By Blanca Torres
CONTRA COSTA TIMES
PLEASANT HILL - Ricardo Perez's first brush with business came when he started selling doughnuts in a park at age 10.
Years later, while studying dentistry, he decided his practice here would offer more than teeth cleanings and root canals.
"I always thought of myself as an entrepreneur," Perez said. "I knew I was going to have a different kind of practice. I didn't want to be ordinary, but I had no idea it would be a spa."
Colleagues laughed at his idea of adding massages, facials and hair removal to his dental services six years ago. Now, Perez sees himself as an industry innovator and presents workshops at dental seminars.
He is part of a growing number of dentists and doctors who offer pampering services to boost revenue, entice wealthier patients and become less dependent on insurance companies.
The number of medical spas doubled from 1999 to 2004 to 471 across the United States, according to the International Spa Association, a trade group.
Perez says he works only three days a week, is not contracted with any insurance companies, and his business is thriving.
His practice, Cosmestic Dental Spa, is painted in earth tones and features an espresso machine and fresh-baked cookies. The doorways are arched with curved edges and aromatic scents fill every room. Each dental visit starts with a complimentary hand or foot massage.
"It puts people in a better mood," Perez said. "It creates a nicer environment to tell someone you need $3,000 worth of work. That flows a little better when they've had coffee and a cookie."
Massages range from $30 to $60, facials are $35 to $95, and waxing costs between $7 and $75.
Many medical spas tend to offer beautifying treatments like Botox injections to smooth wrinkles, Restylane injections to plump lips, laser hair removal and skin procedures like chemical peels and microdermabrasion, which are usually performed by a doctor or nurse.
Other services, like facials and massages, are performed by routine employees.
"This doesn't look like a medical office, but we hold the highest medical standards," said Philip Rowe, president of P & L Enterprises, a medical practice management company that manages Encore MedSpa in Walnut Creek. "We're not doing curative medicine, but we're doing beneficial medicine."
Rowe said the procedures are beneficial because they make clients feel and look better, which contributes to their overall well-being and health.
The spa offers laser hair removal from $99 for the upper lip to $435 for the back. Botox injections range from $200 to $240.
Encore has been open for two years in Walnut Creek on Mt. Diablo Boulevard on the same block as Tiffany's and Tommy Bahama -- an unusual spot for a medical office.
Rowe said many patients prefer the medical spa to a traditional doctor's practice because the wait times are shorter, the environment is more relaxing and the prices are competitive and often cheaper than from other physicians.
"It gives people what they want," Rowe said. "It gives people these treatments inexpensively, conveniently and comfortably."
Many of the people who frequent medical spas are affluent women, especially of the Baby Boomer generation, who have disposable cash and want to look younger without having surgery, said Joyce Carboni, owner of Skinsational Spa in Carlsbad.
"I was listening to my client base when I decided to add those services," she said. "The trend started on the East Coast, and now that it's here on the West Coast, it's growing like wildfire."
Consumers have to be careful and make sure the spa is run by a licensed physician, Carboni said,.
For many doctors and dentists, going after disposable dollars is easier than going after insurance dollars.
"There are some challenges with the payment system," for doctors, said Lynn Kirk, president of the American College of Physicians, a trade group. Another problem is that many insurance companies continually cut fees for services, making it harder for doctors to stay in business while improving quality.
Perez found himself in that situation before he expanded his business to include spa services. He used to be a preferred provider, but dropped the contract because he felt the company was trying to dictate the way he treated patients.
"There was no way I could maintain my quality under their contract," Perez said. "That was considered crazy in the industry. That's suicide."
Perez does receive payments from insurance companies, but most clients pay extra out of their pockets to see him because he is not part of an insurance network. The pampering services like the massages and facials also are out of pocket.
Perez said his business strategy is like "the Nordstrom way of thinking" -- people will pay more for good service.
"I'm probably the most expensive dentist on the block, but people don't mind that," he said. "It's the whole quality thing. They're paying for my time."
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