Recently, I read an article that talked about ways cosmetic surgeons can “steal patients” from the competition. While this might sound like a good idea to some, I prefer a different approach. How about treating your patients so well and creating such brand loyalty that your patients would never ever want to leave you?

When people make a decision—either consciously or unconsciously—to follow your leadership and contact you about undergoing an aesthetic surgery procedure, they do it primarily because of one of two things: your character or your skills.

They want to know if you are the kind of person they want to follow and believe in, or whether or not you possess the surgical skills and expertise to give them the results they desire. If you give them the best facelift or breast augmentation and treat them like a VIP, why on earth would they be lured away by the competition?

There is no “new patient factory,” but I believe that you can capture new patients and keep them, if you really want to. If you treat your patients with care and compassion from the beginning, another practice’s lure of a $50 credit or a discount for showing “proof” of their purchasing intent will not break their loyalty to you.


Most people in the aesthetic industry would agree that word-of-mouth referral is the best way to bring in new patients. Your credibility has already been established by the referral source, and it will build a stronger patient base. Therefore, the first item of importance is the image you portray and how you are perceived by your patients.

Your image via your media appearances, direct mail, postcards, newsletters, brochures, stationery, your office layout, furniture, and your staff’s appearance and demeanor in person and over the telephone are all vital elements that stimulate positive (or negative) word-of-mouth referral. Never underestimate its power.

Let us start at your own front door, so to speak. The telephone is your first line of direct communication with the patient. It is important that your patients and potential patients feel that you and your staff are available to answer their questions, concerns, and (of course) calls. I recently asked a group of 100 surgeons, “Is your receptionist losing you money?” Astonishingly, two-thirds of them responded, “Yes.”


Most prospective patients that call your office want an aesthetic procedure done by you. If they are greeted by a caring, knowledgeable, and experienced receptionist, they might book a consultation with you. However, if the call ends without a consultation—or worse, without the receptionist obtaining the caller’s contact information—then they are seriously hurting your business and losing you money.

In my experience, the receptionist is often the least paid and the least educated person in a medical office. Your receptionist, though, is your “gatekeeper” who plays a pivotal role in the success of your practice. Aesthetic surgery has become a buyer’s market, and your receptionist should be ready to sell them on you. The goal is to turn a call into a consult.


My next question to this same group of physicians was, “What is marketing?” No one raised their hand to answer that question. Here is the answer:

  • Marketing is image, persuasion, and timing;
  • It is anything you do to promote yourself; and,
  • It tells the public who you are and what you do.

With roughly 700,000 practicing physicians in the United States today (up to 20,000+ offering aesthetic procedures), it is a challenge for physicians to develop a good reputation and increase awareness of their practice within their community. In the highly competitive world of aesthetic surgery, building a successful practice is even more difficult as newcomers compete for the same piece of the pie.

Publicity is fast becoming the most sought-after form of practice promotion, as the television and print media are proving to become a priceless source of “free advertising.” With the media’s ever-increasing influence on public opinion, aesthetic surgeons are discovering that publicity is a more discreet, credible, and effective way to increase patient awareness and take their practice to the next level.

Even if two physicians’ credentials are perfectly matched, it is the “news maker” who is viewed more favorably than the one who lines the advertising pages. Although both are paid promotions, the public has a tendency to distrust advertising, whereas they still believe what they see on television and read in newspapers and magazines.


One of the most underestimated, yet profitable ways for physicians to break through the message clutter is to implement permission-based messages in order to encourage patient-doctor interaction.

The Internet is an excellent playground for this type of interaction. Permission-based marketing materials should include a call for action. Make it clear that you intend to talk to them one-on-one. By encouraging this interaction, you are building friendship, trust, and loyalty.

Filling out a questionnaire before or after a consultation is not only an excellent permission-based marketing tool, but it also personalizes the patient and reiterates the patient’s concerns.

The following questions address relevant patient concerns and determine if your practice is projecting the right image:

  • How did you hear of us?
  • What appealed to you about our practice?
  • Were the staff and surgeons responsive to your needs and requests?
  • Do you feel that you were given several options?
  • Are there any surgical issues that need clarification?
  • Do you feel that you were able to make an educated decision regarding your surgery?
  • What do you hope to accomplish through surgery?
  • What are your major concerns about this facility?


Listening to the patient’s wants and needs is crucial to a successful sale.

