medicine
Mindful of the past, movement of the future

Part 4
The 1980s and 1990s, Spas add Doctors

SPA and Medicine viewed as complimentary and inclusive, is indeed the current trend.

Spas again grow and now add doctors to their staff while hospitals and clinics add alternative therapies to their facilities.

The Marsh, a center for balance and fitness located in Minnetonka, Minnesota has long been a pioneer in the integration and programming of complimentary care and conventional medicine. Since opening its doors in 1985, owner Ruth Stricker has sought to provide a balanced approach to health with staff cardiologists, comprehensive physical therapy and exercise facilities, therapy pools, and broad spectrum of classes, as well as offering acupuncture, diet and nutrition programs and a unique Spa operation of signature and classic Spa treatments.

The Marsh has long been host to many leaders bridging complimentary care and conventional medicine such as Andrew Weil M.D., James Rippe M.D., Karl Hammerschlag, Herb Benson M.D. and a host of others questioning, confronting and offering wisdom on our current state of health and healing.

Canyon Ranch with facilities in Arizona, Massachusetts, Puerto Rico and more on the horizon first opened its doors in 1972. Owners Mel and Enid Zuckerman have set many trends in the resort Spa industry including its Life Enhancement Center committed to in depth comprehensive lifestyle programs including a visit with resident physicians, medical screenings and supervision as well as appointments and follow-ups with a team of other specialists such as psychologists, counselors, physiologists and more whos commitment to your well-being embraces a holistic approach.

According to Gayle Brady V.P. of Development "the basis of our spa philosophy is a holistic approach of assessing all of the needs of an individual to develop an individualized program of wellness for optimal aging; that is feeling wonderful and enjoying life longer."

At Miraval, a holistic pampering spa near Tucson, Arizona, the motto is "Life in Balance." The goal of most programs according to spa literature is to have guests challenge themselves physically and spiritually. Miraval’s approach to spa and medicine is one of integrative health and according to Madeleine Randall M.D. (in charge of integrative health at the spa) one of the most important things you can do is to enjoy life "its so important for wellness."

Dr. Randall sees the integration of complimentary care and conventional medicine as "the medicine of the future" she notes that because of current research and the fact that people are changing, today’s spa therapies and medicine is not merely a reproduction of old medicine; it is an altered medicine which is evidence based and therefore a new medicine. She believes the seeds have been planted and that by one person at a time we are in the midst of a whole new care initiative. Dr. Randall has been involved in this initiative since "the 1980s when she studied Native American medicine and the early 1990s where she was instrumental in the implementation of the Healing Connection at UCLA which brought Native American healers, Aryvedic practitioners, Chinese medicine and more together to study the effects on health care practices. In an important outcome study it was shown that in all cases outcome could be improved. The response to this study was outstanding.

At Miraval Dr. Randall recently hosted an integrative medicine conference attended by many of the major university deans and chairs of those universities with integrative health departments. Dr. Randall believes that by bringing the night people together and viewing medicine with a whole person approach, which includes complimentary therapies, the Circle of Life is strengthened and broadened.

Foxhollow Wellness Spas located in Louisville and Crestwood Kentucky has long embraced body, mind, spirit and medicine. Owner Mary Shands, has since its founding included a full array of global complimentary care as well as on site physicians, dentists, chiropractors, ministers, pediatrician, nutritionists, acupuncturists and a highly skilled Spa therapy staff.

According to Robert Zieve M.D., medical director of Foxhollow Spas, Foxhollow is basically resurrecting the European Spa model with its European biological medical clinic. Where in the past there has been a disassociation of Spa and medicine, Foxhollow is again combining native therapies with sophisticated medical concepts.

Using sophisticated technology, the Spa is able to assess ones "biological terrain". For example, using thermography Dr. Zieve can tell if there are blockages in the body and recommend natural therapies such as rhythmic massage or lymphatic drainage to assist the body’s internal milieu to self regulate. This is also accomplished by testing ones pH and finding out if the body is too acidic or too alkaline. The Spa then can bring this back into balance with the use of minerals through baths, diet and nutritional supplementation.

