Medical Spa Conception & Design

By Sam Margulies

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When setting-up a new Medical Spa, one must have a well thought business plan, as well as an efficient management, treatments, and marketing. However, all these elements must be supported by a structure that will allow them to be useful. That structure is the physical existence of the spa. No matter how good your business plan and management team would be, if your floor plan is not optimizing the “utilization rate” of the square footage within an intelligent traffic pattern, you will never be able to achieve a healthy business format.


As an architectural designer specialized in Medical Spas, I regularly receive plans from architectural firms to assess and analyze.  In most cases, the utilization ratio of the surface oscillates from 30 to 55% and the traffic pattern is not adequate for the needs of a Medical Spa, which brings the utilization rate even lower.

In a typical Medical Spa, there are two types of spaces.  The spaces which are usually referred to as  either “Income Generator (IG),” such as the treatment rooms or the retail area, or those that do not directly generate income (NIG=Non Income Generator), but without which the spa could not function.  I have, for example, received some floor plans for assessment with only about 22% of the square footage was IG.  Try to imagine investing one million dollars in a venture where only $220,000 will generate revenue.  I am not saying that 100% of the structure must be IG, however, there must be a reasonable and intelligent balance.

In other words, the best business plan will be worthless if it is not supported by an adequate structure.  The conception and design of the floor plan of a Medical Spa is the element that will have the most dramatic influence on the business viability of your Medical Spa.  Although the colors of the walls and the type of flooring material are important elements, it is not what eventually “makes it or breaks it.”

From a conceptual perspective, a spa floor plan must be based on four principles:

  1. The purpose of the Medical Spa.

  2. The vision of the owner.

  3. The projected clients' experience.

  4. The technical requirements.

The purpose, the vision and the clients' experience must be defined prior to any other elements because they are the basis, the heart of the project.  Before anything else, you must have a meeting with your Medical Spa architectural designer where all the necessary questions will be asked, leading you to define together the real profile of the whole project.  This meeting will take generally between one to two days.  Based on these findings, the spa designer will be able to define the fourth principle, the technical requirements.

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When this is achieved, your spa designer can begin the conception of the first skeleton of the floor plan.  By the way, now a day, most professionals work on computerized systems that allow them to create a first skeleton within a couple of days.  In addition, the designer should present to you a 3D version, allowing you to have a virtual visit of the skeleton, as if you were walking inside a built structure, giving you a better understanding and feeling of this first floor plan.  This procedure allows an immediate feed-back on the floor plan and the traffic pattern, gaining understanding and speeding the conception process of the floor plan.

Once the purpose, the vision and the experience are defined, the spa designer and you have to develop the core of the floor plan that is the “sequenced pattern of your Medical Spa life”. If your sequence pattern begins with the check-in followed by changing in the locker-room, it must translate into the floor plan by a direct and short way from the check-in desk to the locker-room.  If the floor plan is designed with the locker rooms separated from the front desk by treatment rooms or relaxation room, then your floor plan will not support the purpose, vision and experience. 

Let’s take an example of a typical visit pattern:  the client arrives, checks-in and goes to change in the locker room.  When ready, the client goes to the relaxation/waiting room to wait for being picked up by the therapist to be escorted to the treatment room.  Between treatments, the client might need to take a shower and/or visit the bathroom.  After the last treatment, the client goes back to the locker room to change, apply make-up, get some retail products, check-out and go home.  With such typical sequence, you need to conceive the floor plan accordingly, and the physical location of the spaces must correspond to the “sequenced pattern of the spa life.”  Consequently, when conceiving the floor plan, the first space upon entrance must include the check-in desk, followed by a short access to the locker rooms, followed by a short or even direct access to the relaxation/waiting area.  Once in a treatment room, there need to be access to a shower and a bathroom, without having to go back to the locker room through the relaxation area, so these amenities need to be included in the treatment rooms area.  It is not only for the comfort of the client that this is important, but it is also a critical issue for the general management of the appointments, as well as for the square footage utilization rate.  If the clients have to go back to the locker room every time they need to go to the bathroom or to take a shower, it means that you have to increase the average time per treatment.  It might be only 2 to 3 minutes each time, but multiply this by the number of treatments per year, and you would end up with a significantly serious loss in revenue.  As for the utilization rate of the space, this increased traffic to the locker rooms would translate into oversized locker rooms where it is not only the additional space for toilets and showers, but also an increased traffic space requirement allowing more clients at one time in that amenity space of the Medical Spa.  On the way to check-out, you want the client to buy retail products, so the check-out desk (if different than the check-in) must be part of, or accessible through a retail area.

Different areas in a Medical Spa have different and sometime non compatible energy level.  For example, an effort resistance cardio test room will have a high energy level, while the treatment area must is a calming energy.  It doesn’t mean that you cannot have both areas in the same structure; it means that you have to design your floor plan in a way that each space’s energy level will be respected without one over-powering the other.  Let’s further clarify that statement:  if you design your Medical Spa mixing areas with different energy levels, this will ruin the client/patient experience and your chances of seeing this client coming back are slim to none.  This means that your marketing efforts will have to be greater to get new clients to fill up your Medical Spa business, which will translate into higher cost to bring the client in the door. 

