The Provider You Booked Should Be the Provider Who Treats You

You booked with a physician. The confirmation had a physician’s name on it. Then someone else walked into the room.

If that has happened to you, it is not a small thing, and you are not the only one. It is one of the most common complaints in aesthetic medicine, and it is almost never disclosed in advance. Patients find out at the appointment — gowned, committed, and past the point where saying “actually, no” costs nothing.

How does this happen?

Most practices sell the credential and staff the calendar separately. The physician’s name and photograph do the marketing. Scheduling software then treats providers as interchangeable, because operationally they are: a slot is a slot. Some booking systems will quietly substitute a different provider when the day gets tight, and the patient is never told, because from the system’s point of view nothing went wrong.

This is not unique to med spas. It happens at dermatology offices and plastic surgery practices too. Any practice with a marketable name and a staff of injectors faces the same pressure, and most of them resolve it the same way.

Does it actually matter who performs the treatment?

For safety, the setting appears to matter. A survey of aesthetic practitioners published in Dermatologic Surgery in 2020 found that complications originating at medical spas were not uncommon, with burns, discoloration and misplaced product among the most frequently reported. Fillers, intense pulsed light and laser hair removal were the treatments most often involved. Respondents rated medical spas as inferior to physician-based practices on both safety and outcomes.

For results, the reason is plainer. Injecting well takes a working knowledge of facial anatomy, an understanding of how your particular muscles behave, and a memory of what was done last time and how you responded. That last part does not transfer. A provider who has treated you before is working from information a new provider simply does not have, however capable they are.

What do you do differently?

You choose your provider when you book, and that provider performs your treatment. Not a colleague. Not whoever happens to be free.

That is the whole of it, and it is worth being precise about what it means. If you select a physician, a physician treats you. If you select our advanced practice nurse, she treats you. If you select one of our aestheticians, you’ll be treated by that aesthetician. The guarantee is not that one kind of provider does everything — it is that the person you chose is the person in the room.

Cancellations and emergencies happen — we are a medical practice, and pretending otherwise would be dishonest. When they do, we call you. We offer to reschedule with the provider you originally chose, or to see someone else that day. Both options stay open and the choice stays yours. What we do not do is quietly fill the slot with someone else and let you discover it when you arrive.

We also tell you plainly who does what. Laser hair removal, facials and peels are performed by our licensed medical aestheticians, who are very good at them. Microneedling, including Morpheus8, is performed by a physician or our advanced practice nurse. Injectables are performed by our physicians, and our physicians apply and monitor their own numbing.

None of that is a claim that one profession is better than another. It is a claim about knowing, before you book, exactly who will be in the room.

What should I ask any practice before booking?

You do not need to be confrontational about it. Four questions are enough:

• Who specifically will perform my treatment?
• Is that recorded on my appointment, or is it a preference?
• If that person becomes unavailable, will you call me before the day?
• Who performs this treatment when the practice is busy?

A practice that answers those clearly is telling you something useful. A practice that answers vaguely is also telling you something useful.

If you are comparing practices in Philadelphia, we welcome the comparison. Consultations are complimentary, with one exception: the wedding and event consultation carries a fee that is credited toward your plan. Book a consultation and meet your provider before any treatment decisions are made.

References

Wang JV, Albornoz CA, Goldbach H, et al. Experiences with medical spas and associated complications: a survey of aesthetic practitioners. Dermatologic Surgery. 2020;46(12):1543–1548. doi:10.1097/DSS.0000000000002344 (practitioner survey)