Introducing Wellness

in to Spas - Global Trends

Gerard Bodeker

University of Oxford Medical School, UK

&
Mailman School of Public Health, Columbia University, New York

Chair, Global Initiative For Traditional Systems

(GIFTS) of Health, Oxford, UK

www.giftsofhealth.org
 Use of complementary medicine
providers in Britain
The Oxford Healthy Life Survey (HLS III) -
used UK-SF36
8,889: representative of local population for
age, sex and social class
Women outnumbered 2:1 in their use of CP
services.
One in four people (25%) who use CP's do so
for lifestyle reasons (under 45 age group).
 CULTURAL CREATI VES
In each generation a small group of people –
termed ‘cultural creatives’ by sociologists – take
risks, new steps, innovate, and explore the
boundaries of what they want in life.
They then build this into their everyday lives.
Studies have found that the ‘eccentric’ views and
lifestyle choices of these ‘cultural creatives’
become the norm for the subsequent generation.
Cultural creatives are, in fact, the trail blazers for
society’s growth.
Complementary rather than alternative
• Oxford research: 95.4% use CM and
NHS. Only 4.6% use CM alone.
• In Stanford study, over 95% use CM in
addition to conventional medicine.
• Fewer than 5% use CM on its own.
• Very much a case of integrated
medicine - yet integrated largely by the
consumer rather than by the healthcare
system.
.
CM use by our generation’s cultural
creatives is a good predictor that integrative
healthcare will have become mainstreamed
in the next generation
The challenge now is to build the necessary
foundation of high standards and sound
evidence for best practice to become the
norm in integrative healthcare
.
WHO Global Atlas
of
Traditional, Complementary
& Alternative Medicine
.
WHO Global Atlas of Traditional &
Complementary Medicine is designed to
record, analyze and map the status of policy
in this sector around the world.
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 Women as Majority TCAM Users
Women account for over 60% of all prescriptions
individually, and 75-80% of all healthcare purchases,
because they tend to be caretakers for their families.
In use of TCAM practitioners, women in industrialised
countries outnumber men by 2:1.
Research at Oxford found that with certain medical
conditions this was higher – e.g. chronic skin
conditions, 71% of women use complementary
medicine compared with 29% of men.
US research on cancer: women use supplements and
mind-body approaches 5 times more than men.
No formal studies on trends in Asia, but it is likely
that these will be similar.
Higher income, higher use
Consistent trend in West towards utilization
by people with a high disposable income.
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 OVERVIEW
From WHO Global Atlas, we can see that the
majority of the world’s population uses TCAM
on a regular basis:
they pay out of pocket
women significantly outnumber men in the use of
TCAM & each uses TCAM differently prevention
is favoured with a lifestyle approach to health and
well being
Asian traditional health systems are globalising
governments are focussing on regulation of
practice, training, product quality & safety
Integrative medicine, Wellness & Spas
A Price Waterhouse Coopers’ study in 2003 found
spas to be the fastest growing section of the US
leisure industry, growing at a rate of 20% p.a.
Spas - the highest revenue generator of the leisure
industries: bigger than box office and theme park
revenues.
Within the spa industry, medical spas or
‘medispas’ are the fastest growing sector.
They are also a new ‘front line’ of integrative
medicine development
.
 Medispas
A medical spa is a facility whose medical program
is run under the supervision of a licensed
healthcare professional, according to The
International Medical Spa Association.

Industry wide recognition of the need to focus on

wellness - need to shift from a technology-driven
industry to one that focuses on wellness and
preventive health.