Dr. Zieve sees the human body breaking down at younger ages. He notes a rise in chronic fatigue syndrome, cancer, and fibromyalgia in too many individuals who are just in their thirties.

He believes that if people began paying more attention to their rhythms, working on small changes per day that we could prevent a great deal of illness and achieve and maintain wellness. Dr. Zieve finds that unfortunately, when people are living such isolated, fractionated lives it often takes a great illness to make a shift in both lifestyle and emotional habits.

At Foxhollow the clinical, physical, creative, emotional and spiritual aspects of ones life are balanced and benefited by Dr. Zieve’s anthropomorphic medicine, which includes Spa and clinical assessments. He believes it is important to get in touch with the "seeds" of illness in ones life before they can sprout.

Foxhollow has formed an international alliance with the famed Paracelseus clinic of Switzerland. From the Swiss Alps to the sublime country comforts of a Bluegrass estate Foxhollow’s mission is one of health and happiness, longevity and joy.

Don McKay M.D., Director of Plastic and Reconstructive surgery at the world renowned Hershey Medical Center in Hershey Pennsylvania, supports a classic approach to Spa and medicine. Dr. McKay and his clinical nurse manager Carol Lee R.N.B.S. believe that the combination of traditional medicine and the services and programs of a spa are a natural fit benefiting the patient/guest and are pioneering the partnering of such services in Hershey. Dr. McKay and his staff are currently coordinating spa and medical programs with the newly opened spa at Hotel Hershey. The spa offers signature chocolate treatments based upon documented research of the benefits of chocolate as well as traditional spa therapies. Under the direction of Jennifer Wayland – Smith the spa will also be offering pre and postoperative services, lifestyle assessments and recommendations, on-going wellness services and information. This would link to the Medical Center where blood tests and stress tests, are done for executive health programs (for example).

For Cosmetic surgery, preoperative consultations would take place at the clinic and then skin care, massage therapy etc. would be performed at the Spa. This would enhance the outcome of surgery performed at the clinic and combine the best of both facilities; medical expertise and clinical applications with spa therapies performed at the luxurious Hotel Hershey Spa. This cooperation is significant in that two highly acclaimed facilities are joining programs, and each with a significant industry reputation.

Dr. McKay sees the Spa portion of the equation as still more pampering while medical treatments remain clinical in delivery and facilities. The benefit to the patient is the coordination of services and facilities and the expertise of staff from each facility.

Dr. McKay goes on to note that he practices traditional medicine with a scientific basis and that we need as much current, scientific research on natural therapies here in the U.S. as possible in order to fully bridge the two disciplines.

Over the past several years and on a smaller scale Dermatologists and Cosmetic Surgeons have been adding esthetician to their staff and offices; some successfully and others not. It requires a "meeting of the minds" philosophies and business goals in order to successfully embrace the nuances of a "spa" component.

Long an advocate of the strictest of clinical standards and the exacting science of surgical medicine as well as the benefits of complimentary care, Dr. Theodore Lazzaro and his wife and business partner, Lynda Lazzaro, offer patients undergoing reconstructive and cosmetic surgery, the highest standards of conventional care in an unconventional setting; one benefiting a destination spa facility.

Aestique Ambulatory Surgical Center is located at the end of a winding, tree-lined drive outside of Greensburg, Pennsylvania. The surgical facility, honored by many medical standards’ awards is housed within an impressive, historic manor offering the comforts, views and ambiance of a stately mansion as well as the latest in diagnostic and surgical equipment, nursing and support staff. In keeping with their unique philosophy and their interest and support of complimentary care, the Lazzaros are opening a plush and pampering integrative spa, providing both traditional spa therapies as well as cutting edge paramedical and specialized skin services in 2001.

