SPEAKER_00 0:00

You're listening to Confidence to Thrive, a podcast for ambitious healthcare practitioners and entrepreneurs, brought to you by Alice Binders. Welcome to Confidence to Thrive, the podcast helping growing practitioners and healthcare entrepreneurs navigate the challenges and risks of regulation while building brands that matter. Every episode, Christopher Cloak Brown tackles a different issue facing healthcare practitioners or entrepreneurs, or interviews a guest who is working on the leading edge of private healthcare, building something that matters in their sector or profession. My name is Jody Rainsford, and on today's episode, I'll be discussing with Christopher what you need to know about insurance protection and regulation if you're looking to build or grow an aesthetics practice. Welcome, Christopher. Thanks, Jodie. Great to be here. Okay, so let's think about aesthetic businesses. Let's add a little bit of context here. What are aesthetic businesses and how have they evolved over the years?

SPEAKER_01 0:54

So aesthetics really started with the idea of trying to counteract aging as you get older and all the pinnacle of youth and the fact we don't want to get old and don't want to look old and so on, it's morphed into more of a general beauty thing, just trying to enhance your looks anyway. I think if you look at that sort of aging part of it and counteracting aging, um what people have progressively realized is that the original versions of aesthetics, which is all the anti-wrinkle stuff and fillers and all these things, are just people say plastering over the cracks, or whatever you want to call it in terms of fillers, almost literally blustering over the cracks. At the top end of aesthetics are some really skilled medics, doctors, and scientists. And I think people progressively realised actually what underlies all these wrinkles and cracks and some changes in your skin and all these things is an aging process. And actually, if you want to counteract aging, what you want to do is to counteract that aging process, and progressively you are seeing the top medical end of aesthetics being really in terms of assisting and supporting people and counteracting that aging process, and people are learning a lot about it and a lot of mechanisms by which it happens, and therefore a lot of ways of counteracting it and slowing it down.

SPEAKER_00 2:20

I suppose the challenge with something like aesthetics is that the majority of people who go to aesthetic businesses they're going there for a very specific reason. And once they then become part of that customer base, additional services are added to that, which take them probably well beyond what uh they fully understood was say fillers or Botox or other treatments like that going into completely different areas, completely complementary to what they need. But is the challenge there that uh offering those additional services, moving into those areas that's where it causes the issue for consumers who are getting into areas that they wouldn't otherwise expect to be in simply because aesthetic businesses have such a long, long history of sticking to those core areas uh up until relatively recently.

SPEAKER_01 3:20

I think it is absolutely changing now. Uh interestingly, and and there's a sort of the controversial debate in aesthetics, in that aesthetics probably was more medical when it started and more sort of doctor-led. Increasingly, the people sort of doing more beauty and beauticians have seen the opportunity to expand their services, and so you now have people who are not medically trained going up and they're doing the anti-wrinkle and the fillers and all that standard stuff more cheaply than medics and so on. So the medics are feeling that well, I've got all these medical skills and experience and knowledge, and maybe I need to use that and lean on that. You can couple that with if you just look at the sort of transition of the market, it maybe started with mainly ladies, increasingly more men. But if you go back sort of 30, 40 years, mainly ladies in their 30s who start to want to prevent that or slow down or hide that aging process. That's the original client base, but that client base then gets older, and then they start to experience all sorts of other health issues. Menopause, in particular, that is actually really the world is starting to understand a lot more about that, and it really is quite an issue as I trip around all these events and shows and learn more. It's like, wow, that really is quite something, actually. The help and support and dealing with menopause, and in a particular so the striking thing to me is in menopause, people talk about brain fog, and it just sounds frankly a bit patronizing. Well, what's really happening is that estrogen is the fuel for the mitochondria in your cells, and it's the mitochondria that generates the energy in your cells. So as your body goes through menopause and stops producing estrogen, it stops fueling your cells. So brain fog is actually up to a 25% reduction in the operation of your brain cells. So it's not surprising that people can't remember why they went into the living room at that point. All the help and support around that has become part of it, and then you move from that into menopause also has an impact on the thyroid. So you can get the thyroid gets added into that and various support around the thyroid. There's a link to cancer and breast cancer, and a lot of breast cancers are actually oestrogen fueled. So there's a big sort of question around hormone replacements, and if you have breast cancer, whether you should be taking hormone replacements or what you should do. It very rapidly comes almost full circle. And we've talked about the complexities of functional medicine and the very detailed knowledge of biochemistry and biochemistry circuits and processes in the body. So to really assist someone through the aging process where their youth might also be catching up with them, which is a part of functional medicine, you need all the skills and knowledge, and very quickly you start to get to if you're really going to offer a full service of that, you're right up at that high end.

