Dr Manav Bawa shares advice for new practitioners entering aesthetics
Have you just finished your foundation course? Not sure what to do now? We have all been there! I remember walking out of training with a fantastic new skill set, and wondering what to do next? With many practitioners feeling like this, it is no wonder a high percentage of delegates do not move forward in medical aesthetics.1
Within this article I aim to guide those practitioners who have just finished their foundation training, or are about to begin, to get set up and start seeing patients, which is one of the first and hardest steps to being a successful aesthetic practitioner.
Prior to completing your foundation course, it is important to think about whether you would like a lifestyle business or an exit strategy2 as this will dictate what type of a business you will run, or how aesthetics will work within your lifestyle. A lifestyle business is one which can be set up around the practitioner’s current role, for example, to bring in a supplementary income for an NHS worker. There would be minimum expenses and it does not require a formal business structure. Many practitioners have started with this type of business including myself, renting clinical rooms on an ad-hoc basis and supplementing their income while they grow their patient database.
The typical entrepreneur would create a business with the sole aim of selling it, therefore have an ‘exit strategy’. They would invest in its value as much as possible and once a high enough profit can be obtained the business will be sold. For example, an entrepreneur could invest in the opening of a clinic and create a formal business structure with policies and processes in place, and employing staff to fill all levels. Once the business has grown and is worth a profit, the clinic could be sold to an established chain of clinics.
A business plan is essential,3 and many can be freely downloaded from the internet.4,5 It is certainly worth spending time completing this, as it will keep you on the right path in terms of financials and strategy. This will also help you to plan your future vision, which is a great concept to have, as it will give you something to work towards.
Consider a company name for your aesthetic clinic; this is certainly harder than many think! Your values, ethos, background and vision will all help you create your brand and company name. Remember this will represent you in the public domain, so consider your unique selling points, patient demographic and location.
One of the most common questions I receive as a trainer is, “Where can I treat patients?” There are numerous ways, with one option being to rent a medical consulting room initially on an ad-hoc basis and progressing to a more regular sessional basis once you build your patient base. Many practitioners have built a successful practice by creating a clinic space within their home and mobile practice is an alternative method, however my concern has always been the difficulty in managing infection control when treating patients in their own home, which is even tougher in the current climate. It is also worth noting that the Joint Council for Cosmetic Practitioners (JCCP) emphasises that practitioners working from their home address should meet audit guidelines outlined in its Premises Standards,6 while the British Association of Cosmetic Nurses recently stated, ‘There is no risk assessment that can demonstrate fully all the stringent measures required to carry out a cosmetic medical aesthetic treatment in the home. The environment does not lend itself to all that is necessary to ensure adequate patient and practitioner safety of treating a patient in that setting, and therefore this practice is not recommended’.7
Instead, joining a larger and established clinic is a great way to be part of a larger team and to potentially learn from experienced practitioners. It can be daunting to approach a large clinic, however my advice would be to look at the transferable skills you have from your background, create a portfolio of your work and keep approaching clinics, as many look for inexperienced practitioners to train in their own philosophy and techniques. The most important part is to be yourself!
If you are looking for supervision, another option is to consider joining the JCCP which, along with the Cosmetic Practice Standards Authority (CPSA), recommend forming networks of practitioners and have devised a supervision matrix to enable everyone to have access to a practitioner as a supervisor or mentor.8 Supervision can be directly with the experienced practitioner or virtually, and junior practitioners can discuss complex cases, complications or anything they need help with.
The first thing to do after the foundation course is to organise indemnity. There are a number of insurance companies that specialise in the aesthetic medicine sector such as Cosmetic Insure, Enhance Insurance or Hamilton Fraser Cosmetic Insurance, so contact them to obtain a few details and quotes. Also speak to your current indemnity provider as they may be able to provide insurance for the aesthetic treatments you will be providing.
Have you thought about which products you would use and where will you would purchase them from? There are numerous products on the market, and I would recommend researching and contacting product specialists of the reputable aesthetic medicine pharma companies. Discuss the range of products they have, how you would use each one to treat patients and what kind of support and additional training opportunities they offer. Remember to also do your own research to ensure you’re confident the products are reputable and safe.
The next step would be to register with an aesthetic pharmacy such as Church Pharmacy, Healthxchange Pharmacy, Med-fx or Wigmore Medical to purchase your products and consumables from a reputable establishment. Many pharmacies are now offering starter packs, which can be useful as they contain everything you would need for your first few patients.
