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  • The demand for cosmetic procedures, both invasive and noninvasive, is increasing dramatically.

  • A thorough consultation is invaluable for patient education and comfort.

  • Patients vary widely in their desires and expectations, and the consultation is the ideal time to tease out a patient’s individual preferences.

image Beginner Pearls

  • The interaction with the front desk sets the stage for everything that follows.

  • Etiquette for a physician’s office staff must be similar to that seen in high-level hotels or retail stores.

image Expert Pearls

  • A cosmetic interest questionnaire that lists problems and procedures the patient wants to discuss helps to streamline the consultation.

  • Use a variant of responsive listening—repeating back to the patient what he or she expressed to the nurse or assistant in the preliminary interview.

image Don’t Forget!

  • The appearance of the reception area is particularly important when treating cosmetic patients.

  • The public generally does not understand that surgery may be less expensive than the combination of nonsurgical procedures necessary to produce desirable results.

image Pitfalls and Cautions

  • Patient expectations must be set by the physician with both clinical and financial boundaries: the patient who expects to pay for one syringe of a filler but requires at least six syringes to attain the desired result will not be satisfied.

  • Body dysmorphic disorder is the most common psychiatric condition seen in patients seeking cosmetic procedures.

image Patient Education Points

  • Be clear that nonsurgical procedures can provide excellent, but still not surgical, results.

  • A physician must say “no” to any treatment they believe is medically or aesthetically inadvisable.

image Billing Pearls

  • Do not automatically write off procedure fees or offer reimbursement without checking with your malpractice carrier; returning money to a patient prior to discussion with your carrier could negate your insurance coverage if the incident is litigated.


The demand for cosmetic procedures, both invasive and noninvasive, is increasing. According to the 2016 Consumer Survey on Cosmetic Dermatologic Procedures conducted by the American Society for Dermatologic Surgery (ASDS), the percentage of people considering cosmetic treatment has increased from 30% in 2013 to almost 60% in 2016, with nearly 6 in 10 surveyed considering a cosmetic procedure.1 The top factor influencing their decision to have a procedure was their dermatologist (53%). Thus, a successful consult is critical.2,3


The first contact a prospective patient has with the office is the front desk, whether by phone, online, or in person. That interaction will set the stage for everything else that follows. Phone calls and emails must be answered promptly. Unfortunately, it is estimated that the volume of phone calls to doctors offices has increased up to 50% over the last decade as patients seek help managing approvals for prescriptions (which may be ...

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