Jeffrey Frentzen

Earlier in the year, discussions about the direction of the national economy were subject to a lot of “spin,” in which many of us said, “Oh, the market is going to be OK,” as if it could be divined as such.

At this point, however, almost everyone in aesthetic practices will not only tell you that business is down, they will tell you how much it is down—10%, 25%, 40%, etc.

In an economy that is in a corrective mode, what comes down must go up. We have been on this ride before, and we survived.

Nonetheless, plastic surgeons who have been in business for decades have told me they have never seen it quite like this. Some of them are freaking out, unduly—this is in California, though, where one-third of all home foreclosures are taking place.

According to the latest ASPS survey numbers, 62% of member surgeons report a decrease in cosmetic procedures in 2008.

As reimbursements go down and the economy gets tighter, some physicians have thought to branch out into doing more reconstructive work, due to so many of them seeing a huge drop-off in high-ticket procedures that are not covered by insurance—the plastic surgeon’s “cash cow” in better times.

Another area in which we have seen some of this “branching” is in purely cosmetic procedures—Botox, fillers, etc.

The branching out is being done, for one thing, as a way to generate income. But it is also because the physicians want to have fun in a down economy. Surgeons are a driven group of people, especially as they get older, and they want to learn, experiment, find a new bag.

Still, what is taking place is affected by perception. I can’t think of a single segment of the economy that has not taken a hit—one exception, maybe, is the foreclosure market, which seems to be doing fine, unfortunately.

At this point, your clients’ perceptions of the economy and their personal futures may be tainted and cast in doubt—the mainstream media has done its utmost to make sure the population is fed scary prognostications and kept uncertain and in the dark during the election year.

Patients and prospective clients might not even want to think about having surgery right now because they are afraid to take 3 weeks off from work—they are afraid for their jobs.

There is a “what’s going to happen next?” attitude among people, even though they still go to work every day and still collect their paychecks, and more than 90% of all home mortgages are not in default.

However, the economy is ultimately driven by forward thinking and perception. Cosmetic surgery is, likewise, driven by forward-thinking people and perception.

You have to look at the economic situation objectively. You can whine or get depressed—many of you have been deeply distressed at the lack of business. You have to figure out a way to get through it. This involves looking closely at the services you’re providing and then looking at your customer base.

Certainly, pockets of demand exist. For example, as of July 2005 we had 78.2 million Baby Boomers. In 2006, the oldest of them turned 62 years old. Those Boomers are not going away, and there is and will be a huge pent-up demand for aesthetic procedures in the coming years.

They are not going to want a facelift that takes 10 or 12 days to recover from. Your job now is to find out who these prospective customers are and what they will pay for, now and in the future.

Start by working on your own premises, philosophically. Figure out who and what you are going to be in the current dry times and the recovered-economy landscape. You’ve got to stay proactive and stay positive.

Look over your infrastructure carefully—your marketing campaign, Web page, the way you deal with patients, the way they get answered on the phone, the hours you’re going to schedule, whether or not you’re going to work Saturday, etc.

Get your name in front of the people in your area. Let them know you are offering what they need in this economy. Find out what that need is, though.

Therefore, this downer of an economy has an upside, and I believe you can count on the surgeon’s mentality to take a gloomy situation and recast it and recreate it in a more positive way.

Jeffrey Frentzen
plasticsurgery@allied360.com