Who is the first person a prospective patient comes into contact with in an aesthetic practice? In most cases, it’s a receptionist who sits at the front desk on the firing line, answering phones and greeting visitors. In many practices, however, this individual is often the lowest-paid employee. The person who is entrusted with setting the first impression of your practice to a potential customer is being paid an hourly wage or a modest weekly salary with little or no incentive to do a better job. There is rarely any room for advancement in this role, which is one of the reasons that turnover is very high.

An aesthetic practice needs to increase profitability without having a negative impact on the patient experience and staff motivation to ensure long-term growth. There can be various ways to get there, including decreasing your expenses, increasing the number of patients, and increasing the average patient spend. Decreasing expenses may seem like an obvious place to start, but you can only cut so much. If you choose to cut salaries or limit days and hours worked, the staff may start posting their resumes on LinkedIn to see what else is out there. Slashing your marketing budget may be equally self-defeating because you need positive exposure to encourage new patients to come in and current patients to have more treatments.

Another common strategy is to reduce fees charged for services. Let’s say that you cut fees by 20% for dermal fillers, neurotoxins, and lasers and light-based devices, and that results in a 20% increase in patients having treatments. What is the end result? You may see more patients, but you may also be losing money or breaking even on every patient treated. When you factor in the decreased cash flow and lost time that could have been used to generate income by treating other clients, this potentially profit-boosting strategy may impact your bottom line in all the wrong ways.

Wendy Lewis


If your goal is to increase the number of patients you see, make sure your practice has the infrastructure to effectively service them. You risk losing more patients and their potential referral sources forever if you are unable to take good care of them. The right balance of the right treatments, the right products and services offered, the right staff, the right patient flow, the right facility and amenities, and the right marketing is what it takes to operate a healthy aesthetic practice today.

Can you afford to raise your prices? Most practices are terrified to increase their prices. However, the cost of new technology, products, and consumables has skyrocketed.

Let’s look at another strategy: Executing a 10% price increase may generate a 10% loss of customers. In some cases, this may actually increase your profits. Physicians and staff can spend slightly more time with a patient, improving the level of overall service provided. Or they may be able to treat other patients, and with the time saved that can result in generating extra income for the practice.

Talk to your suppliers about bulk discounts, favorable payment terms, discounts for payment in advance, special promotions, and other support that might be available. Many vendors now offer monthly specials to their customers or end-of-the-month deals that can be worth taking advantage of if you have the space to hold onto inventory. Also, try to order only once per month to reduce delivery charges.

The most important aspect of keeping patients coming back and spending more is delivering a first-class patient experience. Historically, the overall experience in a practice can be a greater source of generating referrals than producing the best treatment outcomes. The place to cut spending is definitely not on your patient. Rather, you might want to spend more to enhance their experience.

For virtually all new patients, their first point of human contact is on the phone. They may communicate through e-mail, but the live voice is the most important component of bringing patients in the front door. Staff training is crucial to deliver a first-class customer experience. Mystery shoppers and telephone recordings of how patients are greeted provide valuable feedback on how your practice is handling patients.


Happy staff means happy patients. Patients can tell when the atmosphere is tense or unpleasant. They can spot it a mile away. Foster a team attitude and spirit of cooperation that resonates with patients. This will greatly improve the work environment, efficiency, and productivity.

Staff will compare notes, so offer a good pay package that is competitive to attract the cream of the crop. Disgruntled employees should be dealt with as quickly as possible. Incentivize your staff in a way that is fair and equitable to avoid creating a toxic environment. For example, salary plus commission or bonus packages should be formally established and implemented. Perks should be based on merit, performance, and longevity. Money is not the best motivator for everyone. Some of your staff may seek recognition and/or other forms of emotional rewards. Saying “thank you” or acknowledging that someone has done a good job goes a long way.

Turnover not only costs money, but also turmoil, uncertainty, and disruption. Patients like to see the same staff in your practice, especially if they are caring and professional. It creates a better work environment and makes patients feel more welcome so they will stay longer and spend more with you. It is well worth paying good staff more to keep them on board, and reduce additional training and recruitment costs.


5 Paths to 5-Star Service

  • Design the quintessential patient experience
  • Develop a protocol for how to deliver it
  • Train your staff to provide it
  • Increase service offerings based on customer wants and needs
  • Improve staff morale

When evaluating where to spend your money, there are certain key principles to consider. First and foremost, you get what you pay for. If you want to have someone who is paid $10 per hour to greet your patients and schedule appointments, the end result is that you will lose revenue. Fewer patients will come in and have treatments done, which also means fewer referrals.

Don’t cut your marketing spend. Rather, spend the same money in a smarter way and pay closer attention to monitoring the return on investment (ROI). Evaluate contracts you may have that are not getting a good ROI, and cut your losses. Convert your offline dollars to a more efficient and trackable online marketing program.

Invest in good technology. If your computer system is from the year of the flood and freezes up or loses data, start with the right equipment and tools that your staff needs to get the job done. Update antiquated hardware, as well as the software that runs on it for improved efficiency. Offer key staff a Blackberry or iPhone so they can respond to messages or post social media updates on the go in a timely manner.

Lastly, your waiting room is real estate. It is like the landing page, above the fold, of your Web site. Keep it fresh and appealing. Make sure that the carpet is clean, the upholstery is not worn, and that there is sufficient and comfortable seating. Flat-screen monitors, tablets, and the new PatientPad® trump paper brochures and outdated magazines every time. Give your patients an experience worth coming back for, telling their friends about, and worthy of a positive review in online forums.

Wendy Lewis is president of Wendy Lewis & Co Ltd, Global Aesthetics Consultancy and founder/editor in chief of beautyinthebag.com and a contributing editor to Plastic Surgery Practice. She can be reached via [email protected].