Dr Kalpna Pindolia offers a personal perspective on transitioning from working in the National Health Service to medical aesthetics
With the plethora of skills possessed by medical professionals, aesthetic medicine has become an increasingly viable option to diversify in or even to choose as an entirely alternative career pathway. With a relatively young history and continuous growth, there is no denying that medical aesthetics is a discipline that is professionally engaging as an avenue to practise the science, as well as the art of medicine.
After working in emergency medicine for seven years, like many of my fellow colleagues, my priorities had changed. I spent a further three years working as a cruise ship doctor to reflect on my career so far and make future plans. Returning to emergency medicine as a locum after this was a challenge that reiterated my current thoughts of how this particular specialty fitted poorly into my lifestyle. I started looking into alternative options, which involved making a list of aspects of my current role I liked and those I disliked. Then I went on to consider roles that I thought may achieve the balance I needed, using a career coach for support.
I did a foundation and advanced course, as part of exploring many potential options. Needing some short-term financial balance, I then went to work for the Centre of Health and Disability Assessments (CHDA). During this time, I was establishing an aesthetic patient-base part-time and then studied for a Level 7 qualification in non-surgical aesthetics. This was certainly an intense time with a lot of juggling involved. After 15 months at the CHDA, the advantages of a career in medical aesthetics, such as a better work-life balance, whilst maintaining an income, had become undeniable. I then focused on this new and developing passion full-time.
The sense of responsibility within the work we do is also central to the future of the discipline
The journey from being an NHS professional to an independent practitioner has not necessarily been smooth, or easy. The transition from the illness to wellness industry is unique, with completely new types of patients and a different skillset needed. As well as this, booming consumer demand does not necessarily equate to success for the individual practitioner. So, in this article, I shall explore some of the personal challenges I have encountered from moving into aesthetics from the NHS so far, and divulge how I have overcome these.
Moving into aesthetics was perceived with indifference by some of my NHS colleagues and friends. They appeared to challenge my identity as a ‘proper’ doctor. This initially also gave me doubts over my identity as a doctor. When I made the move, family and colleagues would often ask about how the euphoria of life-saving work compares to reducing wrinkles. Because of this, I found myself questioning whether working in aesthetics was less noble then mainstream medicine. I wondered ‘Is the work with the sick, any less valuable than the work we do with the well?’
Now, I have come to strongly believe the work we do in aesthetic medicine is much more meaningful as a medical professional than is sometimes perceived by others. The impact you can have on a patient in this context, through improving concerns and boosting their self-esteem, can be profound and rewarding. Also, you meet so many inspiring aesthetic practitioners, just like you do in conventional medicine. Medical aesthetics is being moulded by our community with pioneering developments that continue to build our evidence base. Technology is evolving with innovative products and devices coming onto the market, just like with traditional medicine.
The sense of responsibility within the work we do is also central to the future of the discipline. Likewise, there are a variety of difficult and interesting concerns from patients who come from diverse socioeconomic backgrounds, culture and life experience. As practitioners in this growing field, we are in a unique position to empower perceptions of beauty.
All in all, I have discovered there is certainly no need to compare what you find rewarding as a medical professional in this specialty compared to the NHS, as long as you are passionate about it. The opportunities to make a difference in medical aesthetics are there for the taking, should you seek them.
One thing I didn’t realise before I first got into aesthetics, is how much I would miss the team atmosphere of the NHS. The camaraderie, technical support and teamwork of the emergency department was special. As well as working alone much more than I was used to, I also felt like I was back to being a junior all of a sudden. Compared to my middle grade role in the NHS and senior doctor role onboard ships, I did not have the same level of experience in aesthetics.
If your attitude is driven by passion for your work rather than financial gain, it helps you to see past the intimidation of competitors and overwhelming business administration
My solution to these challenges was, and still is, to build professional relationships and train as much as I possibly can. Apart from investing in formal training, there are regular industry events in the UK, and further afield. There are yearly conferences in the UK where you can learn from live talks and demonstrations, as well as network with industry colleagues. Company representatives can also assist you with information about materials and provision of training. Additionally, knowing your limits and pacing your progress reduces the feeling of being overwhelmed with the multiple potential services and revenue streams available.
I have had the tremendous benefit of learning from nurses, dentists and doctors as trainers and mentors. From knowledge, technical know-how and business tips, these professionals have been instrumental to my progress so far.
Networking within the field, as well as in the business realm, is vital to progress. Struggling with networking is normal for those who are more introverted by nature, but the more you do, the more comfortable it becomes. Apart from reducing isolation levels, it reveals valuable sources for support in managing difficulties, and identifying colleagues to refer to for advanced treatments or management of complications. Emotionally-supportive people will motivate and perpetuate your progression. They can also support your financial worth with inspiration and business networking.
