The Number 1 Stress of a Plastic Surgeon

By Catherine Maley, MBA

With the number 1 stress of a plastic surgeon, it doesn’t matter if you’ve been in practice five years or 20 years…

One of the biggest stresses of a cosmetic practice is finding a solid patient attraction plan you can count on to bring you a steady stream of new cosmetic patients.

Nothing else matters. Not your new office or your new laser or your killer Instagram videos.

If you don’t have cosmetic patients saying yes to you AND giving you money, you’re in big trouble.

Think of cosmetic patients as your oxygen. When you have a steady flow of them saying yes to you, you breathe easy.

When you don’t, your breathing is cut off and you won’t survive for long.

And it never quits. The anxiety of running out of patients. Even when you’re booked out for months, aren’t you waiting for the other shoe to drop?

The well was running over and now it’s dry. (We saw it happen in past recessions and then again, very recently).

On the other hand…

When you have a predictable patient attraction system in place, you breathe easy.

But here is what usually happens…

Whenever most surgeons decide to grow their practices, they start with the most expensive and costly option available—trying to get new cosmetic patients.

So, they spend a small fortune trying to get these “stranger Internet patients” while they leave untapped profits in their backyards.

For some reason, there is something seductive about going after new patients instead of ethically garnering more profit from your existing patient files.

But please keep in mind… the most expensive act you can ever participate in is to find a new “Internet stranger” patient who doesn’t know you, doesn’t know how to choose a surgeon and has unlimited options.

I’m just saying, it behooves you to have a balanced plan and budget for externally advertising for new “Internet stranger” patients AND internally advertising to your current patients who already know you and have friends who can know you too.

Here is a quick story to illustrate my point.

There’s this farmer who hears of the massive fortunes being made by people mining diamonds. He decides his life is stuck in a rut and he is tired of farming his land because of all the stupid rocks on the property. Rocks all over the place. He can’t walk two yards without nearly falling over these little boulders. He thinks his land is absolutely useless for farming or for anything else.

So, he decides to set out for his fortune. But first, he sells his worthless land to make some money so he can leave. After wasting all his money in a fruitless search for a diamond mine, he returns home. When he gets back, he finds out his old property is now the site of the largest diamond mine in the country.

Those rocks he kept tripping over were really diamonds in the rough! He literally had a fortune at his feet but did not realize it—does that sound familiar?

The same thing applies here. Most surgeons never realize the immense profit potential in their own patient database. Before you write this off, think about how much money and time you have spent building goodwill and trust by servicing your patient base. It’s been thousands and thousands of dollars and countless hours.

That’s where all your leverage is. You already spent the time, money and effort attracting these patients to you. The beauty of our industry is that you have built-in demand with your cosmetic patients because a cosmetic patient who cares about how they look today, will still care next month, next year and next decade.

That means if you have a list of 2,000 patients but only 100 “regulars,” where did your other 1,900 patients go? Yes, some of them moved away; however, the majority of them went elsewhere to continue their cosmetic rejuvenation treatments and procedures.

And, it’s usually NOT because they didn’t get a great result from you. It’s because you’ve been ignoring them, so they wandered off to your competitors.


The best way to grow your cosmetic revenues is with a deliberate, systematic plan of encouraging your patients to return, refer, review and share you on social.

When you have that, you have peace of mind. You no longer need to scramble and jump from one marketing tactic to another. You have a predictable plan for attracting AND retaining cosmetic patients, so you’re building a solid asset of predictable patients who say yes to you.

But you can’t “hope” your current patients will spread the word about you.

Between their hectic work schedules and never-ending list of social and family obligations, your marketing strategy is the last thing on their minds.

So, make the predictable plan easy to understand, simple to use, compelling and fun so your patients happily become your biggest brand advocates.

Please think more strategically about patient attraction AND retention since the number 1 stress of a plastic surgeon is going to get more expensive and complicated to attract new cosmetic patients in the future.

Catherine Maley, MBA is a cosmetic practice consultant, speaker, trainer, blogger and podcaster. Her popular book, “Your Aesthetic Practice/What Your Patients Are Saying” is read and studied by plastic surgeons and their staff all over the world. She and her team specialize in growing plastic surgery practices using creative patient attraction, conversion, follow up and retention strategies as well as staff training to turn team members into converting rock stars.

Visit Catherine for Free resources at or Instagram @catherinemaleymba.

Click below to read “The Number 1 Stress of a Plastic Surgeon” in its original format in Aesthetic Society News, Fall 2020, volume 24, number 4