With the wellness phenomenon at an all-time high, Aesthetics speaks to four practitioners about how and why they decided to introduce this element into their clinics
The wellness industry has rocketed in recent years. Since 2015, it has seen a 6.4% increase with recent statistics showing that it is now worth US $4.5 trillion.1 According to the Global Wellness Institute, it comprises yoga, healthy eating, personal care, beauty, nutrition, meditation and retreats, amongst many other things.1 This, along with the increase in worldwide businesses adopting wellness services for employees2 and the spike in UK and US consumer sites and events such as Goop,3 Women’s Health5 and Bloom,4 confirms that the ‘trend’ (as some once saw it) is here to stay.
But what actually is wellness? Is it an industry? A term? A movement? Well, according to the practitioners interviewed, probably all of the above. It is explained by the National Wellness Institute as ‘An active process through which people become aware of, and make choices toward, a more successful existence’.6 It’s also recognised by the Global Wellness Day website as ‘Being free from illness; a dynamic process of change and growth; a good or satisfactory condition of existence; a state characterised by health, happiness and prosperity; welfare’.7
Interestingly, aesthetic practitioner and clinic owner Dr Rosh Ravindran takes a different stance on the ‘wellness industry’. He explains, “I think it can be a misrepresented consumer-targeted monetised term. Wellness is a part of everyone; we all need connection, belonging, and our mental, physical and emotional health accounted – that’s where wellness comes in. I look at it within a psychological framework based out of relationship.” In this article, we also speak to nurse prescriber and clinic owner Julie Scott, aesthetic practitioners and clinic owners Dr Shirin Lakhani and Dr Philippe Hamida-Pisal on why, and more importantly how, they connected the world of wellness with their existing aesthetic practices.
“I believe the rise in the wellness industry is multi factorial,” shares Scott, explaining, “We know that social media and reality TV has a huge part to play as people now feel they can be seen at any time of the day, so they want to be looking great. However, I also think we are in a generation where people are now more commonly saying, ‘I deserve this!’ or ‘I’m going to treat myself’ and they are generally more willing to spend money on themselves, their appearance and their general health. This then snowballs. Treatments, of all kinds, are normalised and those that don’t have them think they are missing out.”
Dr Lakhani recognises that people are living longer and want to be healthier in later life. “When I first started in medicine, elderly care was full of frail patients. Now, people have a lot more vitality in older age, they really want to live fulfilled and healthier lives; 70 really is the new 50!” she says. Dr Hamida-Pisal adds, “In my practice I am noticing how the pressures of the working world are affecting patients of all ages. In order to perform their very best and stay competitive, they need to make sure that they are healthy from the inside out. There are lots of life insurance companies that now also provide incentives to keep moving and obtain healthy lifestyles, all of which I think is having an influence.”
All practitioners interviewed recognise that the patients who come into aesthetic clinics already have a vested interest in their appearance. However, in order for aesthetic treatments to be successful, they agree that patients have to feel good on the inside. Scott clarifies, “Emotional and physical wellness go hand in hand. If you are not emotionally and psychologically well then you cannot be physically well and what we are doing then may become redundant.”
Dr Lakhani echoes this and simply says, “Aesthetic practitioners are perfectly placed to offer wellness services in their clinics.” Dr Hamida-Pisal adds, “Our patients are already concerned about the ageing process and whilst what we do is usually temporary, we need to start looking at how we can really delay the whole ageing process. This is why the first consultation is vital; I ask my patients if they smoke, how much alcohol they drink, if they follow a specific diet and whether they feel stressed at work. This then allows me to get a clearer idea of how their treatment plan will evolve.”
Scott also adds that a huge benefit of incorporating wellness into your clinic is you are able to get to the root of the problem, rather than just treating it. She explains, “Once where we simply had to put a plaster over a problem, we are now able to get to the source of that problem, treat it and nurture it until you no longer need the plaster. Take a patient who is concerned with their acneic skin for example, rather than just putting them on a topical regime, we would look at the gut health and see what’s triggering the flare ups.”
Dr Ravindran says, “Wellness is a topic that is very current in aesthetics. People are adopting the term ‘wellness’ into their clinics and I think everyone interprets it differently. For some, it’s simply doing the treatments, for others its adding yoga or nutrition to their practice.” He adds, “I think we need to look at what has brought this patient into clinic and more importantly why, in a non-threatening way. Our minds can sometimes have a negative narrative and often say something like ‘I am not successful enough’, ‘I am not beautiful enough’, or ‘I am not young enough’; they fill in the blank of what they are not enough of with an internal attribution of an external or aesthetic concern. Unfortunately, I think there may be some situations where practitioners are using patients’ vulnerabilities for monetary gain. Consumers do not have to justify their motivations for seeking treatment, nor feel at risk of being exploited for doing so.”
