Spas and integrative medicine clinics increasingly offer the same complementary therapies (from massage therapy to acupuncture) and share the same healing goals. They also may share the same legal concerns, as well as risk management issues and opportunities.

According to Katie Hurley, Vice President at Spa Hospitality Worldwide and a leading consultant to spa developers (see Katie’s Spa Director Boot Camp), spas generally attract “four types of clientele: (1) relaxation seekers, who appreciate pampering; (2) results-oriented individuals, seeking to alleviate a particular, current pain; (3) solution-seekers–those who have a serious medical condition that has not been resolved through conventional medicine, and who find therapeutic relief in the spa world; and (4) transformers–clients looking for body-mind-soul transformation.”
Business models and liability risk management tools have to be adapted to accomodate each group. Among these, the second and third group–results-oriented individuals and solution-seekers–require particular legal and business care, as their needs may cross the line into care that legally might be defined as medical. That means legal rules applicable to complementary, alternative and integrative medical therapies more generally might apply: such as rules governing licensure, credentialing and scope of practice; cases on malpractice and professional discipline; and legal rules governing nutrition, dietary advice, and recommendations involving dietary supplements. In fact, depending on how the business is structured, the entire checklist of legal issues applicable to integrative care might transfer over to the medical spa side.
Many spas are unprepared to tackle these issues efficiently and effectively. Simply handing each client a generic liability waiver provides poor legal protection, since such forms may be inadequate or ineffective. Further, since no single regulatory body regulates the industry, the spa manager who is looking to handle legal and liability risk management concerns often is called to supervise a hodge-podge of providers, each governed by their own professional boards and sets of regulations, and each subject to different levels of training, certification, continuing education, and other regulatory requirements. Questions of liability insurance also must be addressed–both for individual providers and for the enterprise. Arenas of risk such as client allergies, contraindications to complementary therapies, and the growing arena of interactions between complementary and conventional therapies (such as herbs and drugs) can easily be overlooked.
In response to these concerns, Katie, a founding member of the International Medical Spa Association, has developed an integral spa business model, aimed at ensuring that care, whether delivered in the spa or integrative medicine clinic, complies with sound risk management principles and cultivates an inside-outside approach to health. According to Katie, the purpose of this new approach is to “maintain safety and standards while promoting whole-being beauty and growth.” By including precisely focused legal services in the overall approach, Katie and I hope such an effort will help industry become more responsive to the new medical-legal environment as well.
From the integrative care perspective, the goal is to be “clinically responsible, ethically appropriate, and legally defensible.” In other words, care should be grounded in sound risk management principles while encouraging wholeness: minimizing potential liability while maximizing potential transformation. While it may seem paradoxical, the twin focus on law and healing, in fact unites both pragmatic considerations and the highest intentions of serving wholeness at all levels of being.