One can understand the need of classically trained physicians to study scientific research documenting the benefits of alternative therapies. A look at just a few accounts of health fraud pertaining to alternative therapies in Arthur W. Hafner’s P.h.D book: AMA Guide to the American Medical Association Historical Health Fraud and Alternative Medicine Collection underscores this point. This is a fascinating compilation of a variety of devices, therapies and elixirs reputed to cure illnesses, promote beauty, and perform miracles. It is interesting to note however, that some of the files contained within on such alternative therapies as mineral baths, mud baths, Chinese medicine and more, are now once again mainstream in today’s Spas and require accredited degrees to perform.

Today, research by the National Institute of Health, and especially the office of alternative medicine (OAM) The World Health Organization and the American Massage Therapy Association Foundation is beginning to fulfill the need for scientific documentation as to the benefits of alternative therapies. According to WHO:

• Through its Traditional Medicine Program, the World Health Organization (WHO) supports Member States in their efforts to formulate national policies on traditional medicine, to study the potential usefulness of traditional medicine including evaluation of practices and examination of the safety and efficacy of remedies, to upgrade the knowledge of traditional and modern health practitioners, as well as to educate and inform the general public about proven traditional health practices.
• A genuine interest in various traditional practices now exists among practitioners of modern medicine and growing numbers of practitioners of traditional, indigenous or alternative systems are beginning to accept and use some of the modern technology. This will help foster teamwork among all categories of health workers within the framework of primary health care.
• During the last decade, there has also been a growing interest in traditional and alternative systems of medicine in many developed countries. One-third of American adults have used alternative treatment and 60% of the public in the Netherlands and Belgium, and 74% in the United Kingdom are in favor of complementary medicine being available within the framework of the National Health Service.
AMTA The American Massage Therapy Association Foundation Research in progress includes:
• A Comparison of Massage Therapy – Interventions in Pediatric Bone Morrow Transplants
• Sports Massage: The Science of Complete Motion
• Employee Outcomes Following Worksite Acupressure/Massage
• Effects of Connective Tissue Massage on Migraine
• Sickle Cell Pain: Alternative Approaches to Pain Control
• Use of Massage on Cancer Pain Universities are also adding curriculum to their medical departments to address the interest and demand for alternative therapies.

According to Florence Comite M.D. associate clinical professor at Yale University School of Medicine during her presentation at last November’s I’SPA conference in Las Vegas "Spa and medicine seem to be a natural alliance, when you look good you feel good, when you feel good you naturally take better care of yourself." At their Destinations Health "they recognize that each of us and our bodies are unique and therefore require a customized plan delivered in a healing and supportive environment." It is customary that during in services at the hospital patients and their treatment are discussed by a variety of specialists and involves coordination of services and treatments incorporating both complimentary and conventional care.

The University of Minnesota Medical School now offers a graduate minor in "complimentary therapies and healing practices" through its center of Spirituality and Healing. According to a June 1999 Minneapolis Tribune article:

"The university says it will put an academic spin on alternative medicine, encouraging scientific research to see which kinds of treatments work and which do not.

It also signals a change of heart inside a pillar of Minnesota’s medical establishment, which until recently shunned alternative medicine."

"Ten years ago, we never ever could have seen something like this happen at the university," said Dr. Gregory A. Plotnikoff, a longtime advocate of blending alternative and conventional medicine and an assistant professor of internal medicine and pediatrics. "The whole culture has undergone kind of a sea of change."

Courses include such subjects as Clinical Aromatherpies, The "M" technique of touch therapy, Spirituality and Resilience, Cultures, Faith Traditions and Health Care, Introduction to Traditional Chinese Medicine, to name a few.

According to their brochure the Center for Spirituality and Healing will:
• Facilitate the public’s access to research and assist in the review of the research available about complementary therapies
• Coordinate the research efforts that evaluate complementary therapies at the University
• Promote high quality research into the safety and efficacy of complementary treatments
• Encourage scholarly discussions among researchers, health care providers and individuals and families making health care choices.

