You Drive For Show, But You Putt For Dough

drive for show but putt for dough

I have just been to the go to link 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 دراهم الاسهم الاماراتية 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 see url follow-up.

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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 فوركس باكستان wasting their time.

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

اسعار الذهب فى السعودية اليوم 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 go here 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 source site 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 كم سعر الذهب اليوم للبيع 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.افضل-شركة-فوركس-عالميا-للتداول-عبر-الانترنت 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.

تداول الذهب الفوري 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.

You Don’t Need Doors On A Go-Kart!

I was reflecting on the ‘How to Grow Your Private Practice’ meeting that we had recently and thinking about how I could improve things.

We spent the morning talking about the تداول الخيارات الثنائية باللغة الأردية most cost-effective way to get more patients and then in the afternoon we went through the importance of setting goals and having الخيارات الثنائية كيفية تفقد ثروة brand values and priorities that encapsulate what your practice stands for.

I thought that I could perhaps tone down the part about the goals and values.

You see, this is an area that I have spent a lot of time working on in my own practice, but that is because I want to develop a click national brand and to grow my practice in to something that is bigger than myself.

However, I realise that this is not for everybody.

There are many surgeons who just want a more efficient and slightly busier private practice so that they can perhaps drop some sessions in the NHS, or maybe pay off the mortgage or send the children to private school.

Whatever the reason, they are quite happy to continue to be a sole practitioner and have no intention of having a significant number of staff or being in charge of a large team.

So, I though that perhaps my time spent on goals and values could be cut short and we could spend more time on the getting more patients bit.

However, my brother made a good point.

He said

it is like building a car

You can show people how to make wheels and doors and an engine, but you need to start off by deciding what sort of car you want to build.

Do you want a family saloon or a racing car?.  Because the parts necessary to build each of these are very different.

I mean, you don’t need to bother with doors if you are building a go-kart!

You need to decide what sort of practice you are trying to build.

If you are happy being an individual surgeon and are comfortable with what you are doing at the moment but just want a little more, then maybe you do not need to think too much about engaging in social media or developing referral partnerships with allied services.

However, if you want to leave the NHS and focus solely on building your private practice, then you might need to think more carefully about how you can develop and open up these other referral sources and avenues.

You reap what you sow

And the more time and effort that you put in to building your car, the more it will be worth when you sell it.

If you have the chassis of a mini with the body of a 4×4 and a motorcycle engine, don’t be surprised if no one wants to give you much money for it when you come to sell.

If you are interested in coming to the next meeting where will talk about how to go about systemising and streamline your private practice, then click here to join the Priority List and I will make sure that you know the details before anyone else and get the opportunity to take advantage of priority registration.

How do I create a brand when I am just an individual surgeon?


One of the key things that I have learned about developing a successful private practice is that it is important to differentiate yourself from others – you need to make patients want to come and see you over and above everybody else.

Obviously, word of mouth referral is a core source of patients for most of us.

This is a great way to get patients to request to see you personally.

But what about those patients who do not have personal experience of your service?

In order to attract these patients, you need to develop yourself as a brand.

You may think that as an individual surgeon you are unable to develop a brand, but in fact you can.

Most major companies started with an individual and many of the largest brands in the world are backed by an individual.

People like to relate and engage with individuals as this gives credibility to any brand.

In fact, I think that a major problem with many of the cosmetic surgery companies is that they do not have an individual identity behind them and so it is difficult for them to build trust and loyalty around their brand.

It is a competitive world out there and if you do not develop your own brand then you will need to rely on getting patients from the hospitals or other companies who are busy building their own brands.

They say that you should:

build your dream or someone else will hire you to help build theirs

(Tony Gaskins)

Why do people come to see you?

  • Is it because they have been treated by you in the past or they know someone who has been treated by you in the past?
  • Is it because the hospital have put the patient in your clinic because you can offer a clinic slot at a convenient day and time for the patient?