More treatment rooms may not always result in more treatments and more income.  In some cases, it just translates into higher costs and more operational expenses.  It is the utilization ratio of each treatment room that makes all the difference.  In order to reach the best utilization ratio for each treatment room, your Medical Spa designer must conceive the plans with a deep knowledge of how a Medical Spa operates, what are the general and specific needs of a Medical Spa, as well as of your specific project, incorporating the correct amenities for the structure and creating the best traffic flow with the adequate supporting spaces.

The floor plan is the most important element in the creation of the client experience.  If the treatment rooms are too small, the reception area is too crammed, or the corridors too narrow, then the client experience will become negative.  If you proceed to a treatment of one hour at the price of $100, for example, and if the treatment room turns out to be too small, then the client will become impatient and the one hour would feel much too long and the $100 will be perceived as an overcharge.  Such an experience might turn into a statement that would sound something like “I paid $100 and I was parked in an over-sized closet for too long.” This would then turn into a bad word-of-mouth for the business and call for a constant damage control.  The key word here is “perceived.”  It is the perception of the client that prevails and that will decide the overall experience of the client, including the possibilities of return visits to your Medical Spa.    It won’t matter how good the treatment was, if the perception of the experience of the client was bad or, even if it was just uncomfortable.

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From a business perspective, the location of the different spaces in the Medical Spa is definitely a critical aspect.  If a dispensary is located too far from the treatment rooms, it will add two minutes to the average treatment/time allowance.  Two minutes added to each treatment, because of an incorrect floor plan, can lead to a loss of direct income of several hundreds or thousands of dollars per year. Other serious mistakes in the spa design will prevent your clientele repeat business and, will multiply your marketing expenses in order to keep a viable utilization ratio of your treatment rooms. 

Going back to the utilization rate: Most of the time, a project begins with a detailed business plan.  When that plan is ready, one needs to build or to find an existing location that will meet the needs of the business plan and support its goals.  For example, it is necessary to estimate some space for locker rooms, relaxation area, separate spaces for men and women, a staff break room, a dispensary, utility room, proper corridors and so on.  All these additional spaces will not generate direct revenue, but without a corridor, there would not be proper access to the treatment rooms and without utility room, you would not be able to provide heat, AC, light nor water for the treatment rooms. With just a few treatment rooms, it would not be necessary to provide locker rooms.  When, however, exceeding a certain number of rooms, in order to keep the services at an acceptable level, as well as the  utilization rate of each room, you need to incorporate changing rooms or locker rooms; otherwise, the utilization ratio of treatments per room would drop dramatically.  Then the question becomes: How big the locker rooms need to be?  Based on the number of rooms and amenities, your medical spa designer needs to calculate how many people could be at the same time in the locker room without feeling stressed.  For every square foot that will generate direct income (IG), you need additional space that will not generate any direct income (NIG), but without which your Medical Spa will not be operational.  The smaller  the Medical Spa is, bigger becomes the surface percentage that would be required for the NIG spaces.  On the other hand the bigger the spa, smaller would be the required surface percentage for the NIG.  The reason for this is simple.  With only one or two treatment rooms, you will still need two restrooms, but with 10, 20 or 30 treatment rooms, your ratio toilet/treatment rooms will drop considerably.

When you have your business plan ready spend one or two days with an experienced Medical Spa designer.  He will help in defining the type and the dimension of the location you need, in order to support the projections of your business plan, giving to you the right direction to develop the kind of business you expect to have.

The incorporation of Vastu Shastra or Feng Shui principles and techniques has an important influence in the conception and design of a Medical Spa.  There is no simple way to use these arts but you can follow the core and most important principle: the energy flow.  In order to comprehend this principle, imagine that your spa is the bed of a river, and that the goal of the design is to create the smoothest path for that river to flow, in every part of your Medical Spa.

Visualize a Medical Spa where a wall would be built just a few feet from the front door.  The water of the river would splash against the wall, and the river (energy) would not flow smoothly inside the Medical Spa.  Now, imagine that the retail area of the spa would be so cluttered that you would need to zigzag all over, to go from one side of the space to the other. The river would have to separate and rush around the obstacles, and the calm river would become rapids; not exactly the kind of energy you want to create in a Medical Spa.

Every aspect in a Medical Spa must be thought of, in order to create the right experience for the clients.  What exactly, is this experience that all spa professionals are talking about?  Let’s try to define it: “The clients’ experience is how they feel while spending time at your spa.”  It is not an intellectual state of mind that we are talking about.  It is more of a body feeling, a heart enjoyment.  The clients’ experience is what they come for, that makes them feel good, that is of value to them and that makes them come back again and again to your Medical Spa.

The principles of energy flow are an essential part, in the creation of this experience, by creating a structure within which the energy flow will be well balanced.

In conclusion, remember this:  When opening a Medical Spa, you are investing most of your money or, of the banker’s or investor’s money, in the construction of the Medical Spa, based on the conception and design of the floor plan.  Therefore, it is in the conception and design of the Medical Spa where you cannot afford to make any mistake.  My best advice would be, to hire a good Medical Spa architectural designer.  One who is really specialized in the Medical Spa industry, which practices Vastu Shastra or Feng Shui, and understands the principles of energy flow.  If you are about to build a new Medical Spa, then open the door to the river and look at the water flowing evenly and harmoniously into your Medical Spa.

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Author :

Sam Margulies