Why Doctors Should Not Pay For Advertising!


I don’t think that doctors should اسعار الاسهم السعودية تداول مباشر pay for advertising.

I have got no problem with doctors advertising.

It is just paying for advertising that I think is unnecessary and wasteful for most of us.

I actually think that advertising is to be encouraged, although it seems to have a bit of a bad name.

الاسهم المطروحة للاكتتاب في السعودية في 2015 My version of advertising is different to what most people might consider advertising to be.

I see advertising as letting people know that الخيارات الثنائية التفاح استراتيجية we exist and what we are able to do to help them.

Advertising is not coercing people to buy things that they don’t need or pushing a buy one, get one free offer.

When the NHS gives out leaflets about prostate cancer or runs a television commercial about heart disease, this is advertising.

So I think that فتح حساب في البنك الأهلي أسهم advertising is good and we should all raise awareness by providing information to patients to allow them to make an informed decision.

…but I don’t think that we should be http://gl5.org/?prikolno=%D8%A7%D9%84%D8%AE%D9%8A%D8%A7%D8%B1%D8%A7%D8%AA-%D8%A7%D9%84%D8%AB%D9%86%D8%A7%D8%A6%D9%8A%D8%A9-%D9%88%D9%8A%D9%83%D9%8A-%D8%A7%D9%84%D8%AA%D8%AF%D8%A7%D9%88%D9%84&d1f=6a paying for advertising.

Not because of any moral or ethical standpoint, but because it is a find out here waste of money.

I don’t think that advertising in general is a waste of money, in fact it is a very powerful and effective way to communicate.

It is just that if you’re a doctor in private practice and you want to خيار التداول الثنائي في المملكة المتحدة communicate your message, there are much more effective ways to do this rather than paying for advertising.

Most doctors think that the problem with their private practice is that not enough people know about them and so paying for advertising will remedy this.

When the problem is usually that they are not looking after the people who already know about them .

When I look at doctor’s private practices I am shocked at the see lack of processes around dealing effectively with enquiries.

This is the most basic area to focus on and in fact is just the tip of the iceberg.

We all have a كيفية كسب المال لمن تتراوح أعمارهم 13 عاما database of patients:

  • who have enquired but not come to the clinic,
  • who have come to the clinic but not gone on to have a procedure
  • and who have had a procedure but not had a repeat procedure or left a review.

Not to mention our database of GPs and other doctors.

go here There is gold in the database and we just need to nurture it to find it.

There is no point in paying to put more patients into the database if you are not looking after those that are already there.

It is easy to put an advert in a magazine or pay for SEO or online advertising – and there are certainly enough companies out there who will convince you that this is what you need to do.

….but don’t be surprised when you realise that the £1000’s you put in, comes back as only a handful of enquiries worth only a fraction of what you put in.

source url And then you think that advertising doesn’t work.

It is not that advertising doesn’t work, it is just that you are not maximising your opportunities.

I have mystery shopped many doctors practices and it is very common for اوقات سوق الاسهم السعودي emails not to be responded to or the phone not to be answered.

So don’t be surprised that if you put an advert in, you don’t get a return on your investment if you are http://theiu.org/?alisa=%D8%A7%D9%84%D8%AE%D9%8A%D8%A7%D8%B1%D8%A7%D8%AA-%D8%A7%D9%84%D8%AB%D9%86%D8%A7%D8%A6%D9%8A%D8%A9-%D9%85%D9%82%D8%A7%D8%A8%D9%84-%D8%AE%D9%8A%D8%A7%D8%B1%D8%A7%D8%AA-%D8%A7%D9%84%D8%A3%D8%B3%D9%87%D9%85&1e5=9c not answering the phone when someone calls!

You’re much better off making sure the phones are answered and the enquiries are followed up on before trying to get more enquiries.

Not only does this make good financial sense, but it also leads to you building a better practice which is giving a better service to your patients.

قائمة وسطاء الخيارات الثنائية من الحد الأدنى للإيداع Money spent on improving the infrastructure and systems in your practice is much better than money spent on advertising.

