In this episode, host Vicky Eldridge is joined by Dr Emily Mehta, Director of Harley Academy, to discuss the crucial topic of managing patient expectations in aesthetics. From the influence of social media on unrealistic beauty standards to the importance of clear communication during consultations, Dr Mehta shares expert insights on fostering trust and delivering ethical, patient-centred care.
Vicky and Dr Mehta also explore the shift towards more natural aesthetic results, strategies for handling patient requests, and the evolving landscape of aesthetic treatments. Whether you're an experienced practitioner or just starting out, this episode is filled with valuable advice to help you navigate patient relationships with confidence. Tune in now!
Vicky Eldridge
So I'm joined on the podcast by Dr Emily Mehta and she's the director of Harley Academy. Thanks for joining us.
Dr Emily Mehta
Lovely to be here Vicky. Thank you.
Vicky Eldridge
We're going to be talking a bit about patient motivations and expectations. Why is that so important in aesthetic practise?
Dr Emily Mehta
The main reason it's important is, it has such a strong correlation between how much you can enjoy your job, how good your clinic goes. So, from the practitioner's point of view, learning how to assess and handle challenging motivations, high expectations will really just help you enjoy your aesthetic practise, keep you out of some sticky situations with patients you shouldn't treat. And then from the patient's point of view, of course, it's so essential that we understand this so they can actually feel good at the end. People often talk about results in aesthetics and they're always talking about the aesthetic results, but you can give a perfect aesthetic result and if your patient's unhappy with it, then I don't really feel like you've achieved very much, so, it's essential.
Vicky Eldridge
Yeah. And obviously making sure that your patients are leaving happy. So much of that is tied up with their experience, isn't it? And that very much starts from perhaps even before they've walked in the door.
Dr Emily Mehta
Absolutely, yeah. It's what they bring in, their entire experience with you, and then, of course, how they're followed up and looked after afterwards.
Vicky Eldridge
How can practitioners better manage expectations? Because I know it's something that people find challenging, isn't it?
Dr Emily Mehta
It is. It's very challenging. So the main way you can help manage is to explain. So explain, explain. Explain the limitations of treatments, what could go wrong, and check understanding. It's an essential part of the informed consent process. However, with the best will in the world, you can do all that perfectly and you still might not have managed their expectations.
Some patients walk in the door with unachievable, unrealistic expectations and there's nothing that you can do to change that. And really, then it's about spotting them and declining treatment.
Vicky Eldridge
How much of a role do you think things like social media play in that, in people having these unrealistic expectations?
Dr Emily Mehta
An awful lot. An awful lot. And there's definitely been a change in the last, particularly five years of practise. I think more recently, in the last maybe even year or two, people are starting to understand that a lot of what they see isn't real. So I would say it's getting slightly better just recently, but it definitely plays a big role.
Vicky Eldridge
There seems to have been a little bit more of a shift, doesn't their background to more natural, less obvious. But we saw this sort of cycle of treatments that trending on social media, perhaps where they were quite overfilled.
Vicky Eldridge
Maybe there was a look that became fashionable in a sense, not with every patient, but certainly you saw it on social media and I've noticed that that seems to be coming back around the other way with people wanting more natural treatments. Have you noticed that?
Dr Emily Mehta
Yes, I have. I think depending on where you work, you'll get a certain type of patient coming to see you. And I think I've rarely had people coming wanting treatments that don't look natural. But one thing I have noticed is that as well as the results looking more natural in the imagery people see on social media, there is less before and after imagery on social media, which I think is a good thing. I remember when I was just getting started at Harley Academy, before and after photos were everything. Every one of social media accounts was full of them. They were all tweaked and edited. A lot of them were unrealistic and now them used much less frequently and more judiciously, which is good.
Vicky Eldridge
How do you manage it if you need to turn a patient down? So if you need to say no, you don't think a treatment's the right fit for them. That's something I know a lot of practitioners feel really uncomfortable about. And also, you know, from a business perspective, you don't want to turn people away. But there's that balance between, you know, being a medical practitioner, being ethical. How do you strike that balance and turn patients down for treatment or guide them in a different direction?
Dr Emily Mehta
It's definitely something I've got better at, and more comfortable with over the years. It is a skill you can learn. I used to be terrified of doing that and I definitely made some blunders. But now, start off by making sure you have forged some sort of good relationship or rapport with them, even if it's just a single encounter before you give them bad news so that they know it's coming from a good place and you genuinely have their interests at heart. And then just explain wholeheartedly, candidly why you can't treat them, which is, you know, because you care about this equally and definitely don't be worried about lost business in terms of, you know, revenue, finances. There's always more patients out there and the difficult patients, if you do choose to treat them, they end up costing you money.
Vicky Eldridge
So true. And that Ends up being where a lot of the complaints or complications, you know, not complications as such, but complaints come forward when patients, their expectations haven't been met and they feel unhappy with that.
