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Spa, MD: Professionalism--Get CHARGED!

By: Steven H. Dayan, MD and Terri Wojak
Posted: April 21, 2008, from the October 2007 issue of Skin Inc. magazine.

The cosmetic medical products and services industry is exploding. Estheticians are increasingly in demand and are enjoying one of the most sought-after positions in the industry. According to a 2005 analysis by Associated Skin Care Professionals, there are approximately 145,000 estheticians in the United States whose profession has a rich history that has developed from a convergence of sources, including foreign skin folklore traditions, cosmetology know-how and medical influences, and the field continues to evolve. During the past five years, highly motivated estheticians have begun seeking advanced training and knowledge in order to create and define their emerging roles. This professional has become an increasingly important and recognized adjunct in cosmetic medicine.
  According to the American Academy of Facial Plastic and Reconstructive Surgery, the biggest increase in cosmetic services is nonsurgical treatments, with a more than 700% growth during the past eight years. Two of the most requested services are chemical peels and microdermabrasion, which are routinely performed by estheticians, clearly demonstrating their increasing value to a medical practice. Because of this demand, more physicians are offering cosmetic treatments and products. Estheticians not only help with pre- and post-operative skin therapy, but also play a less celebrated, but very important and integral role, in managing the psyche of clients. The role is valued by some physicians, but many others are still highly resistant to the medical esthetic position. Many have heard negative comments or have been burned in the past from unprofessional estheticians. 
  The following principles are designed to identify and brand the core ethics of professionalism for those seeking positions in a medical practice, but they are applicable to all esthetic professionals.
  CHARGED stands for:

Clothing
       What you wear is very important to your clients, who will base their judgment of your skills and competencies on your appearance. Most will feel better if the esthetician is dressed a bit more conservatively than the client. If you are dressed too conservatively though, clients might feel as if they cannot relate to you. Worse, however, is to wear the clothes you would when going out on a Saturday night.
       A professionally tailored, cleaned and pressed lab coat gives the appearance of authority and cleanliness, and is imperative in a medical setting. Your level of hygiene will be interpreted as a symbol of your clinical thoroughness. Nails should be manicured at all times, without chipped polish or bright colors. When you are working in a health care environment, sterility is always an important issue, therefore open-toed shoes should not be worn in the treatment rooms and long hair should always be tied back.

HIPAA
        In a medical environment, you may be privy to sensitive information. The Health Insurance Portability and Accountability Act (HIPAA) concerns how patient information is managed. In today’s information age, medical records can too easily become exposed. How you chart and document a client’s treatment is very important. You will need to learn to write professional notes and, if they are placed in the same chart as physicians’ notes, they should go on a separate piece of paper. They may be subject to legal review at some point, so it is imperative that they are honest, clear, concise and accurate.
        The chart must be cared for diligently because the dissemination of medical information can be damaging, unethical and illegal. It should never leave the office, because it is the office’s property. If you leave the practice for any reason, you are not permitted to take anything from the chart, including contact information or receipts, because this may be deemed illegal. You can never release this information to anyone.

Advice
       Your words and recommendations will likely carry more weight in a medical setting than in a spa. You will have a fiduciary responsibility to do what is best for your client and this can never waver; your guiding principle is to always have your client’s best interest in mind. They are seeking honest skin care advice and although some spas may put pressure and heavy incentives on upselling products and services, this should not be the priority in a medical esthetic environment.
       Although you want to give your clients suggestions about how to care for their skin, you must never give medical advice. This may sound simple, but you would be surprised how easily such a thing can happen. For example, if a client is on an antibiotic for acne and you tell them that you don’t think they need it because your treatments are sufficient, you just offered medical advice and could be held liable.

Responsibility
       You are more likely to acquire added responsibility if you choose to work in a medical office. It is your duty to follow up with clients after treatments to make sure that their service worked properly and home-care products are being used correctly. Other responsibilities include being at work at least 30 minutes before your first appointment because it is extremely unprofessional to be late for a client’s appointment. You also must ensure that all necessary products are in stock, your treatment room is set up and your equipment is in working order. Remember that everything you do must be in compliance with the United States Occupational Safety & Health Administration (OSHA) regulations for a medical office.

Gossip
       Do not gossip. Cardinal rule No.1: Never talk about one client to another. Often a client will come in and ask how her friend is doing. Don’t take the bait. Her friend may have had some work done and this woman is fishing to find out if you know anything about it. Clients are always very receptive when you politely tell them that you are not at liberty to discuss a client’s personal details—they will respect you more and will also feel more comfortable opening up to you. Also, you should not gossip with your coworkers about clients. Just because Bea, who is 74, has a tattoo of her boyfriend Bud in a private place, that should not become fodder for the staff to discuss at lunch the next day.

Education
       Education is one of the most important aspects of the medical industry and it is constantly changing; there will always be something new to learn. You must keep abreast of new procedures and treatments, or your clients will go elsewhere. Regardless of how much you think you know, a true professional will always realize that there is more to learn. Take as many credible classes as you can; go to seminars and training programs for anything related to the skin care or medical industries. To succeed in any career, you must make time for education. If you graduated 10 years ago and have not obtained any advanced education, an employer will get the impression that you are not serious about your career. 

Demeanor
        In order to be a professional, you must look like one, carry yourself like one and act like one. Your stature, respectability and reputation will be based on good skills, along with professional and personal demeanor. You must put yourself into your clients’ shoes. Being empathetic is hard to do, but it will result in your being a great esthetician. You must feel what your clients are feeling. Ask questions, listen and do not babble. You are there to help them with their skin and their psyche, and you have to remember that this may be a traumatic time for someone who has just gone through surgery. To be taken seriously, it is imperative to be viewed as smart, sensitive and professional, but it is still important to maintain a healthy distance from clients’ emotional issues. This will allow you to view their problems with acute objectivity. Empathy is the hardest skill to teach, and some may never get it; however, it can be learned and is practiced in all walks of life.

A way of life
  Professionalism in medicine carries over into your personal life. When health care professionals leave the office, they are still thought of and defined by their profession. It is with open arms medical estheticians are welcomed into health care industry positions that are not just a job, but a way of life.