Life as an entrepreneur: A conversation with Dr Leah Totton

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Ahead of her Entrepreneur Masterclass at The Aesthetics Business Conference 2024, we chatted with Dr Leah Totton about her career in aesthetics and the lessons she’d learned as an entrepreneur.

It's been 11 years since Dr Leah Totton heard those famous words from Lord Alan Sugar on BBC’s The Apprentice: “You are going to be my business partner.” The then 24-year-old had plans to open a chain of clinics – Dr Leah Clinics – and was impressed with her business plan and cool head in the show’s weekly tasks. With three sites up and running and her “most successful six months ever” under her belt for the first half of 2024, her plans have well and truly come to fruition. On 8 October 2024 at The Aesthetics Business Conference, she will share some of the secrets of her success as part of our Entrepreneur Masterclass.

Vicky Eldridge sat down with her to reflect on more than a decade in aesthetics.

Vicky Eldridge: What qualities do you think it takes to be an entrepreneur?

Dr Leah Totton: The most important thing is to be hard-working. That quality runs through every single entrepreneur I know – their work ethic is really, really high. Over the last decade, the real entrepreneurs, people who are really running businesses that they're scaling and who have lasted the course, haven't just dipped in and out. I don't think it's possible to succeed in any business, not just aesthetics, without hard work unless you are very fortunate and start a completely novel concept. However, in most companies, unless you're Steve Jobs or Mark Zuckerberg, you're in marketplaces where you're offering a service or product that already exists. Of the successful entrepreneurs I know, I'd say it's correlated with how hard they work.

VE: That's something that runs underneath being a doctor/medical professional, that sort of drive and work ethic.

LT: Yes. I think that is why we've seen the cosmetic space globally boom the way it has: because you've got a lot of very hardworking, very smart people who are now business owners. Most clinics are still owned by doctors in the UK. You've got highly educated, intelligent, and extremely hardworking business owners who are typically used to working in the NHS, a very demanding workplace.

That's why it's very competitive in the non-surgical space. Doctors make good entrepreneurs, and essentially, your competition, if you like, is normally every bit as intelligent, qualified, and hardworking as you are.

VE: Most people will know you from winning The Apprentice 11 years ago. How has that impacted and shaped your career as an entrepreneur? Was there anything you learned during that process?

LT: I learned the most, not necessarily from the process itself but from having Alan Sugar as a business partner. They're two different things. During The Apprentice, you learn skills throughout the show, like the importance of marketing and branding. You learn a bit about advertising. You learn about leading a sales team, that sort of thing, which was useful.

I've learned a lot from Alan Sugar, but one of the most valuable things I've learned from him is not to look at what your competition is doing. Only focus on your own business.  I was asked recently in an interview who I considered my competition to be. I couldn't name them. It really struck me that that is something I've learned from him through the years. We spend no time or energy doing competition analysis.

VE: I think that's such a good point. Because a lot of people worry about what their local competition is doing.

LT: It's a lot of wasted energy. My advice to anyone starting out now is it really makes no difference what anyone else is doing. You've got to do what you're doing well, and your clients will come to you. They'll go to someone else if you don't do a good job.

Try to avoid the industry in-fighting; you shouldn't spend your energy disputing that you are more qualified or better than a nurse or more than a dentist, or another doctor or surgeon. This interdisciplinary or cross-disciplinary bickering is confusing for patients and really unhelpful to the sector as a whole.

VE: How important do you think having a mentor is in business?

LT: I think it's more important to have the skills and knowledge of the treatments, if I'm being honest. You can still succeed in aesthetics if you don't have a business mentor. It's more important to have a clinical mentor if you're starting because they're going to be things that you need to refer to outside of your practice, no matter what your skill level is.

VE: One of the things you had to do during the process for The Apprentice was a business plan. How important is having a business plan?

LT: I had to do it for The Apprentice, which was part of why I won the show. For me, obviously, it was very important to secure investment. If that is a route that you're exploring as an entrepreneur, I think that's something that more and more doctors are now looking at as a means of financing. Previously, a lot of aesthetic clinics were self-financed, but more recently, we've seen interest from investors in this space. It is becoming an attractive option for investors. It's now a much more established industry than when I was pitching 11 years ago.

A business plan is important to obtain the initial investment, but in terms of day-to-day operations, you have to be fluid and flexible because there are things you'll have no control over, such as a global health pandemic! We had planned to open another clinic in 2021, and then COVID hit. Obviously, that's something that's being delayed, and then I had a baby.

But having a roadmap is good in the initial phase of starting a business. I looked at mine as a roadmap of where we were going and what we hoped to do.

VE: What are some of the biggest challenges you faced when starting and running your business over the last few years? Is there any advice or something you've learned from challenges that have come up that you feel that other people might benefit from?

LT: In recent years, managing patient expectations has been something that we, as a practice, are becoming better at. We've had to work on it because we have to be realistic about what we can achieve as non-surgical clinics. We are not performing surgery, which can give more dramatic outcomes—we must make sure that we're setting that expectation in an open, honest, and fair way.

We must understand the patient's perspective before performing any treatments and make sure that that expectation is set appropriately.

We have extended our consult times for advanced treatments. We make sure the before-and-after material we use is realistic—images that will give a realistic view to the patient of what they may expect. I think that has been really important in terms of improving our patient journey.

VE: People often say that the biggest way to avoid complications is avoiding complaints, which all come from patient expectations.

LT: We have to be really honest and realistic about the result we can achieve as well as any potential risks and complications. We also have to be confident to decline treatment if the patient is not suitable, expectations are unlikely to be met, or we have concerns. Often, after the consultation process, we have patients decide not to go ahead, which is the right thing for them and the right thing for the business because they are patients who are often not seeking the type of subtle outcomes that we can deliver. It's better and fairer for the patient to ascertain this early in the patient journey.

VE: Where do you see the industry and your clinics going in the future? What are you excited about for the future, and how are you continuing to grow and develop the business?

LT: We launched the skincare line in 2022. That's something that has done really well, and our three clinics are doing very well. The clinics celebrated 10 years in business this year and are performing very well. We were delighted to win the best non-surgical transformation result in the 2023 Safety in Beauty awards. We won Most Trusted Clinic in the UK in 2023 and were a finalist for Best Aesthetic Doctor in the Aesthetic Awards in 2023.

We've just had the best six months of trading in the company’s history, the first six months of 2024, which is great.

I became a mum 18 months ago which has shaped my view and also the amount of time I have available but expanding the business is something we will consider in the coming few years.

If you want to hear more from Dr Leah Totton and a host of other business experts and entrepreneurs, make sure you join us for The Aesthetics Business Conference on Tuesday, 8 October 2024, at The Royal College of Physicians.

For further reading relevant to this article, see:

Understanding the patient journey

How to create an aesthetic business plan

Patient selection: How to say no to patients

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