So start by looking at how you can improve your communication and engagement with the people who already know about you, before taking an ad out on the back of a bus!

How I Got Out Of The Hole


How I Got Out Of The Hole

Over the last few years, I have gone from doing OK, to doing really badly and now I am doing better than ever.

I have been in a really bad place and maybe I was naive, but I really didn’t expect it to be so bad.

follow I left the NHS five years ago and I thought I would make things even better for my patients by opening my own clinic.

If I had known then what I know now, there is no way I would have opened my clinic at that time.

My private practice was doing OK, so I felt that I could cover the overheads of the clinic.

What I didn’t realise was that as soon as I opened my clinic, go to site the local private hospital stopped sending me patients. 

I went from having two busy clinics a week to http://investingtips360.com/?klaystrofobiya=%D8%AA%D8%AF%D8%A7%D9%88%D9%84-%D8%A7%D8%B3%D9%87%D9%85-%D8%AC%D8%A8%D9%84-%D8%B9%D9%85%D8%B1&205=f0 nothing.

I had a بنك الاهلي الاسهم five years lease  with permanent staff and payroll to fulfil.

I had to equip the clinic not only with tables, desks, computers, phones, sofas, and consulting couches, but carpets, paint, window-dressings – I could go on.

It was grim.

I was desperate and I needed to do more work.

I didn’t know where to get help.

I went to plastic surgery meetings and conferences and they talked about the latest advances in implants and devices, which was all very interesting, but it wasn’t going to help me.

I needed to get more patients.

No one was really talking about how you go about getting more patients or keeping the patients that you have already got, which is what business is all about.

I started to go to business meetings and seminars and I found that this had a profound effect on my practice.

In fact, it got me out of my hole.

I realised what I need to do to start making my practice more profitable.

In fact, what I learned was that it was all about delivering a better service to patients.

It is all very well learning about the latest devices and implants, but that is not going to have an immediate and tangible effect on your practice today or tomorrow.

I learned about how to stand out in a crowded marketplace and how to make sure that patients wanted to come and see me rather than just a.n.other surgeon.

I have put together what I have learned in a free ebook ‘5 Steps To Build a Valuable Practice’ and you can get a FREE copy here.

I talk about what you need to focus on in your private practice that will make a difference to the outcomes that you get for your patients.

We are all focused on getting good outcomes, but it is surprising how little many of us think about the whole experience we are giving to our patients:

  • how we handle patient enquiries
  • what information we give to patients before and after they come for a consultation
  • how we can be distinctive and make patients feel special
  • how we can make sure that patients don’t forget about us and encourage them to write reviews and refer their friends to us

It is not about advertising or special offers.

It is about looking after patients.

Please feel free to download a copy and let me know what you think.

You Drive For Show, But You Putt For Dough

drive for show but putt for dough

I have just been to the 2017 BAAPS Conference (British Association of Aesthetic Plastic Surgeons) held at Kensington Olympia every year.

I was lucky enough to be on the faculty and was presenting about my experience of running my own clinic.

It is interesting talking to friends and colleagues because they like to talk about Google AdWords or Internet Marketing.  Whilst I talk about the coffee in my waiting room and sending out text reminders for appointments.

I am happy to talk about the more advanced stuff, but I do not think most doctors need to worry about this.

There were some good talks on PR, managing your online reputation and using social media, but I think a lot of this is people trying to run before they can walk and spending time on the drive rather than worrying about the putt.

“You Drive For Show, But You Putt For Dough”

My talk was a lot more basic and revolved around the steps that I have put in place in my clinic and the message is very simple:

design processes around every step of the patient’s experience and make sure that you follow-up.

You can get a copy of the 5 steps that I have built my practice on below:

5 Steps To Building A Valuable Practice

Download my FREE guide where I share the lessons that I have learned while setting up and building my own clinic.

Check out your inbox for a copy of my guide.

In fact, I would go further because I think if doctors are spending time, money and energy trying to promote their practice but have not got robust systems to deal with patients who are already in their practice, then they are wasting their time.

