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Physicians, Spas Join to Offer Self-improvement in One Location

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CHICAGO - Megan DeBrocke didn't see herself as a candidate for a Botox treatment.

But there the Deerfield, Ill., resident was on a recent day, getting an injection between her brows.

DeBrocke was at her favorite spa, a place she often visits for a massage and a manicure. Recently, the spa began to offer new treatments: cosmetic procedures administered by medically trained professionals. So DeBrocke took the Botox plunge.

"I kind of equate here with self-improvement," she said, sitting on a leather couch in Renu Day Spa in Deerfield. "This is a very relaxing atmosphere."

More medical professionals are setting up shop in spas and salons to offer popular cosmetic treatments to customers. So along with a manicure, spa visitors can opt for a collagen injection or a microdermabrasion facial.

Not to be outdone, some cosmetic surgeons and dermatologists are expanding their offices with massage rooms and offering manicures and pedicures.

"We're turning the art of medicine into a pampering situation," said Daniel Ritacca, a cosmetic surgeon who is expanding his Ritacca Laser Center in Vernon Hills, Ill., to include massage and nail-care services. The center predominantly focuses on vision correction, breast augmentation and other cosmetic procedures.

While most of the services are elective and not covered by health insurance, many of the treatments at so-called "medi-spas" are those traditionally performed at a doctor's office. Some consumers say they prefer the atmosphere of a medical spa over the clinical feel of a physician's office. Others say they are seeking solutions that go beyond taking a pill.

Christale Gray, for example, wasn't satisfied with dermatologists' efforts to treat her cystic acne.

"They like to write prescriptions," the Chicago woman said. "And when those aren't working, they put you on something stronger."

Now, she's treated by a dermatologist at Longevity Medical Spa in Chicago and gets facials at the same place - a combination that she said has kept her face clear.

Founder and cosmetic surgeon Leon Tcheupdjian said there is a real clinical side to the operation, despite the plush decor that includes two plasma screen televisions.

"There is a medical visit where doctors meet with the patients," he said. "You don't escape a doctor in this visit."

The number of medical spas last year increased to 225 in 2002, up 143 percent since 1997, according to the International Spa Association of Lexington, Ky.

"Five years ago, I don't think they even existed," said Hannelore Leavy, executive director of a trade group created specifically for "medi-spas," the International Medical Spa Association in Union City, N.J.

One reason for the growth of the spa business and its medical spinoff: personal appearance has become a higher priority for more Americans. Many are willing to pay upwards of $100 to get rid of wrinkles, body hair and blemishes.

Bruce Katz, a dermatologist and director of Juva MediSpa in New York, said that the aging Baby Boomer population is more concerned with personal health than previous generations and that is helping to fuel the interest in cosmetic treatments.

"They've been in the sun when they were young, and now they can see the damage," Katz said. "Or they now work out regularly and want to make their appearance more in sync with their physical health."

Michael Fleming, a family physician in Shreveport, La., said the growing frustration with managed-care organizations has contributed to the growth of medical spas. Many physicians have complained that the structure enforced by health maintenance organizations to produce profits and keep expenses low have created a conveyor-belt like atmosphere to health care.

"One of the biggest casualties of the managed-care experience is the doctor-patient relationship," said Fleming, who is also president-elect of the American Academy of Family Physicians of Leawood, Kan. By pursing practices outside the auspices of managed care, such as elective plastic surgery and cosmetic treatments, doctors can get back to closer relationships with their patients, he said.

"It allows them to do procedures, to do things and to make a living without having to deal with the reality of managed care," Fleming said.

It is that kind of feeling that has Ritacca, the Vernon Hills cosmetic surgeon, singing the praises of his business.

"I think everybody in medicine is running for the hills because, in medicine, you can get everything from AIDS to SARS - but you can't get paid," he said.

Customers say they like the combination of spa and doctor services.

"It's nice to come to one place to get it all done," said Lauri Stern, of Highland Park, Ill., who has four children. "I can also get a manicure and a pedicure, and I don't have to drive all over."

Anna Pamula, owner of Renu Day Spa in Deerfield, Ill., attributes the integration to a demanding consumer whom has placed a higher value on holistic methods of maintaining their health and appearance.

"Skin care is very sophisticated now," Pamula said. "It's a totally different approach."

A year ago Pamula, who started her spa in 1989, partnered with the Ritacca Laser Center to provide services such as Botox injections and laser hair removal. A representative from the doctor's office sets up shop at Pamula's spa one day a week to give clients a chance to take advantage of cosmetic procedures.

"Our clients love it, and we do a lot of business," she said.

Still, while the idea of combing medical and spa treatments makes sense to many, Saschah Bianchin of Chicago is uncertain whether there will be a huge explosion in the creation of medi-spas. The owner of Salon Liv in Chicago said it could be difficult for spa-owners to find physicians to join the practice and for spas to gain the credibility needed to be part of a medical office.

Doctor's offices, she said, are more likely to have success in the partnership, provided they are willing to go to the expense of converting their offices to create a spa-like atmosphere.

As for her business, Bianchin plans to continue focusing on hair and make-up services and won't consider adding medical treatments such as Botox and laser facials.

"I think that would be tacky," she said.


(c) 2003, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.

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