Managing Patient Expectations Part 2 - Botox Training MD

Read Managing Patient Expectations Part 1

Managing patient expectations is a learned skill but one that you have to master in order to run a competitive and profitable cosmetic practice.

Be aware of is patients who are complaining about previous providers. It's a potential indicator that this client might be a difficult client to deal with.

Clearly if someone is continually bashing another doctor (provided that the didn't do something that caused obvious harm) and they're angry with that doctors and his staff, that's going to put me on guard.

Now, there are situations where a patient's anger is appropriate.

I have a patient right now, that for years, went to another provider, and when she came to me and told me that she's switching providers, I did become a little alarmed right out of the bat. But once I got to know her my misgivings were removed. She had been going to this other physician for years and years and years, and she was upset with him because of the treatment she received for the previous several injections... but she attributed it to the front desk since the clinic had became very busy and impersonal. So I think you have to look at each patient individually. She was legitimate with her complaint and we have a great relationship but there are others.. If a patient is very, very angry, and constantly bashing a former provider and complaining about results you need to be aware, because you could be the next one on their hit list.

I think it's important to take as much time as you can so that you're comfortable and the client's comfortable. To simply make a decision that you're not going to treat that patient and you are now wasting your time, sitting in that room with the patient is the bad approach because then the patient's gonna be angry.

As far as I know, I've never sent anybody out of the office angry because I declined the treatment.

I really make the decision very rapidly as to whether I'm going to treat them or not. I think with time you develop that. I know within the first minute or so if I'm going to treat or won't, but I spend the same amount of time sometimes for both of them - the person I'm going to treat versus the person I'm not going to treat -  because to make that person angry is not what I want to do for a number of obvious reasons.

Often, I can convert them into doing something else that's realistic or telling their friends that's I'm genuine person.  I listen to exactly what they want and I try to understand what they want to have done. Sometimes it's a very small,small correction they're asking for and I don't think I can alleviate it... a very tiny line that I can barely see. So I listen to them, I give them a mirror, I have them point it to me. I try to totally understand what they are pointing up. And most of the time, I can see what it is they want me to correct.

However, if I don't think I can correct it and I think that it's unrealistic, I don't tell them: "That's unrealistic", I explain to them the limitations of the product and the scientific discussion. This product is made for this procedure, not unfortunately for what you want to have done and what you want to have done, I'm unable to correct this in the way that you're asking for.

Some patien'ts don't accept that and will respond with..  "But you're a plastic surgeon or you're an aesthetic physician, this is what you do." So then you have to educate them more with, "Unfortunately we don't have all the tools available". (The 'no magic wand' defense.)

So, even if you've decided that you're not going to treat a specific patient, I think it's really important to spend time with them, see what they want you to do and have them leave happy.

Managing Patient Expectations Part 1 - Botox Training MD

Managing patient expectations are crucial to the success of any aesthetic practice.

If you are not 100 % on board with understanding and dealing with patient expectations, I believe it's going to be difficult to be successful with any aesthetic practice.

The way that I manage patient expectations starts from the initial correspondence with my clinic. My front desk staff typically will notify me if anything out of the ordinary is discussed on the phone at a new patient's consultation request. So, if for instance, they have a request that's perhaps out of the ordinary or they're perhaps not comfortable with the way the conversation went, they'll let me know so I'll have right off the bat, I'll have a little understanding that maybe it'll take a little bit more time with describing what can be done or perhaps the mode where I am not going to perform a procedure.

It's just as important and more difficult sometimes to actually refuse to perform a procedure than it is to do a procedure, have an unsatisfactory outcome, and recover from that. So I want to make that kind of clear again that if somebody presents to you that you do not feel comfortable treating, it may be more difficult to refuse that treatment than it is to actually deal with somebody who develops a complication or unsatisfactory result. However, interestingly enough, if you take the time to explain to a person why you don't feel you can't perform what they want, it can actually turn into a positive experience in the form of her/him recommending other patients to you. Or maybe that person selecting a different treatment that you offer. So, again, we start off right out of the bat, by making sure that our front desk is well aware that I need to be informed of anything out of the ordinary when a patient calls or comes in for the first time, not matter what it is.

There are two things I'm looking for. Out of the ordinary being number one, and number two would be behavior that is really not acceptable social behavior, like anger or overly demanding behavior. I like to know that too because if somebody is angry or demanding with the front desk in an unacceptable manner, then that is a clue that perhaps their behavior will be the same after I treat them.

If you're in this field long enough, you're going to hear some strange requests.

We get calls not too infrequently, once or twice a year from clients that are in the process of changing from a male to a female or a female to a male and they would like to have some, not only surgical procedures but some nonsurgical procedures like Botox or Dysport and a filler like Restylane or Juvederm. Typically, they are often required to have psychiatric evaluation before they undergo the actual transgender operation. So I've had a few instances where I had to contact their psychiatrist or actually put them in contact with a psychiatrist before treating them. So that's a little out of the ordinary.

And the other out of the ordinary are extremes of age. Teenagers calling for Restylane to augment their lips or Botox and knowing how to deal with that. And that would simply be... they have to be over 18. I mean you have to understand the..or appreciate the indications for Botox and it's right on the label.

Read: Managing Patient Expecations Part 2

About: Marc S Scheiner MD is a plastic surgeon who teaches Botox and filler injection technques to physicians and clinicians through Botox Training MD and his 14 credit CME two-day hand's on seminars.