If you have not got a robust system for dealing with enquiries as well as a process for following up on those enquiries, then there is no point in trying to encourage more people to enquire.

You should be sending out information demonstrating your values and ethics and explaining to patients what sets you apart from others providing a similar service.

These systems are very basic but, you need to spend time and careful thought to discover what your values are and then communicate these to potential patients .

The problem with most doctors is that we are so terrified of looking like we are using hard-sell tactics that we tend to ignore patients altogether.

How many patients have made an enquiry through your website but have not heard from you following your initial response?

In fact, I have performed ‘mystery shopping’ of many doctor’s practices and there are a huge proportion of us who do not respond to enquiries at all and so this in itself needs to be looked at and processes put in place to ensure that these are not missed.

If you have not followed up on your initial response you are ignoring patients who have asked you for help.

You have to realise that most patients make enquiries to several practitioners at the same time they are enquiring to you.

It may be that your email gets lost in the sea of emails that we all get.

There is absolutely nothing wrong with sending another email a few days later saying:

I hope you got my email, here are some further details about me and my training

.. or

…here is some more information that other patients have found helpful who are considering the same procedure.

Similarly, after people have been to the clinic, do you follow-up with them?

How about sending an email saying:

I hope you got the quote we sent to you, it was nice to see you in the clinic and I hope I answered all your questions.  If you have any more questions I would be very happy for you to contact me directly, or you can visit me on my social channels.

It is all about follow-up

  • before patients come to clinic
  • after they have been to clinic
  • and after they have had the procedure

Follow-up, keep in touch and show that you care.

Forget marketing, PR or any other fancy and expensive techniques you might hear about. 

Get the basics right first before you start worrying about trying to get more patients to know about you.

Different Is Better Than Better

I was just walking to school with my little boy this morning and he was singing along rapping, pretending to be like Honey G.

It led me to think about who actually won X-Factor and I could not for the life of me remember.

I asked my wife and she could not remember either, but we both clearly remembered Honey G and so did my little boy!

Can you remember who won the X-Factor?  I bet you remember Honey G.

Obviously, Honey G was not the best contestant in fact she was quite far from it, so why do we all remember her rather than the ones who were technically better performers?

In fact if you think about competitions in the past we usually do not remember the winners, we remember people like the Cheeky Girls or Wagner, because different is better than better.

Ideally you are different and better (Susan Boyle), but this is not essential (Jedward).

The problem with just being better without being different is that everyone says that they are better. 

People will only know you are better after they have used your service and so it is often too late, because many procedures only need to be performed once.

You need to demonstrate a tangible advantage over your competitors to set yourself apart in a crowded market. 

It is about taking time to think about how you position yourself and how you present your services.

It may not involve actually doing anything different, but if you can present it in such a way that it stands out, then you have more of a chance of being remembered and that will give you a distinct advantage.

I do not think it will give you a long-term sustainable practice in itself because at the end of the day you will still need to deliver the goods and provide an excellent service, but it might just set you apart enough so that you have a career more like Lady Gaga rather than Matt Terry.

It does not have to be anything wild or wacky like wearing a meat dress, it could be something as simple a sending all your GP letters on good quality green headed notepaper, but half the battle is to be conscious of these things and always looking to improve your practice and service.

I was talking to a cardiologist at the last ‘How To Grow Your Private Practice’ meeting and he wanted to see more patients with arrhythmias.

I couldn’t help but think that the market was wide open for him.

If he could put together a 5-point arrhythmia health check, which could be something like:

  1. ECG
  2. 24hr tape
  3. Echocardiogram
  4. some relevant blood test
  5. CXR

I have just made that list up from my armchair knowledge of cardiology, and it could be a 3-point or 7-point health check – depending on what tests might be relevant.

Then start mentioning it whenever you can in every GP letter that you have a 5-point arrhythmia health check.

Perhaps you could email or send a flyer to the GPs on your database advertising the fact that you offer a comprehensive screening tool for patients suffering from arrhythmia.

