Learn lessons on saying "no" from the point of view of a cosmetic plastic surgeon.


By Jeffrey Donaldson, MD

Any industry that is built upon reputation and personalized results must refuse certain sales opportunities in order to preserve its standards. The cosmetic surgery industry's intersection between healthcare and retail is unique: It requires being a doctor first, a surgeon second and a businessman last to optimize patient outcomes. In the field, patient needs trump profits absolutely every time, but the emphasis on quality and consumer experience is broadly relatable among other fields. Overall, the key is having a process to follow when determining whether or not to say "no."

Below are a few tips that can help determine when and how to turn away business professionally in the cosmetic surgery industry-with broad applications in any field:

Screen prospective clients and customers:

An ideal cosmetic surgery patient is a happy, healthy, well-balanced individual who is looking to feel like their best self. This person has good self-esteem, realistic expectations and understands that a customized procedure will address an anatomic concern. He or she has the sophistication to research options, the wherewithal to take action and the perspective to enjoy the result. Medical risk, emotional health and maturity are important factors that come into play when assessing a prospective patient. A competent surgeon and staff also look for cues to determine motives and expectations. Are they realistic? Is anyone else involved in the decision? How long have they been weighing their options? Outside of the healthcare sector, reputation and ethical standards are also important to business, and so each customer might be screened by similar methods.

Have a thoughtful approach:

Plastic surgery is an industry built on trust. Patients need to feel comfortable in order to have a rewarding experience. A patient's safety should always come first. In this industry, there are non-negotiable patient criteria that ensure safety thresholds and ethical norms. These should be clear to all employees. For instance, the body-mass index should be low, smoking is prohibited and the patient must treat each staff member with respect. Owners of other businesses may want to think about establishing checklists or basic guidelines for employees to interpret and react to certain situations.

Provide your team with the necessary resources:

Investing time and resources into establishing a business culture based on shared core values in which people are taught to recognize more subtle "red flags" and feel empowered to act upon them is also a vital step to laying a strong business foundation. When an owner is fortunate to trust an employee's judgment and dedication to the company's best interest, then the employee is free to follow instinct. This freedom, within parameters, reinforces the team and the mission.

The customer is not always right:

Turning away unqualified patients, like unqualified clients or customers, decreases adverse events, improves overall staff and customer satisfaction and can ultimately help drive business growth. Owners of thriving, reputation-driven companies should feel empowered to be selective about who they work with, focusing on value and margin instead of volume and gross profit.

While the thought of turning away sales may frighten business owners, in the end it really helps build up your reputation and trust with customers (or patients). In the long run, this helps increase positive word of mouth and often helps increase your bottom line.


Jeffrey Donaldson, MD, is a board-certified plastic surgeon and owner of Columbus-based Donaldson Plastic Surgery, specializing in cosmetic interventions for the face, breast and body. He can be reached at drdonaldson@donaldsonplasticsurgery.com or (614) 442-7610.