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Refusing to treat, justified or not?

It’s funny how our minds work. I can’t remember my first complaint but I can remember the first patient that I declined to treat. It felt so alien; declining to treat a patient, when in the NHS you are expected to treat every person who walks through the door. At the start of my aesthetics career declining treatment was a choice I had yet to learn. I did not have the confidence nor the skill to politely decline treatment to a patient that did not align with my practitioner values. I guess you could say I learnt the hard way, so now when I teach aesthetics there is a whole section on when to decline treatment. I really wish it had been a part of my initial aesthetics training as I believe it is hugely important. It definitely would have saved me a few bumps along the way!


We are all aware of how vital the consultation process is, it is the basis of our plan, of when to accept or decline a treatment. It’s during this time with a patient that we can gauge expectations, the reality, their willingness to receive information and our own limitations. The decision to not treat a patient could be because of several of those factors or just one factor alone. When I started my practice I vowed to treat every patient as I would want my own mother or sister to be treated. The main questions constantly popping into my mind are; Is this treatment justified? Am I going to get a good treatment outcome? Am I going to meet my patients’ expectations? Is the risk of treatment greater than the reward? Does my patient understand the procedure fully? If you are unable to answer yes to all of the above questions, is continuing with treatment the most ethical option? Declining treatment should be viewed as a positive within this sector, it helps us maintain a safe and ethical practice whilst safeguarding our patients. The hardest part for me was acknowledging the red flag waving frantically in my head, ignoring this would have saved me that initial uneasy conversation, but it would have brought along 10 other issues for the ride afterwards. Trust your intuition- it’s a valuable tool!


Grace Cobner



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