It may be that any cardiologist worth their salt would perform those exact same tests for a patient with arrhythmia but the fact is that you are putting yourself out there as an expert with an interest in this and you have your ‘5 point arrhythmia health check’.

I saw an advert on the television for an insurance company that said that if you insure more than one car with them, you get a discount – they call it their ‘multi car policy’.

I am sure that other insurers would do this routinely, but this company decided to make it their own by calling it their ‘multi car policy’.

Don’t get mad – get even!

Ideally your different is better, but even if it is not, it is still good to think of ways that you can differentiate yourself from everyone else.

5 Steps To Building A Valuable Practice

Download my FREE guide where I share the lessons that I have learned while setting up and building my own clinic.

Check out your inbox for a copy of my guide.

Drop Your NHS Sessions While Maintaining Your Income

Dreams Are Free.

Goals Have A Cost.

Time, Effort, Sacrifice And Sweat.

How Will You Pay For Your Goals?

-Usain Bolt

Everyone has dreams.

Dreams are easy.

Whenever I tell people that I have left the NHS and I am now in full time private practice, pretty much everyone I speak to looks at me and says:

I wish I could do that.

It is a shame really because there was a time when people would think you were crazy to leave a full-time permanent NHS consultant job before retirement age.

But now people look in envy and most wish they could do the same.

Since I have started talking to people about developing their private practice I have realised there is a big difference between dreams and goals.

Everyone has a dream, this is a good thing.

You might want to reduce or completely cut your NHS commitment.

You might want to pay off your mortgage or move house, get a nicer car or put your children through private school.

These are things that we all dream of. 

Having more money or more free time or both.

If you ask most people if they would like to earn more and work less – it is a ‘yes’.

It is easy to dream about these things.

But it is another matter if you actually think about and set goals that will allow you to achieve you dream and even more difficult still to ensure that you achieve your goals.

You see, goals are tangible and specific outcomes. 

Goals are things that you can be held accountable to. 

Goals are hard and most people would rather just dream because it is a lot easier.

Perhaps your dream is to drop two sessions in the NHS.

Well if you want to achieve that dream what would need to happen?

Perhaps you need to make more money in your private practice to account for the shortfall in your salary.

So, how much more money would you need to make, an extra £1,000 a month, say?

So, what would need to happen to make an extra £1,000 a month?

Do you know what your average customer value is?

Maybe you need to treat an extra one or two patients every month.

How many more people would you need to see in clinic in order to generate one or two extra operations?

Do you know what the conversion rate for outpatient appointment to operation is?

Perhaps you need to see 4 more people that month.

So how many more enquiries would you need in order to generate 4 more initial consultations?

Do you know what your conversion rate from enquiry to consultation is?

Perhaps you need 20 more enquiries every month.

That is 5 more enquiries every week.

Now you have a goal.

If you can regularly and predictably get 5 more enquiries every week, you should be able to generate enough financial stability to drop the NHS sessions and achieve your dream.

Of course, you need to monitor it and make sure the new enquiries you generate are as good a quality as previous enquiries to make sure that your conversion rates are representative and that it all filters through to the increase in revenue or profit that you have forecast.

Of course it does not end there.

The next step is to think about how you are going to generate an average of 5 new enquiries per week every week.

How do you generate enquiries now?

Have you even thought about that?

I will always maintain your best source of enquiries is your current database, both of patients and GPs. 

This is the first place to go if you want to build your practice.

The last place most people think of is your easiest and cheapest source of income.

5 Steps To Building A Valuable Practice

Download my FREE guide where I share the lessons that I have learned while setting up and building my own clinic.

Check out your inbox for a copy of my guide.

A good source of new patients is by holding a free consultation event.

It is amazing that although many people offer free consultations in their normal clinics, if you start advertising that you are holding a free consultation event, you are much more likely to get patients to attend.

Make it an evening event to make it sound more special.

You do not necessarily have to lay on anything too fancy – you could just have it as part of your normal clinic.

