June 24, 2021

lips online trainingDr Tim Pearce recently posted a poll on Instagram and asked his followers what they feel is the hardest thing about being an aesthetic practitioner. The most popular answer was managing patient expectations.

In this blog, Dr Tim shares his years of experience with tried and tested communication and consultation skills to address some of the significant problems that aesthetic clinicians face when trying to balance the wants and desires of their patients with what can realistically be achieved. By following some simple steps during your consultation, you should be able to avoid the dread of disappointed patients who feel that you did not deliver what they expected.

Dr Tim will be discussing more medical aesthetic training tips as part of his upcoming webinar series, so if you’re looking to increase your CPD-certified learning and want to learn more skills to make you a better practitioner, then step one is to register for the free webinars by Dr Tim.

Why is managing patient expectations so difficult?

The skill of effectively managing patient expectations when it comes to aesthetic treatments is often viewed as a difficult or tricky process. This is because it is similar to playing a game, but one whereby the rules are not set in stone, each party interprets the gameplay differently, does not always show their hand enough for the opposition to understand their strategy, and ultimately, each party may be too invested in wanting to win the ‘game’ themselves to even consider than they actually need to work as a team to achieve the best result.

This analogy means there can often be two extremes of opinions or polar opposite starting points when embarking on an aesthetic treatment journey, such that the practitioner may be thinking,

I provide the product, I look after you, and I manage the risks

meanwhile the patient may be thinking

I pay the money, I get the things in my life sorted because I paid you the money for the product

This is not going to produce satisfaction on either side because each is too invested in their own gameplay, and they are not meeting in the middle to achieve a join goal.

Problem expectations to look out for in aesthetic practice

A good aesthetic clinician needs to work hard to ensure that all the outcomes of treatment are discussed, settled, and opinions modified if they are unrealistic, so that both parties can compromise and agree on what is going to happen.

Of course, sometimes the expectations between the patient and the practitioners can be too extreme and agreement is simply impossible.

The patient who expects everyone to notice their new look

paparazzi photographerThe most common example of this is when the patient has lots of unconscious expectations. For example, they may have had treatment in the past and been happy with their results, but have ultimately been disappointed because their partner, friends or family did not notice.

Now, you and I know that this is a sign of a good aesthetic clinician, when the results achieved from treatment are natural and the patient does not look ‘done’ or over treated, but the patient’s expectation of future treatments is that their results ought to illicit comment from others. This is a clear mismatch in expectations.

Thankfully, this type of patient is in the minority, but there are ways to spot individuals who may be expecting that the outcome of their treatment is a flurry of compliments and attention from those in their inner circle. They may try and validate the expense of the treatments they are considering undertaking by verbalising that they hope so-and-so will see a change or be impressed with their investment etc.

The patient who expects you to work magic with one syringe of dermal filler

Another influence on patient expectations can come from you, via the claims made in your marketing. The polished presentation of your before and after photographs may not truly represent the investment needed (both in time and money) to get from A to B, leading patients (especially those with small budgets) to believe, or even expect that such results can be achieved with a single treatment or a small quantity of product. Be sure you do not inadvertently make misleading or unclear claims about how much ‘work’ has gone into the results you achieve with your patients when using their case studies to secure new business.

How to understand your aesthetic patient’s expectations

The number one tip for successfully managing patient expectations in aesthetic practice is getting your patient to FULLY articulate their expectations during the consultation.

Your consultation should last around 45 minutes, especially the first time you meet your patient. If at any point you feel like you do not have all the information you need, then you probably do not. Remember, what the patient tells you is not usually everything you need to know, you must probe to get them to tell you what you feel you need to discover so that you can get to the bottom of their expectations. You achieve this by a systematic approach to discussing all the areas that will be impacted by their decision to have an aesthetic treatment – their look, their behaviour, their life changes etc.

For more insight into the psychosocial well-being of your patients and why aesthetic clinicians need to ensure that they not only address the aesthetic result or outcome but also understand how unconsciously the patient is seeking to look a certain way so that they will feel and behave differently, which will allow them to achieve things which they currently feel are unattainable, have a read of our previous blog on justifying medical aesthetic treatments.

Some patients my start the consultation like a shopping list, telling you which product they want and how much. This is your cue to find out what they expect to gain from their ‘shopping list’ and then you can start to discuss the reality of what it would achieve.

Do not be afraid if a patient produces images of celebrities to tell you what they want or do not want. This is often simply a visual aid to help them to explain something for which they do not have the medical vocabulary nor the technical skill in terms of the understanding of the composition and movement of anatomical structures. Embrace it, they are usually not seeking to look like a facsimile of the celebrity, but can reference things they like and their hope to achieve a similar result from their treatment.

Of course, you need to be on the lookout for signs of a patient who is asking for treatments that they do not need. Download Dr Tim’s Body Dysmorphia and Modification Checklist to help you spot dysmorphic patients.

5 steps to better manage patient expectations during an aesthetic consultation

aesthetics consultation

  1. Reflect back at the patient – repeat back to them what they are hoping for, the physical changes and the psychosocial impacts expected from the treatment, to help you to confirm if you have understood them correctly.
  2. Modify their expectations – inform them that the physical changes are not 100% guaranteed, but with your skills and knowledge you hope to reach a certain goal. Talk in terms of ‘relative improvements’, for both the physical and the psychosocial impacts. Ensure that this will be enough to give them what they seek – more confidence, a positive outlook on life etc.
  3. Get them to reflect this back to you – ensure that the patient validates and confirms everything you have told them about what you can achieve (both due to budget and facial anatomy) and the expectations you can reach, so that you agree.
  4. Be open about the things you cannot do – do not over promise your results. Remember you can soften lines, but you may not be able to make them disappear, things take time to improve and often cannot be expected to resolve completely after an initial treatment. However, it is vital that you are honest about that to avoid disappointment and dissatisfaction if they were expecting something more miraculous.
  5. Repeat the patient validation process – confirm that they understand what cannot be achieved as well as the improvements you believe they will see.

Following these simple steps during your consultation should have a significant effect on reducing the number of disappointed patients you have on your books.

Tip 4: Be consciously aware of the aesthetic

Dr Tim Pearce SculptureYou will need to hone the ability to notice the body language and unconscious cues from your patients which tell you how their current aesthetic is making them feel unhappy. Learn to notice the aspects of their face which have put their aesthetic off balance – making them look or feel angry, sad, old, tired, or less beautiful. Once you build a conscious awareness of the aesthetic, you can create your treatment designs to try to change it for every patient. You cannot get the best results from delivering injectable treatments without an awareness of the aesthetic. Even perfectly executed injections can produce ugly results.

It does not require a prerequisite for artistic flare and can be learnt with the correct training and mentoring. You can also try to study faces, learn how they change with ageing, how these changes impact beauty ideals and facial proportions. If you do have a joy for art, you could even consider drawing or sculpting faces to really get a feel for the contours, shadows, and dynamics of the face.

Aesthetics Mastery Show

Managing Patient Expectations

How to avoid complaints with great questions

Dr Tim unpacks the topic of managing patients’ expectations in his Aesthetics Mastery Show. He outlines exactly what injectors should ask and say in the consultation if they want to avoid ‘underwhelmed’ complaints altogether.

Are you still anxious about delivering cosmetic injectables safely?

If you want to learn more about mastering medical aesthetic treatments and complications or conquering the anxiety of where to place your needle, then register for the next Dr Tim webinar.

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Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

Thousands of delegates have benefited from the courses and we’re highly rated on Trustpilot. For more information or to discuss which course is right for you, please get in touch with our friendly team.