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Patient behavior red flags – Why do patients act that way?

Throughout your career, you come across cosmetic patients who stir up trouble and make your life difficult and unpleasant.

The “difficult” can range from a little such as they require way more hand-holding than normal. To a lot -such as they sue you or set up a hate website for the world to see!

What’s so crazy is that they started out “normal” enough. They appeared pleasant and even charming. 

Ok, maybe there were some patient behavior red flags you missed or thought you could handle. They were late to appointments but still expected to see you promptly. They were rude to your staff but friendly to you and so on. 

But somehow it blows into a full drama that is taking up your time, your emotional energy and creating sleepless nights.

Patient behavior red flags to watch out for

While you can’t “fix” your patients, you can at least better understand why they act that way so you can identify them much sooner and save yourself angst. 

Because if you better understood human behavior, it would be much harder for these toxic people to affect you because you wouldn’t be so easily charmed and misled. You would see through their manipulation and not let them take control. 

Here are 3 (of many) Laws of Human Behavior most prevalent in cosmetic patients and what to watch out for:

The Law of Narcissism

Narcissists are not what they appear to be. While they may look and act confident, the opposite is true. They have such a damaged and fragile sense of themselves that they rely on external factors to feel that they exist at all. They have no sense of self and lack self-esteem; they desperately create it by making everything about them.

And that leads to drama, mind games and disregard for you since this is all about them. 

Since they are so wrapped up in themselves, they are horrible listeners, interrupt frequently, get the conversation back to them so they can tell you how great they are. At least, that makes it easier for you to spot them.

The Law of Role-Playing

Cosmetic patients wear a mask that shows them off in the best possible light, so they appear confident to you. 

That means they say the right things, smile and are interested in what you are saying. 

However, underneath, there is usually a whole bunch of insecurity, fear and doubt. 

So, if you take them at “face value”, you never know their true feelings, so you don’t address them and that’s why they end up with your competitor who did. 

patient behavior red flags

However, if you become aware of the patient behavior red flags. Even though patients are wearing a mask, they can’t control their nonverbal cues so watch their facial expressions, tone of voice changes, tension in their body and nervous gestures and note when their body is contradicting what they are saying.

The Law of Irrationality

Your irrational patients don’t have the ability to think before reacting. They can’t open their mind to what is really happening, as opposed to what they are feeling at that moment. The decisions and actions they take create more drama, conflict, and blame.

This irrationality comes out in negative ways throughout their lives – mistakes they keep repeating, unnecessary conflicts that follow them wherever they go, projects they never started or finished, anger at circumstances they complain about but never turn into action to change them. 

Your best defense is to be curious and ask lots of questions to understand this patient’s point of views on plastic surgery, expectations, and their post-op support system.

Pay attention to changes in their body language and tone of voice as they answer certain questions. If they quickly change demeanors when certain questions are asked and their buttons are pushed, beware.

Examples of Red Flag Cues

cosmetic patient behavior red flags

Human nature is a dense topic and can be studied for a lifetime. But for our purposes here, here are common examples of cosmetic patient behavior red flags you want to be alert to prevent problem patients:

  • The patient is reserved and wants 360 lipo and a BBL so when you ask them how this will change their life, the patient becomes animated and verbally visualizes how this will “finally” get them the boyfriend, job and/or friends they’ve always wanted.
  • The patient was super friendly to you but will not follow your processes. They ignore calls from your staff to complete the paperwork and labs and they want you to make exceptions because they are not interested in following your tedious protocol.
  • The patient was pleasant enough before the surgery but has turned very unpleasant after the fact. They are complaining they are in pain and want more medication, they won’t come in or they flip out when you can’t see them when they do want to come in.


The goal is to listen, watch and observe the most important cues coming from your prospective patients:  Doesn’t listen, looks away, incongruent body language and changed in tone of voice. 

Also, use the most important tool you have … your intuition. When you or your staff have a bad feeling about a patient – pass. There are plenty more down the road. 


All of us have these human behavior traits. The trick is to “know thyself” so you have spent time within to identify your own quirky behavior and get space between what is happening externally and your reactions to it. 

Check out Robert Green’s book, “The Laws of Human Nature” for a lot more in-depth analysis into why your patients (and you) act the way they do. It’s a 600-page book but worth the read because the more you understand cosmetic patients, the more money you’ll make 😉

catherine-maley-book- 1


A Complete Guide to Understanding Your Aesthetic Patient and Growing Your Aesthetic Practice. Catherine Maley, MBA went straight to the aesthetic patient to get the answers you need to succeed with your patients.


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Catherine Maley

Catherine is a business/marketing consultant to plastic surgeons. She speaks at medical conferences all over the world on practice building, marketing and the business side of plastic surgery. Get a Free Copy of her popular book, Your Aesthetic Practice: What Your Patients Are Saying View Author Profile.

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