Introduction

When I was studying Masters in Dermatology in one of the best institutes in India, KMC Manipal, I used to often wonder whether I would spend my whole life consulting patients with itches, ulcers, scabies, leprosy and fungal infections. However when I started my own practice as a dermatologist, focused on treating cosmetic problems, I came across many patients who spoke about their bad experiences with their previous dermatologists. Some of the common complains that caught my attention were:

•  “My previous dermatologist did not spend more than 2 minutes consulting me. She was always in hurry whenever I  went to her  clinic for treatment”
• “Doc she burnt my skin with laser and when I showed her my face, she did not even bother to look at it. What kind of doctor is she?”
• “ She was not soft-spoken and never assured me of flawless skin after the treatment”

I realized that these patients were different and needed to be treated in a different manner.  Many questions cropped up in my mind, like:

• Should I spread red carpet for them. Make each and every one of them feel special whenever they walk in my clinic?
• Should I wish them on their birthdays and anniversaries?
• Should I address them by their names and pay attention to every individual
• Should I invite my loyal customers for get-together and know them better?

After pondering for quite a time, the one answer that came up for all these questions was YES.   Since then my whole focus has been to be their special doctor.

Understanding My Patients and Creating a Special Bond with them

I have always maintained that patients seeking cosmetic treatment are very demanding and expect a solution for their every cosmetic concern. This puts lot of pressure on me to satisfy them, because a NO can deeply disturb them.

Every patient has his or her set of questions or problems. Their questions can be as simple as, “Doc I have an oily skin, then why should I use moisturizer?” or as bizarre as “I have heard that laser hair removal causes cancer later in life. Is it true?” Though this can be irritating and sound stupid, dealing with such queries is part of my daily cosmetic practice.

As a skin specialist you need to have flawless skin because your patients treat you as your role model and want to imitate you. In other words, you inspire them and they feel that they are in the right hand. Many of my patients say to me, “You have flawless skin and I want mine to be like you”

I have been in cosmetic practice for more than a decade now and I love my profession.  I have created a special bond with patients and they like the way I speak to them, assuring that they too will have a flawless skin. Hence they wait for months to get an appointment. It is very satisfying for me to see smile on their faces and I do not mind seeing 100 to 140 patients a day.

The Typical Profile of Cosmetic Patients is very different

Patients don’t mind waiting, provided it’s worth it. However I try my best to arrange the appointments in such a way to cut down their waiting time to minimal. However factors like traffic jams, long distance to travel in a city like Mumbai; and some cases that require longer consultation can extend the waiting period.  However my staff usually engages them in complimentary treatment, paying attention to their needs.

• Patients Seek Honesty

Patients don’t expect perfection, but honesty. As a dermatologist, I often come across chronic, recurrent conditions of varying aetiology like freckles, acne, melisma, which have various internal as well as external unknown causes and triggers. Treating them with lasers gives them a feeling being under the magic wand that will erase all their skin blemishes. However I am honest to them and discuss all the possibilities of recurrence and treatment failure with them before starting any treatment. This is the backbone of my practice.

• They Have High Expectations

Practicing in a 5-star clinic with lasers and all modern updated technology raises the expectation of my patients and they ask me question like “Even with laser, you mean melasma will not go away permanently? “  I have to explain them that laser is not a magic and just an external treatment for resistant cases. There may be an internal cause that triggers the skin problem and hence no permanent cure to such a problem. I patiently explain them and they agree to sign up for temporary treatment because that is the best solution they can have. At the end I frequently hear them say, “Oh our previous dermatologist never said that. He said your skin blemishes will go!!”

• Willing to Pay through their Nose

Cosmetic patients have deep pockets and I am often surprised, when average looking patient readily pays for expensive Botox and laser treatment.  I remember one such patient, a 62 years old lady who had taken a bank loan to do skin treatments like Botox and fillers. When I asked her why she did so, she said, “Doc my skin is the only thing that I will take with me when I die. Rest all the diamonds and properties that I own, will be left with my family. My skin is my priciest possession”.

• Patient Trust You only

Patients Insist on seeing only YOU. Well that is at times pretty frustrating. They know that doctors aren’t omniscient; they just want them to share what they know. Sometimes I wish I could clone myself. Hey wait I cannot clone myself, but I can do something similar. Train and educate my assistant doctors and teach them to deal with my patients in the same way as I would. For that I conduct regular training sessions for all my staff so that they can understand patient problems and solve them independently.

• They Like You if You accept your Faults

Once your patients trust you, it is bond of lifetime. Uncertainty is fine, as long as they are told the truth. Also they accept that doctors are human and that medical errors occur. They don’t aim for retribution, but they want doctor to acknowledge it and sincerely address it. Have I never burnt any patient with lasers? Yes I have and I am sure most of my successful colleagues would agree with me. Have I apologized to my clients? Yes many times. And that only wins their trust. They know I am human.

• Patients are Surprised if You offer them Options

They need an option:  People don’t know that they have options, especially when it comes to saying no. They are used to doctors telling them what they need; they are surprised when I mention that they have a choice to “NOT get a test” or “NOT take medications”. However I discuss why they should and what will happen if they don’t. However I always say that “If you don’t do dermaroller, you won’t die!!”

• Worried about  Side-effects

They are very scared of side effects.  Almost every patient walking through my door is on self- medication like multivitamins and calcium. They pop pills like peanuts and when I ask them why they are taking calcium, the answers are hilarious. “My gym friend advised me”, “Am I not supposed to, I am 41. It strengthens my bones” and the best one is “for the white patches on my face” or “my son has white spots on nails which is due to calcium deficiency”. I always end up lecturing them on the need for good nutrition and not depending solely on supplements. No one thinks that these supplements could also have side effects. However when I have to prescribe an antibiotic or a topical lightening agent, I have to face so many questions. But that is how some of my patients are.

• Patients are Looking for  Role Model

They are looking for a life coach and a role model. People aren’t just looking for a paper prescription or a doctor eager to inject Botox into their faces. They want a doctor who is good listener and adviser on all aspects. Because most of us don’t spend time discussing about lifestyle changes, most people don’t want to go to their doctor at all, and prefer to find ways to improve their lifestyle and prevent disease. None of us can undermine the effect of good nutrition and balanced lifestyle on skin. People crave connection and caring. They want face-to-face interaction with “their” doctor. They want to be listened to, heard and be told. Knowing their medical history is only the start; they also want their doctors to understand and connect with them emotionally, physically, and spiritually.

• A Five-Star Environment that Attracts Patients :5- Star Hospitality is a key to a successful cosmetic practice:  Over the years, my dad and brother were always amazed at the amount I spent on beautifying my clinics. They could never understand why I would take bank loans and decorate the clinic. After all they are in business too. And I never could explain well. When I had a menu card for the choice of refreshments in my clinic, my dad frowned “have you started a restaurant here?” Don’t we all like to put our best face forward? That’s all what I want to do. Since I am in the business of beauty, I believe in creating a luxurious environment in my clinic, what is wrong with it? You can’t call yourself a cosmetic dermatologist and have a shabby, falling, dull and dead place. I want my clients to look forward to an excuse to drop by at the clinic.