SPEAKER_00 6:09

Something like aesthetics has again being on the leading edge, also puts it right at front and centre of uh social media influencing, introducing it to much younger uh people than has ever been experienced before as well, shattering some of those democrats, which offers uh commercial opportunities. And again, like you say, going into the male area as well, more men seeking these type of things. So lots of opportunity, lots of commercial need and desire and different ways of offering it. So, in what way does the regulatory framework and insurance manage to keep up with the risks? Where are the potential uh gaps that someone who is trying to grow an aesthetics business or build an aesthetic business, where are they likely to come up against problems?

SPEAKER_01 6:59

So, for us, the big thing in really aesthetics, but all of this stuff is actually dealing with complaints and claims to start with. All of this stuff's done for image at the end of the day. So people are concerned about their image, worried about their image, and it's fine. But as with everything, they're extremes. Certainly, one of the big issues that's talked about and trained in all aesthetics is assessing people for body dysmorphia. So people who just don't like the look of their body and want to change it will never be happy and never be satisfied. So it's assessing your client base, dealing with your client base, then dealing with the complaints and claims that come from that. All things aesthetic and cosmetic are known to have more complaints than all other branches of medicine, just by the very nature of it and by the very nature of the people who are attracted to it at the end of the day. You have to be careful and you have to deal with these issues quickly and effectively. I think what you find is that when a complaint comes in, it's normally the patient just wants the issue rectified in the early stages. So it's about identifying the issue and working with them to rectify it as quickly as you can and not letting it escalate. We find the danger in all of this space is letting unhappy people talk to lawyers.

SPEAKER_00 8:19

And so I imagine because it's like you say, because it's aesthetics, it's very clear whether there is an issue or not. It can be relatively clear-cut as well, whether someone's doing this to look better. If they don't feel like they look better, that's part of the perception as well.

SPEAKER_01 8:36

It's exactly that, Joe. It's feeling like they look better. In some ways, it's debatable. It has to be a treatment that's rewind all the way. You have to have this informed, the whole informed consent thing is massively important here. We keep coming back to this theme. It's about explaining to the client exactly what they can expect and exactly what the treatment's going to do for them. And it might or might not look good, generally speaking, it should do, and the skilled practitioners will choose treatments. And it's in a show recently, you know, there's not just a medical skill, there's an artistic skill to this. It's being able to imagine what people will look like and imagine what looks good and creating that. And there's definitely an artistic skill to this. But there's also if you just go back to that mental health side of it, if you live in a mold-ridden council flat and you have you know your lips done nicely, you still live in a mould-filled council flat. It's yeah, it's not a magic wand. So you definitely need to be careful with that. Yeah, the whole image side, it's we like the industry, we're very supportive of the industry and what it can do, but it does have a dark side, it does have dangers.

SPEAKER_00 9:47

We've talked about the fact that having the processes in place in terms of making sure that there's clarity up front, also having the processes in place to deal effectively with complaints and claims so that they get uh processed consistently effectively before legal cycle in. In terms of uh cover, then in terms of insurance, uh what is the best protocol for ensuring that you have the correct cover? Is it being very open and clear about what you're offering and how you're offering it to your insurance company, or are there other aspects that need to be considered?