He continues, “There is in fact a recent study pending publication from Stephen Dayan et al. that found that aesthetic treatments could lead to an increase in quality of life than antidepressants for depressive patients. It is titled ‘Are cosmetic procedures comparable to anti-depressive medication for quality of life improvements? A systematic review and controlled meta-analysis’ and whilst I recognise the limitations in making widespread assumptions about these findings, this is what we are ultimately dealing with and trying to achieve here.”
Dr Ravindran says, “Choosing your clinic’s services should come down to patient need and evidence-based treatments. It is vital there is an alignment with practitioner and patient expectation.”
Introducing wellness services into an aesthetic clinic often involves third-party support or the hiring of new staff. Scott says, “We are not here to diagnose when it is outside of our remit. We should always refer on but, if you can, it’s preferable to do so under your own roof if you have the means.” Scott notes that it is also vital that the practitioner who you decide to work alongside respects and values your morals and ethos. She shares, “I had to do a lot of research and talk to a number of colleagues for recommendations before I got the right people on board. One of the practitioners who now works in my clinic was actually my personal doctor for a number of years. These people are an extension of you and your brand – your patients will expect the same service from them that you provide so finding the right fit is crucial.”
Dr Lakhani says that the services you choose can often be determined by consumer interest, current zeitgeist and your individual patient needs and desires. She explains, “Look at DNA sampling for example. This has seen a huge rise in popularity over the last few years and it works well because it’s the most personalised treatment you can get; however, you have to make sure that your patients will be willing to pay for a service before you invest in it through thorough market research. I think this service will take a while to take off here, unlike in the US, as it’s quite expensive. UK patients aren’t used to paying for investigation services as we have the NHS. Even though we have patients that come in and pay for botulinum toxin and fillers, when it comes to paying for a blood test, they can be a bit put off.”
Dr Hamida-Pisal says that there can be challenges with patient compliance when it comes to wellness services. He says, “Whilst we can offer ‘wellness treatments’ such as nutrition plans and stop smoking services, we can really only advise on what they should be doing. The work often has to come from the patient as they are the ones that have to make the changes. If we are able to equip them with the knowledge and practical advice to make the everyday changes easier for them, then all they will need to do is follow a plan in order to achieve amazing results.”
Scott believes that another challenge can be establishing expectations for your new practitioners. “I had a new practitioner join us and her expectations for referring new patients were very different to mine. I saw it as a reciprocal relationship whereas she thought it would be based on me feeding new patients to her. She didn’t feel that there was a need to generate her own as she was using my existing patient base. So, we sat down and established clear expectations for each of our roles and discussed how she could build new business separately. I learnt a valid lesson to be really clear about each practitioners’ expectations from the beginning. It’s absolutely a two-way thing,” she says.
Dr Lakhani says, “One of the main challenges of incorporating wellness into your practice is that more and more patients are asking me to treat their general health. You need to know when to draw the line. For example, when a patient has asked me to prescribe antibiotics for a chest infection, I refused and advised them to go to their GP. However, if a patient expresses concern about weight management and hormones, as I am working in that field, I would write to the GP and see how we could work together. There is huge demand for private GPs in aesthetic clinics nowadays.”
Dr Ravindran expresses the importance of continued support when you start incorporating a wellness service into your clinic, something which he believes many practitioners fail to do. He says, “What I must stress is that if you support your patient with wellness and don’t finish it, it’ll leave them more vulnerable. Equip them with suitable resources to support their needs, build their social and cognitive resilience, be a part of their team. In turn your patients know and trust that you are available to them, that your door is always open, not just for an aesthetic treatment or monetary transaction. People can read authenticity, if you are genuinely there to help create the best version of them, they will see and feel it.”
All practitioners agree that the focus on wellness is just going to get bigger and will thus likely filtrate into many more aesthetic clinics. “In the future, I think we are going to see a lot of additional professions within clinics to make up an overall ‘general health’ service. This could include private GPs, minor op surgery and hair restoration services. I am certainly going to be looking to add more services to my clinic, but it’s all about cherry picking the right services to enhance your patient’s experience and undertaking your research to ensure that it will be successful,” says Scott. Dr Lakhani says she would like to see a stronger focus on gynaecology. “In the US for example, it is part of the annual routine checks by GPs and people in the UK are becoming more and more aware of these check-ups and treatments. Incorporating a gynaecological service into your clinics could be very beneficial, however it must be done by a qualified professional,” she explains.
“I believe that in 2020 there will be a larger focus on nutrition and preand probiotics in aesthetic clinics, as well as a greater understanding on how this can impact skin ageing and the metabolic system,” shares Dr Hamida-Pisal. He continues, “I think wellness in the future is all about building a solid network of reputable practitioners from different fields around us so that we can help patients from the inside out.”
Dr Ravindran concludes, “I think that wellness will come to be just as important as any other modality in your clinic. Just as you train in injecting fillers for example, the same attention and dedicated training needs to be given to emotional and psychological wellness. This needs to be taken very seriously. It’s how you provide authentic services for the lifetime of a patient.”