Home' Spa and Clinic : Volume 65 May 2016 Contents patient/client is burned and develops
blisters or scars after laser, IPL or a peel, or
suffers hypo- or hyperpigmention despite
all due care, if you have not explicitly
explained what these risks could entail, your
footing will be very shaky.
Informed consent also means explaining
to a client that they may just not achieve
the result they desire. Some people are
"responders" to treatments, and others
simply aren't. It all comes down to individual
physiology and factors like age, skin type
and texture, weight and body shape (for fat
loss and contouring treatments).
An all-encompassing consent to the
effect "I authorise so-and-so to carry out any
procedure in the course of my treatment"
is not valid. It should be specific for a
If, for instance, consent is taken for
microdermabrasion, it's not valid for
any other procedure like an acid peel.
Additional consent will have to be obtained.
RISK REDUCTION REMINDERS
The following points can assist you in
• Assess if the client appears to understand
the information being provided. Address
any language, cultural or cognitive
barriers to good communication.
• Discuss their concern with them and
your assessment of the likely outcome of
treatment. If, for instance, they suffer from
severe melasma -- a form of pigmentation
notoriously difficult to treat -- and you
have doubts that the treatment will be
successful (at least, as successful as the
client is hoping), share this uncertainty,
the reason for it, and what possibilities are
being considered for treatment.
• Discuss the proposed treatment,
including the risks (eg. in the instance
of melasma, of causing loss of, or even
deeper pigmentation) in clear and
understandable language. Inform
patients about other reasonable options
for treatment and related risks.
• Inform clients if part or all of a treatment
is to be delegated to members of staff
other than you.
• Ask clients if they have any concerns. Give
them the opportunity to ask questions.
Answer the questions and assess that they
appear to understand.
• Even when patients wave aside all
explanations or seem prepared to submit
to the procedure or treatment without
discussion, explain that the risks should
still be discussed.
• Print material, videos and other handouts
can all support the consent discussion but
do not replace it.
• Document the consent discussion in
your records in a timely manner. Written
consents are preferable in situations
involving ongoing treatments, and where
there are more-than-average risks with
a cosmetic procedure. The failure to
adequately document the consent discussion
is a recurring theme in medico -legal cases.
DON'T PRESUME KNOWLEDGE
As the old saying goes ... a little knowledge
is a dangerous thing.
"Dr Google" has become the universal go -
to for people diagnosing and treating their
own aesthetic concerns (and the results often
aren't pretty) or deciding on their own course
of treatment that you should carry out.
With the hype created via Dr Google, in
print and visual media regarding "beauty" and
"shape, size and appearance of body parts"
and so forth, they can front up to a salon, spa
or clinic armed with a swag of "knowledge".
Whether it is accurate, complete,
balanced or suited to their individual needs
is an entirely different matter.
"Under-questioning [clients'] impulse
decisions can make or break your business,"
says Dr Flynn.
"The greatest enemy of knowledge is not
ignorance but the illusion of knowledge, as
Dr Stephen Hawkings has famously said.
"Consumers will often come to us telling
us what they `need'. Some practitioners
may be intimidated by this approach or just
want clients to be happy -- more unethical
ones just see the opportunity to make more
revenue - rather than doing what's best."
This is a recipe for disaster. You have
a right to say no if you do not believe a
treatment is right for a client. Remember
that, in the end, it will also rebound on you.
DON'T STICK YOUR
HEAD IN THE SAND
As unpleasant, even frightening as it is to
have a client on the warpath unhappy with
their results, as unreasonable as you might
think they are (or indeed are) being, don't
ignore them and hope it will go away.
The longer you postpone dealing with
a bad situation, the worse it can get -- and
even provoke legal action that could have
Remember that maintaining as good
relationship with clients as possible often
works better than the best informed consent
in these situations!
Invite them to your office (if they have
made the complaint by phone or email) and sit
them down for a discussion, so you can assess
the situation close up. Offer niceties like coffee
or tea and be as convivial as possible.
Hear them out, making notes and asking
pertinent questions. Try to avoid becoming
defensive or responding to inf lammatory
accusations or behaviour - unless of course
it becomes so intolerable that it would be
best you politely asked them to leave.
Take photos of the client to record the
issue that they are unhappy about (to this end,
it is best that you have taken photos before
treatment so you have a reference point).
Without admitting culpability, offer
remedial suggestions -- unless you truly
believe their complaints are fabricated or
Document your notes and photos and
call your insurance provider and/or legal
advisor re further steps.
COSMEDIC.COM.AU (DR FLYNN);
spaandclinic.com.au | 47
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