"There is a need for the Academic Health Center to support research and education for health professionals in the area of complementary care and spirituality. The evidence based approach will add substantially to the knowledge base while promoting the appropriate application of the therapies." Frank Cerra, Senior Vice President for Health Sciences, Academic Health Center, University of Minnesota." The University of Arizona College of Medicine developed the nation’s first postgraduate fellowship program in integrative medicine. Under the direction of Andrew Weil, M.D. the program accepts board certified physicians who may study mind/body techniques, Traditional Chinese Medicine, herbology, Native American medicine, and more. According to Dr. Weil at his recent I’SPA address "Integrative medicine could re establish the positive patient/doctor relationship that is so vital to success and commitment."

Hospitals and clinics are also dedicating space and committing to full spa programs or alternative health clinics.

Hackensack University Medical Center in Hackensack, New Jersey opened its Spa "Beyond" in June 2000. The Spa is located on the ninth floor, which also houses the offices and clinics for dermatology, and cosmetic and reconstructive surgery.

Hackensack’s highly successful Executive Health program with comprehensive screenings, assessments, and programs for both the specialized and different needs of women’s and men’s executive health in part fueled the development of Beyond. Traditional Spa services such as facials, body treatments, massage therapy, scalp treatments, hydrotherapy and nail services are often customized by pre or post consultations with Director Marijane Hubbel R.N.B.S. or resident physicians – The spa is a state of the arts oasis designed with a serene Eastern influence. The brochure underlines Beyond philosophy with its tag line: "ancient wisdom, modern medicine."

Another hospital recognizing the need and growth in alternative care is Woodwinds Health Campus located in Woodbury, Minnesota known as a "hospital that cares about your comfort." Located on a beautiful site, it opened its doors in August 2000 offering a full spectrum of patient care including: maternity, 24 hour emergency call, surgery, radiology, heart and lung care, and GI services, as well as its Natural Care Center offering, massage, acupuncture, chiropractic and naturopathy and retail and wellness assessments. (Woodwinds is a partnership of Healthcare East and Children’s Hospitals and Clinics)

The Natural Care Center embraces the philosophy of integrative health combining cutting edge technology and holistic therapies to enhance patient and family centered care.
Director of Operators Debbie Miller notes "the center has far exceeded any of our original expectations!"

Conclusion; The future of Spa development in the United States seems destined and driven to define spa therapies as scientifically therapeutic while conventional medicine must face and embrace the demand and benefits of complimentary care. This is not to say that all Spas must have a medical department or liaison, nor must every medical facility add "Spa." There remains a demand and a place for pampering and escape and there will always be a need for sophisticated, clinical medical facilities devoted to conventional medicine. For some, reviving the original concept is the ticket to success. Remember the Hall of Waters which by the mid 1960s was a windowless, vacant building? Today through the efforts of six private citizens the Hall of Waters again offers baths & massage including its original and unique light vapor bath as well the opportunity to sit at the world’s longest water bar (more than 100 ft long) with original art deco crystal chandeliers twinkling from above.

As Director, Ms Bates explains; "this is a health spa based upon the old European model where you never get just a bath or a drink of mineral water; you are getting a treatment."

Clearly there is a revolution underway and with it comes also new considerations on facility design, operations, and proformas as well as marketing efforts, and staffing requirements and training.

According to Tamara T. Hauck L.Ac., Dipl. Acupuncture & Chinese Herbology (NCCAOM) "I think the biggest factor that will influence the spa concept of the future will be for the people who develop and mange spa programs to incorporate medical professions into their staff at a managerial level, shifting their focus from one of beauty and pampering to one of beauty, pampering, and restorative healing. This will require adapting the perspective of those ancient physicians that believe we are part of nature and everything in our environment and lifestyle will influence our health. For many health and wellness developments, integration is the direction of the future."

© MEDICALSPAS

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About the Author

From the Swiss Alps to the sublime country comforts of a Bluegrass estate Foxhollow’s mission is one of health and happiness, longevity and joy.