  1. Check that patient details, such as name/address/e-mail/telephone (cell or home and business), are correct.
  2. What procedures are they interested in? Have they had similar treatments or aesthetic procedures in the past? If so, with whom—if they will tell you.
  3. Ask when they would realistically like to schedule a procedure.
  4. Explain the procedure that they require, and the fees (don’t use the word “costs”).
  5. Show before-and-after photos of other patients.
  6. Demonstrate any technology that you may want to use on the patient, if possible.
  7. Ask the prospective patient if she has any questions, and listen carefully to her.
  8. Ask if there is anything she has seen or heard that makes her at all uncomfortable.

If so, briefly explain the procedure(s) again. Address the specific objection or area of concern, and then ask again if there is anything she is uncertain or unclear about.

The most successful aesthetic practices are the ones that understand that the patients who walk through the door do so because they want to, not because they have to. In an aesthetic practice, you are dealing with healthy patients who will pay cash for services rendered.


For more than 22 years my mantra has been, “If you want the Saks Fifth Avenue customer, you have to look like Saks Fifth Avenue.” While the following items might seem basic to some of you, they are not to everybody. Even now I find myself in a doctor’s office and feel as though I must have stepped back in time. If you want to obtain and retain a great patient base, you must offer quality surgery and quality service, and it should show.

Your Web site:
Many aesthetic surgery practices have maximized the Web’s potential for new business, but publishing a Web site requires a dedicated effort and your own set of aggressive, attention-getting tactics.

Avoid elaborate, unnecessary graphics that take a long time to download. If your site takes too long to download, the prospective patient will most likely not wait around to see your site and simply cancel the downloading process.

One of the easiest, least expensive ways to promote a Web site is to link your page with every other noncompetitor that shares the same interest, be it an association, referral service, etc.

While your Web site should serve as an information piece for patients, it should also double as a virtual media resource outlet. Your Web site is a great place to interact with patients, be it through a blog that you can update weekly, e-newsletter, or new product opportunities.


  • Are the chairs too high? Too low? Comfortable?
  • Are refreshments offered (such as coffee, lemonade, water, fruit juice, etc)?
  • Is the lighting dark and dismal or warm and friendly?
  • Is the décor dowdy and old-fashioned, or bright and sharp?
  • Is the office inviting or cluttered?
  • Are the magazines in your waiting area up to date?
  • Do you have any items to create a warm atmosphere, such as a water fountain, fish tank, music, television, flowers, aromatherapy, etc?
  • As you move throughout the office, can you hear the staff talking about other patients/procedures/personal information?
  • Do you have brochures or other educational materials available?

Your Office:
Giving good, caring service is paramount to the success of your practice. Your office should be aesthetically appealing, inside and out. Patients should want to stop and look, and want to come inside. The best receptionist will act like a concierge at a high-class hotel.

Often after I have given a presentation, I encourage attendees of my workshops to go back to their practice and sit down in their reception area and imagine what a patient must see and feel when they sit there. Then walk around the office and look into each office and treatment room. Are files piled high on top of the desk? Are files or folders in view? In an aesthetic practice, as in any practice, privacy is important.


Looking at the appointment from the perspective of the patient can provide you with the opportunity to improve your relationship with them.

The visit can be broken down into five parts. Each part is necessary and takes the patient’s time. The parts are as follows:

  1. Setting up the appointment;
  2. Getting to it;
  3. Waiting for it;
  4. Meeting with the practitioner; and,
  5. The follow-up.

Obviously, some of these parts take more time than others. (This is where complaints usually start.) To cut directly to the chase, what follows is a detailed breakdown of each of these parts.

1) Setting up the appointment
How do patients set up their appointments with you? Can they “get right in”? Each person’s definition of “get right in” differs. In general, they are looking for an appointment within a day or two (or even a week) of their call, and at a time that suits them.

They are used to convenience. They can buy fast food on the way home, do their banking at midnight, and get their eyeglass lenses made in an hour. If they have to wait too long to see you, especially for a minor procedure or injectable, that’s inconvenient from their point of view. Convenience means patients “getting in” at a time that suits them. This could mean early morning or late evening; they need your help in getting in to see the surgeon.


