Practitioners' First Choice
Practitioners' First Choice

Refusing to treat- justified or not? 

Insta @larossaesthetics

This one is something that I wholly believe is inter thread with confidence- and if you asked me this only five years ago my response would be a different one. 

It’s simple really; every time we see a patient, we take with us our ethics, our skills, knowledge and character. We take with us context, insecurities and at times our anxieties.. we walk into that room very different to the person next door who may have the same certificates hanging on their wall… 

Fact is this, every decision we make to treat we need to justify- for me it isn’t about profits but about the patients gain vs risk. If I believe to my core that the treatment requested will actually perpetuate them into an endless spiral away from the very goal they have- well I will be saying no. If I believe that the gain is so microscopic that it doesn’t -to me- justify the risk of the procedure.. then it’s a no from me…if I feel that my patient needs support and not treatment, then support is what I will be recommending.. 

Now don’t get me wrong, with full transparency, I didn’t always.. at the beginning I doubted myself and was always led by the patient and I learned the hard way. The lesson – we invest every breath of our bodies into our skill so we are qualified enough to know when treating is the right thing to do.. and also when it is not… 

Stand by your ethics, your competencies and your principles.. do not let fear or intimidation be the reason you ignore that voice in your head that screams, ‘don’t do it!’.  Make sure you’re listening and make sure you have the confidence to respond to it.

Insta @gracecobner

It’s funny how our minds work. I can’t remember my first complaint but I can remember the first patient that I declined to treat. It felt so alien; declining to treat a patient, when in the NHS you are expected to treat every person who walks through the door. At the start of my aesthetics career declining treatment was a choice I had yet to learn. I did not have the confidence nor the skill to politely decline treatment to a patient that did not align with my practitioner values. I guess you could say I learnt the hard way, so now when I teach aesthetics there is a whole section on when to decline treatment. I really wish it had been a part of my initial aesthetics training as I believe it is hugely important. It definitely would have saved me a few bumps along the way! We are all aware of how vital the consultation process is, it is the basis of our plan, of when to accept or decline a treatment. It’s during this time with a patient that we can gauge expectations, the reality, their willingness to receive information and our own limitations. The decision to not treat a patient could be because of several of those factors or just one factor alone. When I started my practice I vowed to treat every patient as I would want my own mother or sister to be treated. The main questions constantly popping into my mind are; Is this treatment justified? Am I going to get a good treatment outcome? Am I going to meet my patients’ expectations? Is the risk of treatment greater than the reward? Does my patient understand the procedure fully? If you are unable to answer yes to all of the above questions, is continuing with treatment the most ethical option? Declining treatment should be viewed as a positive within this sector, it helps us maintain a safe and ethical practice whilst safeguarding our patients. The hardest part for me was acknowledging the red flag waving frantically in my head, ignoring this would have saved me that initial uneasy conversation, but it would have brought along 10 other issues for the ride afterwards. Trust your intuition- it’s a valuable tool!

Picture of Megan

Insta @the.aestheticsnurse

“What do you mean you won’t put more in my lips? I haven’t had any product for over a year”, it’s a phrase we all will hear at some point. I find I refuse to treat clients quite regularly. It’s a process that never gets easier. I definitely agree with Grace’s sentiment that we should be taught in our aesthetics training how to say no, we are taught about body dysmorphia and how to identify it but not what to do about it. Sometimes it isn’t just that clients want more filler, it can be that it isn’t possible to achieve their dreams with needles alone; sometimes surgery is required. It’s important to learn how to manage your clients expectations of treatment but also to think about what would happen if you did treat them and they had an (maybe in your opinion) unsatisfactory outcome. For me, my business is my baby! I don’t want my clients unhappy and also don’t want them walking around with substandard results I’m not proud of. 

It’s always going to be harder to say “no” than it is to just say “yes”. It’s a strange feeling of guilt you feel when you and your client both know what you’re about to say! I always assure them it is in their best interest. I sometimes tell my clients “this is in your best interest, it’s not like I got up today, came to work and decided I didn’t want to earn money”. I make it clear I want them to have the best results possible and that often brings them comfort and a giggle too! Stick by your guns, it’s hard but it will do you and your business better in the long run.


One Response

  1. Completely agree with all the above. In addition though I find myself declining to treat patients if I don’t share the same visions with them. I can’t be passionate and good at a treatment or style that I don’t believe in. Eg big lips. Massive cheeks, witchy chins and over chisel jaws. I actually find it easy to decline to treat by saying I am nit the clinician for you. I can’t produce something if I can appreciate the vision.

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