TORONTO -- Shoppers Drug Mart takes its most aggressive step into the beauty business this weekend with its first stand-alone clinic to offer Botox injections, fillers, laser treatments and medical-grade peels.
But while the Beauty Clinic by Shoppers Drug Mart is being touted as "a natural extension" of the drugstore chain's moves into the cosmetics space, some wary observers fear it further commodifies medical procedures increasingly regarded as casual touch-ups that don't require the expertise of a physician or surgeon.
The inaugural shop opens Saturday in Oakville, Ont., just west of Toronto, after a soft opening Dec. 22 that saw a steady stream of customers come through the sparsely furnished, three-bay clinic, says Sarah Draper, senior director of healthcare partnerships & innovation.
"This is really what our customers have been asking for," says Draper.
"We're kind of a trusted expert in the space and are positioned pretty well, I think, to offer enhanced beauty services in a setting that's comfortable and convenient for people."
Tucked into the corner of a suburban strip mall, the nearly all-white colour scheme, minimalist decor and serene atmosphere evoke a spa-like retreat.
A "concierge" greets arrivals and confirms appointments in the entryway, where a bank of medical-grade beauty products covers one wall. Visitors are ushered into a tucked-away waiting area, where cushioned seats, tablets and sleek wood privacy screens offer a quiet space to fill out paperwork.
Draper says one of three nurse practitioners then conducts one-on-one consultations with each client and takes "an in-depth medical history" to determine a treatment regimen.
"Our nurse practitioners all have medical esthetics certification and over a decade experience in nursing," she says, noting their higher medical classification gives them authority to prescribe and administer injectables.
A medical esthetician handles lasers, chemical peels, and microdermabrasion.
The Loblaw-owned chain says procedures and training were developed in consultation with doctors who provide ongoing advice, but physicians are not onsite.
That's what bothers Dr. Michael Brandt, a facial plastic and reconstructive surgeon in Toronto who wonders about quality and whether staff are able to adequately respond to medical emergencies.
"You wouldn't sign up for surgery at a grocery store," says Brandt, noting that while there are many excellent providers in the field, the lucrative industry has also attracted less qualified practitioners.
"All medical procedures have indications, contra-indications, alternatives and limits as to what each of those procedures can provide and with each of these procedures you need to go through a very careful assessment of the patient and then make an accurate diagnosis. None of this is cookie-cutter."
And while nurse practitioners have the authority to conduct these beauty treatments, Brandt questioned whether all of them should.
"Just because a professional has the authority to perform a procedure does not automatically mean it is appropriate to do so," he says, noting there are nonetheless very qualified nurse practitioners in esthetics. "Is it appropriate for a nurse practitioner to be performing surgery? They might have the capacity to do it, they might be allowed as a delegated act to do it, but most people would choose to have a surgeon perform their surgery."
Brandt warned that if improperly applied, lasers carry the risk of severe burns, scarring and discolourations. If a filler is injected into a blood vessel, it can cause an occlusion of that vessel, killing anything it supplies.
Still, there's no denying that growing public interest has ignited a specialized industry previously the domain of dermatologists and plastic surgeons.
Milica Duran, a co-ordinator for the esthetician program at Centennial College in Toronto, calls it "the fastest growing industry in the world."
"Our numbers and the interest has been skyrocketing," she says of the school's programs, which includes a special one for nurses entering the field.
Job openings, too, are growing: "Now we have more placement sites than students."
She credits that to advertisements, youth-obsessed images on social media, and the aging population.
"We have our baby boomers, we have more money here happening, more social media, more awareness, more education," says Duran. "This is why so many nurses want to go into the field -- there are so many doctors' offices that cannot find qualified staff."
Oakville esthetician Cynthia Webb notes that while some dermatologists and surgeons do their own injections, most delegate to a nurse, such as herself.
She works for a Toronto plastic surgeon and conducts treatments in that clinic, as well as in her own clinic. She can't help but wonder whether the retail giant will erode business for independent operations like hers.
She notes that many patient decisions are driven by cost, and that's what can get them into trouble.
"When they call, the first thing they'll ask is: 'How much is a unit of Botox?' Well, you're not paying for the Botox or the neuromodulator or the filler. You're paying for the experience of the practitioner," says Webb, a registered nurse who sends all her patients to a doctor for consults and follow-ups.
Shoppers Drug Mart customers can earn PC Optimum points on a variety of services, and Botox injections start at $10 per unit.
Draper says prices are "in line with the market" and that the goal is not to be more competitive than the little guy.
"For us, this is really about providing the service that our customers want in a trusted and convenient space and improving on the beauty offering that we have at the table."
Duran isn't surprised Shoppers has entered the fray and guesses they will expand rapidly beyond the Oakville pilot and a Toronto location set to open later this year.
"We've come so far with lasers, chemical peels and this is all very lucrative," she says. "All plastic surgeons, all dermatologists have either nurses or medical estheticians working for them, even GPs as well. Everyone's in on it."
