I read with great interest the letters about the medical spa series written by Drs. Lauren Reager and Daniel Gross and published in December's Southern California Physician. I have known both of these fine physicians for more than 35 years. Their criticisms are based upon the highest level of professionalism in the practice of medicine. Their letters stimulated me to publicly support their concerns. I strongly agree with their opinions.
Many physicians are dismayed at the publicity for this "movement," as if it somehow advances the cause of medicine. Personally, I was amazed that spas were given such extensive coverage in the magazine and in such a positive light.
Particularly troubling was the list of "Medical Spa Procedures" on the first page of each article in the series. Sugaring? Lunchtime massage? I literally laughed out loud at the amazing pseudomedicine being promoted. How our professional journal could include this list without comment is beyond my understanding.
I think the medical spa trend degrades the image of physicians, the overwhelming majority of whom are hard-working professionals attempting to combat real diseases with real medicine. Some disclaimer is due to your audience. An article featuring a balanced critical analysis of where medical spas fit in medicine (if at all) and a contrary opinion is overdue.
The problem may be that little critical analysis is available, even from government sources. Medical spas represent an entrepreneurial movement, which has no obvious criticism. Cosmetic skin care clinics are hard at work combining all kinds of warm and fuzzy innuendos about health benefits that fly below the FDA radar.
The situation may be similar to the claims allowed by the FDA for herbs and roots: It's not OK to promise health benefits, but it is OK to hint at something that means the same thing. Basically, medical spas are a "feel good" and cosmetic industry. There is certainly nothing wrong with that, unless and until the industry promises actual medical benefits. If that occurs, then, like herbs (which can have true physiologic and biochemical effects), it becomes a form of modern-day snake oil.
The FDA has abdicated regulation of herbal medication and many aspects of alternative medicine as a result of political pressure, which has been publicized in the press. Fortunately, this is coming under congressional scrutiny. However, the spa movement has not received such attention, perhaps because it is directed at well-to-do clientele who can afford such indulgences.
Please redeem yourself with some form of perspective on medical spas that is objective and balanced.
Stephen C. Berens, MD, FACC
Cardiology
Santa Monica
Editor's Note: Thank you, Dr. Berens, for providing an argument against the medical spa movement. Your letter offers just the perspective you were seeking.