Of course you need to get people to attend and again you cannot just wish this to happen.

You need to set goals.

Make a goal of say three people.  You should be able to get three people to come to your event shouldn’t you?

How are you going to get those three people?

Start by inviting your current database.

Send out an email or a letter to all the patients on your database letting them know that you are having a free consultation evening.

Ideally you will have segmented your database (will will talk about this at the next meeting).

You will have a group of patients who have enquired but never come to the clinic and these are the ones that might be worth writing to if you have their address.

You will also have those who have already been to your clinic and so you might write to these and ask them to bring along or recommend the event to a friend.

You could make your consultation event have a theme.

If you are an orthopaedic surgeon, it could be patients with knee pain or if you a dermatologist, it could be skin lesions.

You could write to the GPs to let them know you are holding this free event and maybe include some cards or flyers to leave in the waiting room for their patients.

These sort of things take time and effort to think about and execute. 

And you need to monitor the response.

It is hard work to start off with but if it works, it is the sort of thing you can repeat every month, perhaps changing the topic of the event.

So that is your plan to get an extra three patients a month – where do you get the other two from?

What about people who have enquired over the last month or two and for whatever reason you have not been able to get hold of.

Would it be worth giving them another call?

Let me answer that question for you:  Yes it would!

What about people who came to see you in the last few months who said they would go away and have a think about it.

What about the DNAs, have you followed up with them at all? 

These are all great cheap sources of patients.

They are cheap because they have already found you and made an appointment to see you so you have got their contact details.

Everyone is busy and if you are in a competitive speciality patients might well be receiving topical and relevant information on an ongoing basis from your competitors and so it is easy for them to forget about you unless you remind them.

Again this sort of thing is difficult to start off with but if you find a system that works, you can just implement it into your practice so that you automatically contact patients a week after they have enquired or a month after they have been to the clinic to check in with them and see if they need any more help or information.

You will be surprised at how effective this is in improving your conversion rates.  It also shows you to be a caring person and it is reassuring to the patient that you are engaged and contacting them to give them the sense that they will be looked after afterwards if they do choose to have the procedure with you.

Do not just take my word for all of this, try it yourself.

If you do try it, make sure you have a baseline of numbers before you start so you know whether it is making a difference or not.

You need to look at the events at every step of your practice and you need to measure and monitor these regularly, at a minimum monthly (if you don’t know what these are – download my free guide below).

5 Steps To Building A Valuable Practice

Download my FREE guide where I share the lessons that I have learned while setting up and building my own clinic.

Check out your inbox for a copy of my guide.

You see, I never said this was going to be easy.

It takes hard work and sweat which is why most people do not do it and they just continue to dream about financial freedom or a busy successful practice.

If you really want to make changes in your life you need to have goals, not dreams. 

You need to hold yourself accountable to those goals and if you do not reach the goals take a look back at them and break them down as much as possible into constituent parts to see where you need to improve things.

Is it that people were not taking action on the email or letter you sent out, talking about the consultation evening?

In which case you need to change the letter, change the people you send it to or make it specific for a particular topic or ailment or not make it specific for a particular topic and make it general.

Is it because you were trying to follow-up on patients who have enquired and you could not get hold of them?

Do you need to send them a text or do you need an alternative method of contact?

On your contact form, do you ask for email and/or phone.

You do not want to ask for too much information, but perhaps some people prefer the options.

If you cannot get someone on a mobile phone number, do you text them?

Do you realise the email open rates are usually around 20-30% whereas text open rates are around 90% in the first five minutes.

You heard that right, in the first five minutes!

Text open rates are not only massively higher but they get read straightaway.

If you are not utilising text messages you should be. 

You see this stuff is not simple and you may not get results straightaway.

You may have to tweak things and change tack.

General Eisenhower said:

Plans Are Useless, But Planning is Indispensable

Or as Mike Tyson said:

Everyone Has A Plan ‘Till They Get Punched In The Mouth

We need to be prepared to change our plans if we are going to achieve our goals.

If you do not have any goals, you will not have any plans.