To start with, I would recommend ordering a few products for stock or on a ‘per patient basis’ following a consultation, as the first few months can be unpredictable in term of treatments and revenue. This is exactly what I did when I started as I did not want to be left with stock getting near to its sell-by date. I also did not want to spend money on products I may not use. Regarding prescription-only medications, in England only doctors and dentists are allowed to keep stock, for all other practitioners, they must be prescribed and ordered for a specific patient. Remember that the General Medical Council says that you must undertake a physical examination of patients before prescribing non-surgical cosmetic medicinal products, so they should only be prescribed in the patient’s name following a face-to-face consultation. You should not prescribe these medicines by phone, video-link or online.9
One the biggest mistakes I made was to wait for almost a year for an ‘all singing all dancing’ website. When we went live, it was brilliant; however, for most of the time it was in the making, nobody knew that I was practising! So, I would certainly advise publishing a one-page website as fast as you can presenting who you are, your background and credentials, as well as the services and treatments you provide. When patients search online for a practitioner or service, for them to be able to find you, you must have an online presence. While a social media page is great for promoting your business, it doesn’t offer all the information a website can offer. Educating patients is a great way to engage with them, and ensure you cover the treatments you provide as well as details about each one including how it works, how long it takes and how much it costs. You therefore could create your own website or hire a digital marketing company to do this for you. It is also wise to create a Google business listing, known as Google My Business, so your clinic can be found on Google maps.
Marketing yourself can be extremely overwhelming with many platforms available. I recommend starting with simple social media such as Instagram and Facebook. They have their own algorithms which are constantly changing, so have an appreciation of them if you want to excel on these platforms. Post regular and engaging content to remain in your current and potential patients’ feed. Other ways to market yourself would be local advertising within lifestyle magazines or leaflet drops. Remember word of mouth can be a great way to grow organically, so treat your patients well, and they will tell their friends. Patient reviews are a great way to market and promote your work, so utilise a third-party service patients can leave reviews on, for example, TrustPilot or Google.
Try to have a few patients lined up to treat as soon as you complete your course, as it is good to keep up the momentum and excitement, as well as to avoid deskilling. Patients could include family and friends, or through marketing prior to the course.
A common question is how to market yourself when you haven’t got years of experience? I used my medical background to promote myself, the products I was using, and I focused on enhancing the patient journey as much as possible.
I started by approaching a local beauty salon prior to my foundation course, and I negotiated a collaboration where they would refer me patients, and in return they would receive a fee. This worked well as I built my experience through referrals from an established business. On the other hand, please do note that the General Medical Council has guidance for doctors that states they should not accept payment for referrals as it gives rise to a conflict of interest.10 Similar standards apply for nurses and dentists.11,12
Collaborating with local businesses can also bring in patients as they will have received a recommendation from a third party (your collaborator) and so will have a level of trust already formed. Local business networking can be very powerful in this way and can work well for all parties.
As you start to grow, you could use before and after photos to promote your work. Good quality photography is essential for this. Standardise your photos as much as possible, for example, always have the same plain screen behind patients, take pictures at the same angles before and after, as well as using a good quality camera. I started off using my iPad camera, then purchased a DSLR camera with a refurbished flash, a tripod and black screen, which didn’t cost too much.
It is essential to maintain detailed patient records for medicolegal reasons,13 as well as reviewing procedures, finances, diary management and tracking key performance indicators, which will help you grow. A digital patient management system can really help, as well as allowing before and after photography comparison. This can enhance the patient journey by showing your patients their progress at their review, as well as helping you learn from your results. There are numerous ones out there – from free to a significant fee – and choosing a robust and reliable system will really help to manage your time as well as aid business growth.
Using an automated approach will also save time and money, thus boosting your profits; for example, in my experience, reminder emails or texts will reduce the number of patients who do not attend their appointments. Using a paperless system will also avoid storage issues and, currently, with heightened infection control, it is much easier as there is no paper, only a computer or tablet to clean. A good system could also integrate with your website or social media allowing bookings to be made online, again saving time and costs. Some commonly used software systems include Aesthetic Nurse Software, Clever Clinic, Consentz, iClinician, iRejuvenation, Pabau, and Sellsio, to name a few.
Once you start building you patient database, it is important to spend time on retention, as it is more economical to retain current patients than obtain new ones.14 Ideas of how to do this could be to book patients in for their next treatment before they leave, newsletters to maintain a constant presence or even reaching out to patients with a quick phone call to see how they are and if you could help them in any way.
Moving into a new industry can be daunting, as well as overwhelming initially when looking to become a successful practitioner – we have all been there! Get a head start by planning prior to your course, focusing on your own medical aesthetic journey, and working smart towards your own personal vision and goals by spending time on strategy and planning of your business.
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