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he spa industry is per- ceived as frivolous and self-indulgent at a time when the glo-

bal economy is austere. Secondly, its rather extravagant claims are frequently not evidence-based. T irdly, and most signifi cantly, it is not perceived as part of the healthcare system, which is a high hurdle. We don’t have a healthcare system in

the US, or globally, we have a disease man- agement industry, so there could be the opportunity for the spa sector to be at the leading edge of true healthcare. T ere are some areas of concern within

the industry: certainly some extreme and questionable dietary practices. Some of the extreme fasts and dietary restrictions are not only questionable, but dangerous. T e more invasive the procedures, the more you need clear evidence that they work, because it involves risks. For example, if colonics are not implemented properly they run the risk of perforating the intestinal tract, or other complications. It doesn’t mean don’t do it, it just means you need a certifi cate of effi cacy and to follow up what happens.


Clinical professor of medicine, the University of Arizona School of Medicine and the University of California School of Medicine, San Francisco

The constituents and com- ponents that go into some of

the herbal remedies are worrying. Without true analysis and disclosure to the individ- ual of what they are taking, what the purity is and how standardised it is, you sim- ply cannot know what the consequences will be. T e axiom is that if something is powerful enough to work, then it is power- ful enough to have side eff ects. Rejuvenation injections is a highly ques-

tionable area [see SB06/3 p30]. T ere’s scant evidence that this works, whereas there is compelling proof that certain hormone injections cause cancers and changes in the immune system that are destructive. T ere are two images portrayed of the spa

industry. T e negative perception is that it is selling whatever will sell to whoever is gullible enough to buy it. But, on the posi- tive side, these are centres where health is the objective, with long histories of provid-

“Some herbal remedies are worrying. Without analysis, you cannot know what the consequences will be. T e axiom is that if something is powerful enough to work, it’s powerful enough to have side eff ects”


think the spa industry needs to break out of the box of tourism and hospitality, and its lux-

ury, pampering image and use existing research to engage with the healthcare and corporate wellness sectors. A colleague and I have just reviewed

the existing research into massage and concluded there is signifi cant evidence to justify the inclusion of massage in pri- mary healthcare, yet there are few links between the spa and healthcare industries. I have oſt en suggested the spa industry should create a fund and a scholarship, to support research that would provide an evi- dence base for spa therapies. If such a fund were made internationally competitive, it would attract the top postgraduate students and researchers to develop their energies towards spa-related research, which could have a huge impact. I feel the spa industry is still in an embry-

onic stage and there are many opportunities for growth. Spas have blossomed from the hospitality and tourism sector, which, while

SPA BUSINESS 3 2010 ©Cybertrek 2010

ing therapeutic treatments. Although these centres need more scrutiny and documen- tation to back up their claims, they do seem to have real promise to create optimal states of health. If there was adequate documen- tation that tracked the intermediate and long-term outcomes of health claims, then the spa industry would be open to a diff er- ent, and larger, global audience, especially the corporate market. One of the fi rst things the industry needs

to do is to create a database for all spas to access, which draws upon the available glo- bal evidence of what works, what doesn’t and what needs further research. T ere are now a number of delegates from this year’s Glo- bal Spa Summit [see p38] who are working towards such a database and we hope to have initial components online by May 2011. T e industry could aid this process in

many ways: by contributing funding, submit- ting reports for possible inclusion, or even by putting forward preliminary research on innovative new therapies being used.

Dr Pelletier is a medical and business consultant to corporations such as Canyon Ranch and Rancho la Puerta.


Professor of complementary medicine, RMIT University, Victoria, Australia

it commonly invests in market research and feasibility studies, does not necessarily understand

in-depth medical research. I really do believe and, based on the evi-

dence which already exists, that spa therapies do have a positive health benefi t. If this is clearly demonstrated to governments and health insurers, then the spa industry could be opened up for government subsidies and health insurance rebates and an expanded range of funding opportunities. I think the industry is pivotal to what

is needed globally, which is a total para- digm shiſt in the healthcare system from an illness model to a wellness model. T e health arena is one of the biggest industries in the world, but the spa industry doesn’t yet interact with it eff ectively. T is is to the detriment of both sectors. We know health systems around the world will become unsustainable within the next

15 to 20 years, unless they move towards a health promotion model that engages con- sumers and puts them in control. T e spa industry already has this model. T e writing is on the wall for the health

industry, with the ageing population and the growing pandemic of obesity, depres- sion and diabetes. T e fi rst hotel chain to come out with

evidence-based spa therapies, because they’ve done specifi c medical research on their treatments, will have a major advan- tage over their competitors. Because we are in a crunch and the spa industry is feeling the squeeze, those competitive advantages are going to be really important.

As well as his post at RMIT University, Dr Cohen is the president of the Australasian Integrative Medicine Association. He is a medical doctor and has PhDs in Chinese medicine and biomedical engineering.

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