• As aesthetic doctors we have a duty to safeguard our patients, even if it means saying no. Patients have often already researched the treatment they want, and have an expectation of the results that can be achieved. However sometimes these expectations may not be realistic and the requested treatment is inappropriate or even unsafe for that individual.
  • Aesthetic treatments are expensive. Can a patient afford a full course of treatment? Do they understand that results may last a limited period of time? Do they understand that they have to maintain treatments to keep the result? Ageing is a constant, and anti-ageing treatments don’t stop!
  • We live in an age where saying “no” is something people don’t hear very often. We are living in a “yes” and instant world. But a doctor first needs to take a thorough medical and drug history. Is their prescribed medicine a contraindication to the planned treatment? Have they had an upper respiratory infection? Have they had a vaccine recently or any invasive dental work or an auto-immune condition? All these affects whether a patient can safely have treatment.
  • What might the patient not be saying? Doctors need to ask questions and listen. Let your patient talk. You may very well pick up things, some subtle and some completely glaring. Listen for the red flags. Why does the patient want the treatment? Are they feeling pressured to keep up with friends, are they trying to make somebody love them?
  • How does the patient feel about themself? Don’t be afraid to ask these difficult questions. What upset or distress might be behind the request for treatment? The treatment might not be the remedy for these concerns. How is the patients mental health? Are they competent? Could they perhaps have body dysmorphic disorder?
  • We have to remember that we are doctors first. In that moment with your patient ask yourself: “What is the vulnerability of this individual and how can I best serve the person in front of me?
  • If saying no is the best thing you can do in that moment then that is what you do.

Thank you to Sharon Brown, BACN for the inspiration for this information.