If so, then you do not have a brand that people are seeking out.

Don’t worry, because most doctors don’t have a brand and you can build a busy and successful practice on word of mouth referrals and the patients that the private hospitals point your way.

However, do not be surprised if one day the hospital decides that they want to pay you less or they want to give the work to someone else.

You should also be aware that if you don’t have a brand, then you don’t really have anything to sell or pass on when you retire.

Don’t be fooled in to thinking that because you have a successful private practice, it will be worth something to someone else when you decide to stop working, because it won’t.

Word of mouth referrals will only go so far after you have gone and patients coming through the hospital will have no problem seeing the next available consultant, particularly if the hospital chooses to promote them.

The obvious example of this is the NHS, which has a very strong brand and will always have a constant stream of patients coming to it.

No matter how popular or successful you are in the NHS, when you leave, there will be a seamless transition to the next doctor who takes your place because patients are coming to the brand that is the NHS, not you (your existing patients may love you and follow you out to the private sector, but new patients will have no qualms about seeing whoever takes your place).

It is by no means easy to develop a brand otherwise everyone would have done it, but at the same time, even in your own small individual way you can take steps to develop and nurture your own identity and give patients a reason to want to have you as their surgeon.

So how do I develop my brand?

The first thing is to take some time to step back and consider what it is that you are offering. I do not mean facelifts, Botox or breast implants, because everyone is offering that.

I mean what is it that sets you apart from all the others?

Why should patients want to come to see you?

Take a step back and think about this.

What do you want your brand to stand for?

Picture yourself as the head of a large chain of cosmetic clinics – what would you want your company to be known for?

What standards would you want your employees to work towards?

The best brands have these standards well defined:

  • Virgin is known for fun
  • Apple is known for innovation
  • Volvo is known for safety
  • VW for reliability
  • British Airways for luxury
  • Ryanair for value

You might want to be known as the expert in a particularly area, such as large breast implants or natural results or non-surgical treatments or rhinoplasty, or you might want to be known as the surgeon who can fix anything and provide a solution to problems of any part of the body.

They each have their benefits and will attract certain sub-sets of patients.

Your brand has to be directed at a sub-set of people.

You cannot expect to have a brand that appeals to everybody all of the time.

If you try this you will end up appealing to no one.

Do not think of what is best in terms of business, but think of what you would actually want to do and want to stand for.

Do you want to be known as someone who gives the best value for money and the best pricing for non-surgical procedures or breast implants?

Or do you want to be known as someone who has the most comprehensive aftercare?

Ideally your brand will not be limited to a particular procedure, because that makes it difficult to scale.

If you look at the list above of successful brands – their brand values do not stand for the thing that they do.

The Virgin brand does not stand for record shops and the Apple brand does not stand for computers. This allows the brand to branch out in to other areas and does not limit the growth of the company – this has been demonstrated clearly with Virgin, who can sell anything from trains to credit cards to mobile phones and the brand identity is still relevant and valued.

You have to picture yourself in a room with five or six other people who work in your area, all of whom can perform the same procedure that you can and you have to describe to a patient what you are offering.

You cannot just say ‘breast implants’ because everyone is offering that.

You have to help the patient to make a decision and give them something to differentiate you from the others so that they can make a decision as to whether or not you would be right for them.

If you do not give them anything then it is a lottery as to who they choose.

You need to give yourself a competitive edge but do not worry, it does not have to be too spectacular because you can rest assured that your other colleagues in the room probably have not thought about this either, so even a small edge or advantage will go a long way!

Once you have got your edge, or brand identity, then you need to go about promoting this.

Now you might think that you have not got a big budget to put billboards or television adverts on to promote your brand and actually, when you think about it you have to consider how any company promotes their brand.

The way to promote your brand is in every contact you have with your prospects or patients.

Once you have your edge you need this to show every time a patient comes in to contact with your practice, whether that be visiting your website, Facebook page, phoning you up, or coming to the clinic – this is why you need to control these things as much as possible.