Joining associations such as the British College of Aesthetic Medicine (BCAM) and the British Association of Cosmetic Nurses (BACN) can also broaden your education and industry network. Social media groups on Facebook can provide peer-to-peer support. Journals are also a great way to expand your knowledge base, as well as to get to know industry colleagues and their areas of interest, which may be aligned with yours. There is certainly a special supportive atmosphere embracing aesthetic medicine where we are all continually learning, no matter what your experience level is in the industry.
In the era of social media, and with somewhat small industry circles, I found that your work is scrutinised more by colleagues and potential patients in the privately paid health industry, compared to the relatively closed area of NHS work. Perception of the quality of your work can vary, as does the definition of beauty for an individual. There is always that worry about how your work will be perceived, especially in a specialty where the definition of good outcomes is open to interpretation.
Patients rate and recommend your services on a number of different platforms, like social media, which you might not be used to. Good ratings provide social proof of a patient’s confidence in an aesthetic practitioner. A quality consultation process, investing time to discuss realistic expectations and potential risks, is well worth it in this respect. Negative responses are best dealt with calmly and with professionalism to limit any further damage to your reputation.
As I have grown in experience, I have accepted that the anxiety this can cause is actually an advantage, because it ultimately demonstrates that you care. From feedback, whether positive or negative, comes the chance to develop and grow as a professional as well as personally.
There is no doubt that celebrity culture and the internet have popularised the aesthetics specialty, and with this is the spread of misinformation and unrealistic expectations. The world of private medicine is about practitioner reputation and patient satisfaction for a paid service. To manage the patient’s expectations, allowing plenty of time for the consultation leads to better outcomes and helps the patient’s understanding of your medical decisions. I can spend up to an hour with a patient at the first consultation.
The transition from the NHS to aesthetics may be unique in its demands, but it is also a life-changing opportunity
As well as this, using your communication and empathy skills empowers the patient so that you can both come to the most appropriate shared decision. Informed consent is a concept most medical professionals are generally experienced with, so using this builds the foundations of balanced patient choice.
Aesthetic medicine is ethically challenging and you need to take into account psychosocial and ethical parameters. Patients seek assistance on their perception of their appearance. Awareness of conditions such as body dysmorphia is crucial and an essential component of continuing professional development. Knowing when not to treat and the process of declining treatment can be extremely difficult, but is also central to delivering responsible treatments.
Robust reinforcement of the positives allows for acceptance of more negative statements, such as ultimate refusal of treatment. If the patient is approached with confidence and considered with empathy, these discussions get more comfortable over time.
Maintaining rapport is of great importance should the patient require onward referral too. If we remember that non-surgical procedures subject the well patient to medical and psychological risk, weighing up the decision to treat does become less daunting over time.
As medical professionals, we have a multitude of talents including anatomical knowledge, communication skills and clinical abilities. However, marketing, business operations, advertising and financial administration are not usually within our expertise, coming from the NHS. This new venture can be intimidating and it is the nature of the aesthetics specialty that, often, when you are starting out, you need to think about these business factors while trying to develop your fundamental aesthetic skills. It is important to become familiar with business topics such as marketing, finance and law. But, we are not all marketers, financiers or lawyers. It is OK if you realise that some areas are not within your remit.
Using your strengths is important, so determine what these are and learn to recognise when delegation would be more efficient and cost effective. Most of my business awareness has been from a combined approach of attending formal courses and conferences that run business workshops and also from discussions with various providers, for instance, business coaches.
Social media is a way of picking up tips as well as more formal discussions with companies, such as digital marketeers, PR agencies and bloggers. It is also often worth identifying your niche early to differentiate yourself from others. This process involves recognising an area within the discipline representing your passion. Defining a space that competition has not isolated as profitable, is a method of generating and improving the viability of your business. You do not always get it right initially, but testing the waters usually reveals what works for you.
I have found that, overall, if your attitude is driven by passion for your work rather than financial gain, it helps you to see past the intimidation of competitors and overwhelming business administration. There are potential patients out there, so remember that it takes time to build your base to grow your business.
In the context of booming consumer demand and better working hours compared to numerous NHS positions, many medical practitioners are drawn to the field of aesthetics. With the various challenges to conquer, there come equal opportunities to grow.
Medical professionals tend to be resilient and adaptive in nature so this change is entirely possible. New practitioners should have an understanding that medical aesthetics is not an easy option or an instant destination, so careful planning, patience and determination facilitates the journey. Driving forward from a place of passion and networking for professional development, perpetuates confidence along the way. Approaching tasks mindfully and constructively gets you through most hurdles and is effectively a source of growth.
After all, the aim in all medical professions is the same for everyone – providing a high calibre and professional service. Aesthetic medicine has afforded me the balance I desire with work as well as life outside of work. In conclusion, the transition from the NHS to aesthetics may be unique in its demands, but it is also a life-changing opportunity.
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