Leaving the NHS to go into aesthetics: dealing with judgement and guilt

Recently, Dr Tim Pearce welcomed his apprentice winner, Nurse Charlotte to a podcast to discuss a common struggle faced by healthcare professionals who are transitioning from working in the health service into a career in the aesthetic industry, including the uncertainty of when, or if, to go full-time and potentially leave the NHS.

In this blog, we share the key points from their conversation and Dr Tim explores the guilt often felt by doctors and nurse who move away from public health services into private medical aesthetics. They delve into dealing with judgement from others, making financial plans, and the decision to take the leap to leave and go full-time in aesthetics.

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Why do you feel guilty if you want to leave the NHS to practice aesthetic medicine?

Nurse Charlotte explained that she felt so guilty, like many of her nursing colleagues, for wanting to leave the NHS to become an aesthetic practitioner. She does love the NHS and has a passion for the work, but it has taken its toll, and she cannot continue to work full-time in the service. However, she warned that colleagues think it is easy to simply ‘jump into’ aesthetic practice, or do a ‘bit on the side’, one evening a week perhaps; but, as a separate specialism, she maintains that you cannot make that leap unless you put in the time and effort to learn, there is no fast track.

Dr Tim concurred that he too experienced guilt when finally deciding to leave the NHS, a decision for him which coincided with the start of the COVID-19 pandemic. Of course, this gave him a strong urge not to leave his colleagues at a time of national need and stopped him leaving completely. He emphasised that these feelings are the reason that many healthcare professionals go into the field in the first place, with idealistic notions of wanting to help patients and cure disease, driven by their passion and not by money.

Yet, when the months are longer than the pay checks, and progression within the health service becomes difficult, some look for other options when their personal life starts to suffer from standing up for their ideals. Dr Tim recollected some sage advice from his own father who told him that the first sign of burnout is when you stop enjoying the things that you used to enjoy in your job. Reflecting on that he recounted how that happened to him in general practice, many times, when he no longer had time to talk to his patients and listen to their story, a part of the job he loved, due to the increased workload and demands on practice time.

Charlotte agreed that she felt like an awful person when she stopped listening to patients, noting that the minute you stop listening, you have lost empathy and the reason why you became a nurse.

Yet, Dr Tim explained that the emotion that makes you want to listen to your patients, even when you have not got time, is also the same emotional tie that keeps you in a situation that is not good for you – which unfortunately, he believes represents many healthcare professionals who carry a heavy burden within the NHS out of a sense of duty and compliance with their identity as healthcare providers. The system is built on people who went into it for all the right reasons and who never did it for the money. Sadly, their own lives are often being eroded, placing stress on relationships, due to working in a way that is unsustainable.

Dr Tim noted that if every healthcare professional argues that they deserve better pay within the NHS, but ultimately, many leave the institution if there is a better opportunity, then over time market forces would dictate that they need to compete and real value must be recognised, otherwise no one will fulfil the roles. Such a shake up could be a positive for the NHS.

However, he countered with the fact that most healthcare professionals can never let go. He has never let go. Charlotte also does not believe she will ever leave, out of a sense of duty. Knowing how short staffed the NHS finds itself, she does not want to leave her colleagues suffering and has a strong pull to help where she can.

How to combine working in the NHS with practising aesthetic medicine

You can do it on your terms, stated Dr Tim. You can work within the NHS less frequently, chose a part-time option, and still build an aesthetic business.

Dr Tim has proved that this can be done, and you can do both. He remembers lots of people telling him that he would give up the NHS GP work eventually, and he started to wonder if he was being naïve and that combining the two would be impossible, but it is his choice, and he is still able to make it work. His advice is not to listen to anyone other than yourself and build what you want.

However, you do need a plan, where you decide to do less NHS work – reducing hours, changing shift patterns – and establish at what point you can decide to go all in, at least financially.

Dr Tim explained that these days, he does not depend on his GP income at all, so it does not make any difference to him, but there was a point in his career where it was everything, and he had to take the leap.

Having a plan is vital, and it should be based around time and money, explained Dr Tim. He advised Nurse Charlotte to keep her expenses to a minimum to maintain flexibility as she builds her business and recalled how he drove a 12-year-old car when he first started in aesthetics. This gave him the ability to take a huge drop in salary from his junior doctor wage, and still live, whilst he pivoted into aesthetics. During the first 3 years combining it with aesthetic practice, alongside his wife, Miranda, all the money that went into the business stayed in the business, creating a pot that allowed them to hire others and grow their business to what it is today.

At this point, Dr Tim stopped most of his GP practice apart from some locum work and went all into aesthetics. He noted that he worked harder than he had ever worked before in those first few months after growing his team and was devastated when the accounts showed a loss. However, alongside his business partners, he knew this was to be expected and it was not long until they saw their first, tiny profit; that was the sign that they could keep going.

Learning from this experience, he advised Nurse Charlotte to make a financial plan – know how much money you need to live on, work out how many aesthetic patients you need to see to fund that, or how many shifts as an NHS nurse you need to take on instead. Align this with longer term goals, calculated over five years – for example, if you can see a fixed number of aesthetic patients per week, it means that you can drop a fixed number of hours or days within the NHS. Having a mathematical plan like this will motivate you, give you focus, and you will build your aesthetic business quicker, allowing you to move further away from the NHS over time.

Colleagues and bosses may be supportive, but similarly some may be resentful, and you may experience some negativity about your decision, implying that you do not care about patients and are only after the money.

Dr Tim concluded that taking the leap is a high stakes decision, you will take it personally when it does not go smoothly, and that will happen because that is the nature of embarking on something new. Longer term, if you keep going, you will become a very robust team, but it is hard.

Read more of Dr Tim and Nurse Charlottes’ conversations, including:

• Making clinical and ethical decisions as an aesthetic injector
• Top tips to reduce swelling and bruising when injecting lip fillers

Dr Tim loves to hear from his followers, so why not drop him a comment on social media; you can find Dr Tim Pearce on Instagram if you have any questions or comments about facial anatomy, including fat pads and ligaments.

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Aesthetics Mastery Show

When to go full time in aesthetics

In this episode Dr Tim and nurse Charlotte chat about the dilemma facing those who are still working in NHS roles alongside building an aesthetics business. Watch the full Aesthetics Mastery Show here.

The show has certainly struck a chord with other practitioners – here are just a few of the comments posted so far:

Karen Reid-Renner:

“This is absolutely me! I am working harder and getting paid less and still having trouble letting go despite burn out. I need to let go and jump into aesthetics full time and reduce my medical side to do it part time”

Isma Syakila Mazlan:

“Relatable!”

Bare Aesthetics

“Your best so far Dr. Tim Also trying to balance GP life with Medical Aesthetics over here and your statement of “People making up stories to let themselves off the hook…….” is so spot on!!! WOW! You just crystallized the situation perfectly!! Love your work. You are raising the bar for Medical Aesthetics”

Angela Adimando

“This is so true. Thanks for this Dr Tim!!”

Swierp Life

“Thanks for this video. I’m going through this right now”

Read more and join in the debate on the Youtube video or post your comments below, we love to hear from our readers.

Aesthetics marketing eLearning courses

For tips, advice and support in medical aesthetics marketing, Dr Tim Pearce offers the Dream Customer Attraction Method (DCAM) eLearning course by Miranda Pearce. The course contains a wealth of advice about building and growing your aesthetics business.

In addition, browse our FREE business and marketing resources.

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.

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