It is difficult if you are working from one of the private hospitals because much of the contact will be dictated by the brand values of the hospital.

If the patient rings to book a consultation or to change an appointment, then unfortunately you are limited as to how much you can control that conversation although you can let the teams who deal with these enquiries know what your brand values are.

For instance, if you are very amenable to changing appointments at short notice (or not), or very open to performing revision surgery if necessary.

Outside of these areas you need to examine what points of contact you do control and look at how these appear to a patient.

Mystery shopping is a great technique and I would encourage you to ask your friends or family to have a look at your website and put in an enquiry to see what sort of response they get.

You can try phoning the hospital yourself to book an appointment, or get your secretary to do it.

You may be surprised at the response.

If you do use social media such as Facebook, Twitter or Instagram then you need to think about each of your posts to try and make sure they are aligned with your brand identity and your brand values.

All the documentation you send out (I recommend that you send out documentation), whether that be after someone has booked an appointment, or if they have booked for a procedure, or a post-operative instruction sheet after surgery, this should all reflect the tone and ethos of your brand.

People like to be able to differentiate and you will be doing them a favour if you are able to set yourself apart from everybody else.

Obviously, in doing this you will alienate or push away some potential customers but do not be afraid of this because there will be plenty of others who will be attracted to your brand.

Just look at what happened when Jeremy Clarkson lost his job at Top Gear, he made it quite clear what he stood for and there were certainly a lot of people who did not agree with him and hated his style, however, when you polarise opinion you can also encourage a deep and strong following in those who do agree with you.

A brand is everything and will also go towards developing your practice as an asset.

It will also be worth something because you can sell a brand, just look at Jo Malone, who sold her business to Estee Lauder in 1999 and the brand is still going strong.

If you want to set up some time to talk about building your brand or if you would like me to help you to develop your private practice, click here and we can see if you would be a good fit for the Private Consulting Class.


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.

Maybe Independent Private Practice Is Not For You

Many doctors do not have an online presence. For some this is because they are very busy, and certainly with an NHS practice, there is no need to promote your services as there will always be a continuous stream of patients.

However, for others, it is because they are uncomfortable being directly accessible to patients and they have fears that there may be negative reviews and comments posted.  I understand this fear and I think it is very common for doctors to feel vulnerable in this way.

Medicine is not a precise science and no matter how conscientious you are, things will go wrong and some patients will have an unfavourable outcome.

Furthermore, there will always be some patients who may have a good clinical result, but will still be unhappy, perhaps because of their expectation of the result, or maybe because they feel that they have not been treated well.

We all know that unhappy patients are more likely to post reviews than happy patients (see ‘worried about bad reviews’ blog post) and so doctor’s fears have a solid founding.

However, while we all know that adverse outcomes do happen, the idea is that we get good outcomes most of the time.

This is something that I have learned about being in full-time independent practice.

You have to be good

You have to be constantly aware and focused on getting an excellent outcome for each and every patient.   This does not necessarily mean that you cannot have complications, as these are inevitable.  However, you need to minimise your complications by being meticulous in your techniques and your postop processes and you need to be robust in your management of complications.

I have found that some of my most grateful patients are the ones that have suffered complications.

all doctors will get complications, but it is how you deal with those complications that is important

If you are in independent private practice, there is no room to hide with a mediocre practice and service in the same way that you can if you work for a bigger organisation like the NHS or a commercial private company.

It can be a harsh environment and it is easy to feel threatened and isolated. If you have a patient who is unhappy, it is easy to put an inordinate amount of focus on to that and to feel insecure.

This is why it is so important to nurture and cultivate the positives in your practice so that you can build a buffer that will protect you in times of difficulty.

But you can only build the buffer if you are good.

Not just a good surgeon, but good to your patients in how you treat them and talk to them.

And not just in the way that you treat and talk to them, but how everyone who has contact with them treats and talks to them.