SPEAKER_01 10:22

Yeah, it is down to that clarity. There's a little bit, it's it's an interesting one in the whole cosmetic space. And again, this is a space that is moving incredibly fast. There's new things all of the time. So, yeah, there is a clarity. The way we operate is very much if you take sort of certain types of treatments, it's it's we generally try and risk band the treatments, and then we generally try and identify practitioners who we think have a very good understanding of what's out there and what the risks are, and support them to make decisions, because we can't possibly keep up with all the new stuff, and who are we're complete non-medics and you know, non-ascetics people who never had achievements in our life to tell practitioners what they can and can't do within reason. So we very much try and put the bounds in the categories, explain the bounds in the categories, and then let them go or get on with it. And if they've got any questions, they can come back and say, I'm considering doing this, or have you seen this new product? Would it be covered? And again, clearly, it's the best practitioners that those who understand the risks will cover weight loss injections, we'll cover the fat freezing, we'll cover the body morphing, we'll cover just about every single way there is of removing and dissolving fat. There is a new laser. So laser treatments are generally non-medics can do and non-medical practitioners. There is a new fat-burning laser treatment, and again, we always try and review these things after lunch for obvious reasons. Basically, they put a small hole and they insert a fiber optic and they pump laser energy down that fiber optic and it burns the fat inside you. So you can imagine the risk is that you get that too strong, and basically you're not just burning somebody's skin, then you're burning inside their face. So that is one we are incredibly careful with, and that's exactly the sorts of things people need to be assessing and saying, actually, this isn't like the other things. I'm actually sticking a laser inside someone, and that must be a lot more risky than phoning up and asking about. So I mean it's funny you see these things and we pick them up in the end, all this stuff comes through, and eventually enough people ask, and we look around enough, and eventually we figure out what's happening. We can provide some clarity. But on those things, it's if you just think about it, I'm doing laser treatments, and yeah, I've got a risk of burning somebody's skin right now. I'm putting a hole in somebody and sticking the laser inside of them. Maybe I should ask my insurer if that's alright.

SPEAKER_00 12:53

Because you have a client base who is operating in this space at that leading edge, working in these innovative areas, that you uh are able to kind of assess this level of innovation that's going on. So you're keeping ahead of it more so than less specialist advisors or providers, and that kind of gives you an insight that will benefit everyone who is seeking advice from you.

SPEAKER_01 13:21

Yeah, we like to think that, Joey. We like to think we are also very open. We have got some extraordinarily good practitioners who we have worked for with for a number of years, and so we're quite open to taking their views on this stuff and what the risks are, they're the stuff you use it every day and assess it. So absolutely for us, it really is a case of trying to keep up, and and you're trying to keep up with a very, very fast-moving business. But that's part of the reason we always say we're very happy to talk to people, and that's part of the reason. Even if we don't ensure you you help us just understand what's out there.

SPEAKER_00 13:56

And so, if you are an aesthetics business or you are growing an aesthetics business, or you're thinking of adding further services to your existing business, what are the recommended steps from your perspective?

SPEAKER_01 14:09

Yeah, it's always the case of really making sure that you're comfortable. We talk about this quite a lot, this concept now in insurance. With your insurance, your obligation is to have made a fair presentation of the risk. Now, what that means is that the insurer can basically deny cover on the basis of had I known that piece of information, I would not have offered you insurance. So you need to think about what the insurer needs to know about the risk. That's changed. Lots of people hark back to the bad old days of insurance, and then this goes back to the days when people insured ships, and brokers were people who rode horses from the coffee shop in central London down to the Medway ports and talked to the captain about what he was doing, and clearly the ship and the captain had a much better idea of what the risks are because a guy on the horse had never been to sea, let alone to India or or wherever. Um and so the concept from that was that the insured, the person buying the insurance, had to explain the risk to the insurer. Nowadays, you know, your motor insurer deals with thousands of claims every day, he has a much better idea of what happens to cars than you do, and that's all flipped around, and that's this new view where you just have to give this fair presentation of the risk, you have to impart what you know that's important for the insurer to make a judgment. So I think in that, you need to think in your practice about what's new, what's different, what might be enhanced risk, and make sure that your insurer knows, understands, and accepts that.

SPEAKER_00 15:44

And so, again, as we say at the end of every episode, if anyone wants to gain some advice, you're very happy to take a phone call and discuss this with anyone.

SPEAKER_01 15:54

Yeah, as I said, we're we're fascinated by what's out there as well. So we're always happy to chat to people.

SPEAKER_00 16:00

Thank you very much, Christopher, and look forward to seeing you on the next episode. Thanks, Jodie. Thank you for listening to Confidence to Thrive. Before you go, please rate, review, and subscribe to Confidence to Thrive on your preferred podcast platform and help us spread our message to others who are making a difference in private healthcare. This podcast was brought to you by Our Litity, a good advisor to support your business and advisor practitioners over healthcare practices on mitigating risks to your business and thrive. Learn more about how our T can support you by finding the link in the show notes of forfittingallift.co.uk.