If you do not have any plans, all you have is dreams and dreams are nice but they do not count for anything. 

If I have put you off making goals and making a difference then that is fine, carry on as you are.

There is no shame in that, but do not be surprised if you are in about the same position this time next year as you are now.

If you want to make changes you have to do something about it.

Remember Einstein said:

The Definition Of Insanity Is Doing The Same Thing Over And Over And Expecting A Different Result

Make plans, make changes, make a difference.

“If you focus on results, you will never change. If you focus on change, you will get results.”

-Jack Dixon

I Gave Away My Secrets, But That’s OK!

This weekend, we have just had our first ‘How To Grow Your Private Practice’ Meeting here in my clinic in Birmingham.

It was certainly a long day and I knew it was always going to be difficult deciding on what to focus on and what areas we could realistically cover in a day.

In the end, it was actually quite easy to decide on where everyone would get the most benefit.

I’ve been doing some mystery shopping (I encourage you to mystery shop yourself and others, you learn a lot) and it is very clear that most people do not have robust systems in place to deal with an initial enquiry, and perhaps more importantly, to follow up on that enquiry.

Not only is that letting business (and ultimately money) slip through your fingers, but it is also not a very good way to treat people.

Even though we are in the private sector, we are still doctors and at the end of the day, an enquiry is a patient who is contacting us for help.

If we do not respond to that enquiry promptly and efficiently with relevant information, then we are not giving our patients a very good service.

Forget about advertising or PR or doing a lunch meeting for the local GPs.

If you are not able to deal with an enquiry effectively when it comes through, don’t waste your time trying to get more enquiries!

You should focus on looking at how best to service an initial enquiry, whether it comes through by phone or email, and put in place a system so that every enquiry is dealt with in the same way.

This is basic stuff, but it is absolutely vital.

Not only that, it is relatively simple thing to implement.

And that is the next thing – implementation.

It is all very well spending money going to a meeting to learn about how to make your practice better, but the only point in doing this is if you are actually going to make a change to what you do.

To be honest, this is the hard part.

My wife was actually a bit worried about me hosting this meeting because she knows that I have spent the last 3 years attending business conferences, at mastermind meetings and in marketing seminars learning how to build a solid business.

She thought that I was crazy to tell everyone all of the secrets and tips that I had learnt about and honed in my own practice, but I actually wasn’t too worried.

For two reasons:

1)First of all, one of the things that I talk about is having goals and one of my goals is to do more of what I enjoy. I actually really enjoy the process of building a sustainable business.  If I can spend part of my working day helping others to build their businesses, then that will be enjoyable to me, that is why I set up the Private Consulting Class.

2) Secondly, it is a sad truth that most people will not implement half of what I talked about. We all get so busy doing our jobs, that it is hard to find the time to spend on the things that will make our practice run so much better, but that aren’t actually essential.

Everyone who came to the meeting already had a good private practice.  They were busy and making money from it.  They could easily go back to work on Monday morning and not change anything and it would all still work fine.  They are not accountable to anyone.

And this is one of the problems.  You haven’t got anyone to tell you off if you don’t implement things or to praise you when you do.  So it is really hard to actually motivate yourself to do these things.

Trust me, I know!

That is why I am very keen for everyone who attended to feel that they got value from the meeting.  Not just because it cost several hundred pounds, but because they gave up a precious Saturday away from their families to come to attend.

I know that each person could achieve a significant return on their investment if they just implemented a couple of small changes to their practice.

So we all agreed on some achievable goals for the next two weeks and I am going to call everyone up to see if they have achieved what they said they would.

You know what, I bet they will have.  Because I am holding them accountable.

The fact is, that it makes no difference to me whether they achieve their goals or not, but the mere fact that I have said that I will call them and check up on them puts a significant extra level of pressure on them.

This is how this stuff works.

When I was in my mastermind groups for business growth, we had regular coaching calls and would talk about what I had achieved since the last call and what I was going to achieve by the next call.

It is amazing how powerful that is.