  • How many times does the patient have to move? Maybe change rooms to lessen this.
  • Is the environment friendly or hostile? Are there warning signs, hazardous waste disposal signs? Are they needed?
  • Do the machines look threatening? If so, can they be placed behind screens?
  • Are the treatment rooms too surgical looking? Can they be more inviting?
  • Display good before-and-after photos of treatments offered.
  • Place brochures and other promotional literature in view.
  • Make your rooms warm, friendly, and relaxing.

Ensure that the time the patient spends on the phone improves the relationship you want to have with them and them with you. By making it easier for patients to make an appointment, you will emphasize how much you value them.

2) Getting to you
Although they are not even in the office yet, this is really when the appointment begins. No matter how long they spend with you, they may have to spend an hour or so driving, parking, and waiting. As long as they receive great care and attention from you, they will put up with this hassle.

It is always a good idea to ask if they need help with directions at the time they make the appointment. Having a map on your Web site is helpful for first-time patients.

Take the time to ask if she was inconvenienced at all in getting to the appointment. Was it easy or hard for her to find your building, find parking, or find your office in the building? Patients might speak of poorly lit parking structures, unsafe or uneven stairs, heavy doors, etc. By acknowledging these concerns, you show further how much you appreciate and value them.

3) Waiting for you
Put yourself in the patients place, and ask yourselves how well does their office visit start off? How do you feel as you come through the door? Do you feel pleased or relieved that there are people here who care about you? Are you on edge, waiting to deal with abrupt staff?

Try to create a “wait-less” waiting room, ensuring patients are in the treatment room on time and with the correct member of staff.

Patients should be so impressed that they don’t mind the drive to the office, and feel so overwhelmed with care and attention that their wait seems to be only a few seconds.

You should ask the patients how they are being treated before treating them.

4) Seeing you
This, of course, is the reason for the visit. This is where your character and skills shine. Your staff has done their job, and now it is up to you. Are you on time? Are you rushed? Is your focus on the patient in the room with you, or instead on the five others you are scheduled to see before that meeting at the hospital or that game of golf or ladies meeting?


  • Attitude, manners, cleanliness, and demeanor are important.
  • Professional dress or color-coordinated scrubs is preferable.
  • Are they knowledgeable regarding all the procedures offered?
  • Are they efficient?
  • Are they well-respected by colleagues/physicians?
  • Who comes first—the customer in the reception area or the customer calling on the phone?
  • Are they well-groomed and clean?

The secret is to relate to the person, not the patient. As often as you may have heard that before, ask yourself how often you actually do it. Remembering special events, work situations, kids, vacations, etc (even if it is from file notes) can please the patient unexpectedly. Your patients expect good-quality care from you. Give them more than that and they will keep on coming back.

5) The Follow-up
The patient has left the office. Now what do you do? Close the file? I don’t think so. If you or your patient consultant did not book surgery with this patient at the time of the appointment, then the follow-up is crucial.

You must call, and soon. Go that extra mile, re-emphasize to the patient that you value them, that you are the best choice for them, and use this time to further develop the doctor and patient relationship. If you call them, they will call you back—and more importantly, tell their friends—because it shows you care.


The extra effort to show you care goes a long way, especially after surgery. Patients appreciate the recognition you give them.

Look for ways to increase your interaction with your patients. For example, you can use programs that send cards or e-mail messages to patients on special events, such as birthdays and anniversaries. The same applies to special promotions, appointment reminders, media events, and speaking engagements such as educational seminars.

On The Web!

See also “Instilling Loyalty in Cosmetic Patients” by Wendy Lewis in the October 2009 issue of PSP.

Oftentimes, a patient will tell the nurse or receptionist when important things are happening in their life, such as graduations, weddings, celebrations, etc. By simply making a note in the chart about this, you and your staff can double your relationship score with your patients when you ask on their next visit how much they enjoyed the graduation, wedding, etc. Again, it gives the patient the feeling that you really care about them.

I’m a firm believer that if you take leadership in your practice and treat your patients well, they will create a loyal customer base that cannot be “stolen” by any competitor.

Many patients would never dream of going elsewhere because they feel so at home with their current surgeon. Rather than focusing on stealing patients, retain your existing patients and grow your practice based on providing them with the ultimate in service combined with the ultimate in surgical expertise.

Angela O’Mara is a known authority on practice building. She has been a guest speaker at several high-profile aesthetic meetings, including the AAFPRS, ASPS, AACS, and AACD. For more information, call (949) 768-1522;