At the end of the day, all of this is good medicine.

We are treating patients and trying to get the best outcome that we can.

If you are afraid of having an online presence because you fear negative comments, I understand.

But if you are getting a lot of negative comments and are unable to offset these with a flood of positive feedback from your happy patients, then maybe independent private practice is not for you.

However, if you think that independent practice is for you and you would like to have a chat about joining my Consulting Class, click here for more details.

Worried about bad reviews?


I have spent some time recently looking at the online presence of BAAPS and BAPRAS members (Plastic Surgery Associations in the UK).

I have looked at members websites and done google searches of them.

The results are quite varied.

Not every consultant had a website and fewer still had other information available about them such as Facebook pages, Twitter accounts or LinkedIn profiles.

There were very few who had any significant online reviews from third party sites such as Google+, RealSelf, Doctoralia or I Want Great Care.

This may be because you don’t have the time or inclination to set up an account or it may be because you are worried about putting yourself out there because of the potential for bad reviews from unhappy patients.

I think we are all slightly paranoid about getting bad reviews (I know I am) but I do not think that the way to combat this is to avoid having an online profile in the hope that no one will able to post anything negative about us.

If someone is upset enough with us, they will find somewhere online to voice their opinion.

In fact, they are much more likely to post something if they are unhappy with us than they are if they are happy with the service we have provided.

You have probably experienced this yourself.

Have you ever been motivated to write a review or a comment about a product or service that you have used?

If so, I suspect it is the poor service or defective product that you were more motivated to write about than the great hotel stay or reliable hoover that you bought.

You do not have to look to far to find situations where a surgeon has got a disgruntled patient who has taken to the internet to vent their anger and this is the first thing that comes up in a Google search of their name.

Whether you like it or not, our patients will ‘Google’ us when they come to see us.

You have to be realistic – everybody will ‘Google’ it when they want to know more about something.

And everybody loves reading reviews from other consumers.

We do not trust adverts or corporate websites.

But we do trust our fellow consumers.

Just look at TripAdvisor, Amazon, Argos, B&Q, Joules (I could go on) to see how important consumer reviews are.

Trust me – it is not easy to get reviews (this is the topic for another discussion).

But it is not that hard, especially if you actually put some effort in to it and try to solicit reviews from your happy patients (which I hope that you have many of).

I think that it is essential that you have a healthy online presence.

This means that you need a website as an absolute basic minimum, but you should also consider a Facebook page and a Twitter account.  You should also consider Google+ and Instagram.

You need to start building up an online profile that you can control.

You need to engage with patients and cultivate a ‘tribe’.

Do not think that by having this access, it will make you vulnerable to negative comments.

You are vulnerable already!

If you can start to build up a following and start asking for reviews – then if (perish the thought), you do get a negative review, it will be seen in the context of other positive reviews.

Some people like to see an occasional negative review, especially if you are able to respond to it and show that you care, because it lends credibility to all of your other positive reviews.

If you have places that people are able to leave reviews about you (Google+, Facebook, RealSelf), then you are much more likely to be able to pick up on the review early so that you can react and minimise the damage as early as possible.

If you do not have an online presence, then the review could be written anywhere on the internet and it may be some time before you even realise it is there, which could be very damaging.

We are all worried about bad reviews, but you are not going to stop them by putting your head in the sand.

I hope that the majority of your patients will be happy with what you have done for them and the unhappy patients will be few and far between.

However, as I have said, the unhappy patients are likely to post a disproportionate amount of negativity about you and so you need to have cultivated the positive reviews in advance.

Once you have developed a ‘tribe’ and identified those patients who are very happy with you and are happy to tell the word (the mavens), then you can actually use them to help with the damage limitation if you do get a negative post.

I believe that you should respond to any negative posts with an explanation and apology if appropriate, but even better than that would be for one of your happy patients to respond and put in a good word for you.

Remember that the world is watching these conversations, so you need to be aware of how things appear to the observer.