The day before the call, I would force myself to do the blog post, or write the email sequence because I knew my coach was going to be asking.

Of course I could lie about it, or I could just say I hadn’t done it, it didn’t matter to my coach, but the psychology of being held accountable to someone is really strong.

Goal setting


Knowing what to focus on

That is what the Private Consulting Class is all about.

If you couldn’t make it to the last meeting but are interested in attending the next one, then you can register to be put on the Priority List here.

I hold the meetings at my clinic in Birmingham and the numbers I can accommodate are small.  If you want to be the first to know about the next meeting, register your interest here to get Priority Access to a place at the next meeting.




When I talk to other Doctors about marketing and promoting my Practice I can see that some take a dim view of this and I know that there have been calls in the past for advertising to be banned for cosmetic surgery.

I can understand this view and if it was a consensus across the industry then I would fully support it.

However, the problem with the industry at present is that there are a wide range of practitioners who offer cosmetic surgery and it is very difficult to police the practices that go on.

We all know that the word Botox should not be used in advertisements because it is a trade name, and yet it is widely promoted.

Since 2012 I have been in full-time private practice and as I now run my own clinic, it is necessary for me to learn how to market and promote myself.

When I looked into the details of marketing I realised it is not what most doctors think it is.

I know this because I used to think of it as a slightly unsavoury practice that any good doctor would be above.

I used to think that patients would come to me and if someone enquired and I missed the call, then they would always get back to me if they really wanted the procedure.

However, the reality is it can be very confusing for patients and when they are looking for cosmetic surgery there is a wide array of services on offer and the patient has to make a decision about who they are going to trust and allow to do their surgery.

There are only a handful of fully trained plastic surgeons in the UK but there is a disproportionate amount of plastic surgery performed by surgeons who are not BAAPS or BAPRAS members.

The majority is performed by other surgeons who are working in the commercial clinics which operate from dawn to dusk five, six or seven days a week.

Why do so many patients go to the commercial clinics for treatment and why are not all the plastic surgeons in this country oversubscribed? 

I think the answer is marketing and PR.

Cosmetic surgery is different to other forms of medical treatments because patients tend to do their own research.

They choose a practitioner based on word or mouth  recommendation or by searching on the internet.

If you had chest pain or indigestion, you would go to your GP for a referral to a specialist, but the majority of cosmetic surgery is by self-referral.

From a patient’s perspective when they are looking for a cosmetic surgery provider all they have to go on is the public profile that is visible to the world.

Unfortunately, many highly trained and well respected plastic surgeons do not have any significant visibility on the internet or other forms of media and when searching for plastic surgery on the internet the commercial clinics dominate.

Marketing and advertising is in itself not a bad thing; it is just getting the message out about the services you provide.

Of course, it can be done in an unethical way, but it can also be done in an ethical and transparent way.

In fact, to develop a long-term sustainable business the only way to do it is by being open and honest.

I believe we owe it to patients to inform them of the training involved in becoming a surgeon and the difference between the surgical specialties.

They should also know about the level of training required to become an NHS consultant and to obtain admitting rights in the main private hospitals such as Spire, BMI, Nuffield and Ramsey.

I am not saying that only surgeons who have achieved the level of an NHS consultant should be providing the care (although in the NHS all patients need to be under the care of a doctor who has achieved this level), but what I am saying is that patients should be aware of the level of training of their doctors so that they can make an informed decision as to who the best person to perform their procedure would be.

This is all part of informed consent.

I regularly see patients who tell me that they have been operated on by a plastic surgeon, when in fact it may not have been a plastic surgeon, it may have been someone trained in a different surgical speciality or even someone not fully trained in a speciality at all.

Patients are always alarmed to hear that doctors without any speciality training can perform surgery unsupervised which would not be allowed in the NHS, and unfortunately the private sector remains unregulated in this regard.

Rather than being ashamed and dismissive of marketing and PR I would argue that we need to embrace it and encourage it amongst our colleagues, because if we are confident of our qualifications we should be only too pleased to shout about it and to let people know what we can offer.