Patient selection: How to say no to patients - Hamilton Fraser


Managing unrealistic expectations is key to making your practice a success. An unhappy patient can potentially pose a serious threat to your business if they make a claim against you, tying up your resources and causing a lot of stress. Worse still, a disgruntled patient can also seriously tarnish the reputation you worked so hard to build by leaving negative reviews online.

Yet, as a cosmetic practitioner, it can be hard to turn down a patient after all the effort you’ve put in to getting them through the door in the first place. Saying ‘no’ is never an easy thing to do, so at Hamilton Fraser Cosmetic Insurance, we would like to help give you the confidence to manage these awkward conversations better, ultimately supporting you in making your business a success.

“Following the COVID-19 pandemic, patient selection is even more important than ever. Your business may have taken a huge hit over the last few months and it’s your reputation that will bring you back on track. Once you are fully permitted to carry out all treatments, you may experience a number of new clients approaching you by word of mouth from existing clients. This pandemic has been incredibly hard on the majority of the population, so many will want to try new treatments to make themselves feel or look better. During your consultation, please take extra care to look out for ‘red flag’ signs and if you feel the patient is not suitable for treatment, do not be afraid to say ‘no’. The team at Hamilton Fraser is here to assist if you need guidance on declining patients.”

- Emma Bracchi, Senior Claims Technician

Top tips on how to say no to patients

There are three key areas when it comes to patient selection.

Be honest

Tell your patient:

  • The results would not meet their expectations if you agreed to undertake the procedure
  • A less principled practitioner might agree to undertake the procedure, but this would not be to their satisfaction either
  • To go through with the procedure would be a frustrating experience for both patient and practitioner because it would involve spending time, money and effort on unrealistic goals that would not be achieved


Tell your patient:

  • Why their goal is not achievable
  • What would be a better alternative (if applicable)
  • If there is anything your patient can do to become eligible for the procedure (for example, lose weight, avoid the sun etc)

Be gentle and empathetic

Tell your patient:

  • That you would recommend a referral to their GP if you think they might suffer from Body Dysmorphic Disorder (BDD)
  • Why they are not a good candidate for the procedure
  • That you apologise for not taking their request further (if you like) but that you feel they will be set up for disappointment if they go ahead

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