Dr Emily Mehta
Absolutely stress all round for them, you, your clinic staff, lots of review appointments, which is of course wasted time and money. So definitely I would encourage practitioners to have a low threshold for actually saying that a treatment isn't right for that person, always bearing in mind that it's not right for them at that point in time. You don't necessarily need to rule them out completely. And if possible, you can always suggest an alternative either from yourself or from a colleague or another clinic that you have a good relationship with.
Vicky Eldridge
Amazing. From your experience, you know, training lots of different practitioners through Harley Academy. Is there anything people particularly struggle with?
Dr Emily Mehta
Relating to this subject, I think it is their own boundaries get pushed by certain patients. So patients that have a very strong driver for treatment, they're highly motivated to get this treatment, they think they're going to get it or else. And high expectations of the results, not only what they'll look like, but what those results will do for them in their life. They might think this result is going to fix their relationship, get them that job, change their self esteem and so they could be very pushy. And practitioners with less experience might drop subtle hints that maybe this isn't the right way to go, maybe they aren't comfortable doing this treatment. But unless they take that bold step of being explicit in saying no, they can find their own boundaries crossed and then they can end up doing treatments they're not comfortable to do. And sometimes you can get a sort of downward spiral of problems from there.
Vicky Eldridge
Now, you've been a speaker at the Aesthetics Business Conference. Why do you think meetings like this are important? Of course you do the clinical training as well, so that's really important. But why do you think meetings, when we're looking at the business side, the consultation side, are important for practitioners?
Dr Emily Mehta
It's so important. I actually think it's the hardest part to learn and the hardest part to get good information from. Really a lot of it is more about learning from other people's mistakes, learning from the experience and wealth of knowledge that's out there. And it has, I think I referred to this at the beginning of our talk, but it has the biggest impact on how much you enjoy your job. I think a lot of medical practitioners moved into aesthetic medicine to reduce stress, to work in an environment where you're dealing with positive scenarios, to have a better work life balance. Unless you understand how to comfortably deal with all sorts of different types of patients and if you are running a business, to run a business, then you can kind of just bring that stress and poor work life balance with you into aesthetic medicine, which is obviously a shame. So it's really important to have events like this.
Vicky Eldridge
Because the clinical skills are just one part of it, aren't they? It's important to have those, but that's just one part of it. Looking back on 2024, is there anything that's been a highlight for you of this year in terms of the aesthetics market? Anything, you know that has been a positive thing or anything that you feel has been a negative for the market in this year?
Dr Emily Mehta
Yeah, this has been a really interesting year actually. I think it's the first year since I've been practising when there has been a dip or a drop in dermal filler treatments. Dermal filler treatments have really had this meteoric rise over the last 10 years and understandably so they can do really transformative things in a non surgical way. But there has been an increased awareness of the limitations or potential risks. So I think it's both a good and a bad thing. I think it's good for us to be more aware of the limitations and risks, maybe more discerning about how we use these products. But also I can see from the media there's a little bit of scaremongering as well. So it's about getting that balance right and seeing where the treatment fits in amongst other options out there.
Vicky Eldridge
And what about for the future? Is there anything you're looking forward to in the market? Anything you're excited about?
Dr Emily Mehta
Yeah, lots of things. So, my specialism is injectables. That's what Harley Academy predominantly teaches and that's what I predominantly do in my clinic, although I'm very interested in other treatments, energy based devices, et cetera. But as someone who's predominantly injecting, I'm really excited to see more biostimulatory injectables, hybrid injectables, regenerative treatments, rather than just cosmetic implants. And it is a really positive shift. I think that also helps patients mindset about getting more natural booking results, as you said, and thinking more about long term changes.
Vicky Eldridge
And finally, if you had any advice for any other doctors wanting to get into aesthetics as they're thinking about coming into the market, what would your advice be? Or if you could go back and give yourself some advice when you were getting started?
Dr Emily Mehta
Yeah, well, when I started it was a different time, actually. So I think the advice would be different now. Now, so aesthetic medicine is hugely rewarding. I work with quite a large team now, about 30 doctors, dentists, nurses, all full time in aesthetic medicine. All have transitioned from various medical specialties and I never see anyone transition back, let's put it that way. It can be very, very rewarding. However, you do have to go all in and do it properly. And the reason I say it was a different time when I started is, I don't think that was quite the case, sort of, you know, eight to 10 years ago, you could do a bit on the side, be a GP, there wasn't a decent clinic on every high street. Whereas now the market has grown, which is a good thing. But it also means that to have a really successful, fulfilling career, you need to take it seriously. You need to expect it to be hard work initially and commit yourself to becoming a real specialist, educate yourself properly, come to events such as this ABC Hamilton Fraser event and really get a well rounded understanding of what it means to practise in this industry.
Vicky Eldridge
Amazing. Emily, thank you so much. Great to see you. Thank you for joining us.