Medical Spa Society: Two things are needed -- a

physician on premises actively involved in the
patient's care and a level of care that will stand up
to conventional scrutiny by accepted standards
 Medispas
A medical spa is a facility whose medical program is run
under the supervision of a licensed healthcare professional,
according to The International Medical Spa Association.
Industry wide recognition of the need to focus on wellness -
need to shift from a technology-driven industry to one that
focuses on wellness and preventive health.
Medical Spa Society: Two things are needed -- a physician
on premises actively involved in the patient's care and a
level of care that will stand up to conventional scrutiny by
accepted standards
In US, often minor cosmetic procedures offered –
dermabrasion, botox, liposuction etc.
International Medical Spa Association: Code of Ethics
A member of the Medical Spa Association and staff will provide competent care;
delivered with respect for its clients' dignity and rights.
A member of the Medical Spa Association and staff will provide only those
treatments, products, and services that are safe, effective and of the highest
quality.
A member of the Medical Spa Association and staff will uphold the highest
standards of professionalism, be honest in all professional interactions, and shall
not engage in fraudulent, deceptive, or unethical practices.
A member of the Medical Spa Association and staff will make a commitment to
on-going education, to the application of that knowledge towards improving
services and treatments, and to making the most accurate information available
to its clients and the public as a whole.
A member of the Medical Spa Association and staff will respect the rights of its
clients and staff to confidentiality and privacy.
A member of the Medical Spa Association and staff will adhere to the laws,
rules and regulations governing the provision of treatments and services as
required by the state in which it operates.
A member of the Medical Spa Association and staff will respect and value the
community in which it operates and look for opportunities to actively support
and improve the health and well being of that community.
 Integrative care/medispa:
difference in name or substance?
Although not a spa, Memorial Sloan-
Kettering Cancer Center in New York, an
off-site Integrated Medicine Center, has
been offering yoga, Reiki, medical
massage, and herbal remedies since 1999.
They also emphasize the non-clinical
appearance of their spa centre.
.
Evidence base
in
Asian-themed spas
 S Medical Spa Bangkok

.
 S Medical Spa, Bangkok
Dr Pakpilai Thavisin, founder director - dermatologist
S Medical Spa is a leading & award winning medical spa in
Asia. Offers integrated healthcare service, combining
Eastern traditional healing and spa therapies plus the
modern Western medical science.
Classic Spa programmes: spa and relaxation, vitality,
beauty, figure, holistic, and purification
Three new programmes:
1. office syndrome: neck, shoulder and back pain as well as
headaches due to working at a computer
2. speedy facial treatment: treatment during lunch break/after work
3. stress management and sleep medicine: meditation program to
help people suffering from stress and insomnia
.
The Raj – Ayurvedic Spa
Iowa, USA
 .The Raj, a New York Times & Conde Naste ‘best
destination’ spa, is an Ayurvedic spa in Iowa.
The Raj guests are advised:
‘Lipophilic toxicants (man-made toxins), such as PCBs,
DDEs, DDT and other chemicals and pesticides tend to
accumulate in our fat tissues. They have been associated
with hormone disruption, immune system suppression,
reproductive disorders, cancer, and other diseases’
(www.theraj.com)
. Drawing on published research, clients at
The Raj are informed that the Ayurvedic
programs offered “are capable of dislodging
lipophilic and other toxins from the tissues
and reducing their concentration in the
body”.
Is this more detail than consumers want?
The Raj has a high percentage of repeat
guests.
.
Meditation, Yoga
&
metabolic syndrome
 Metabolic Syndrome
Abdominal obesity (excessive fat tissue in and around the
abdomen)
Atherogenic dyslipidemia (blood fat disorders — high
triglycerides, low HDL cholesterol and high LDL
cholesterol — that foster plaque build-ups in artery walls)
Elevated blood pressure
Insulin resistance or glucose intolerance (the body can’t
properly use insulin or blood sugar)
Prothrombotic state (e.g., high fibrinogen or plasminogen
activator inhibitor–1 in the blood)
Proinflammatory state (e.g., elevated C-reactive protein in
the blood)
TM & Metabolic Syndrome
Randomized, placebo-controlled clinical
trial of 16 weeks
TM or active control treatment (health
education), matched for frequency and time,
at an academic medical center
103 subjects with stable Cardiovascular
Heart Disease
 Outcomes
Compared with the control group, use of TM for 16
weeks in CHD patients improved the following
components of the metabolic syndrome :
blood pressure
insulin resistance
cardiac autonomic nervous system tone

Results suggest that TM may modulate the

physiological response to stress and improve CHD
risk factors.
(Arch Intern Med. 2006)
 YOGA
In the US a review of studies suggest that yoga
may reduce many insulin resistant syndrome related
risk factors for CVD,
may improve clinical outcomes
may aid in the management of CVD
(Innes et al 2005).

Yoga reduces age related deterioration in

cardiovascular functions (Bharshankar et al 2003).
 Spas,
Cultural Creatives & the Future
Evidence base for TCAM
Best practice, CPE & professionalism
Wellness
Environmental & social responsibility
Democratization
Future of healthcare
.

THANK YOU

www.giftsofhealth.org