Feeling the pinch: Economy squeezes Aesthetic bookings; proactive push helps derms stay busy

Key Points

EDITOR'S NOTE: Economic turmoil is impacting dermatology practices, particularly those that focus heavily on aesthetics. In this issue, we look at what dermatologists across the country are experiencing, and we talk to one Florida practitioner who says flexible scheduling has helped her to retain a steady patient load (p. 25). We offer tips for attracting and keeping your patients (p. 20). And should you offer discounts? We talk to several doctors who weigh the pros and cons (p. 19).

National report - The precarious U.S. economy has slashed patient spending on aesthetic treatments, and some dermatologists say medical bookings also have declined since the stock market plummeted in the closing months of 2008.

"We're probably down 25 percent on cosmetic treatments" since the fall, says Debra Jaliman, M.D., a Manhattan dermatologist in private practice and associate professor of dermatology at Mount Sinai School of Medicine, New York. Medical appointments also have slipped, as patients shun co-pays, she says.

Trading down

Doctors across the country report that cosmetic patients are "trading down" - booking less invasive, and less expensive, procedures.

Stephen M. Schleicher, M.D., medical director with DermDx Centers for Dermatology, Hazleton, Pa., says cosmetic appointments (which represent 10 percent of his practice) held steady through 2008.

However, "We're seeing that instead of getting facelifts, patients are gravitating to Botox (botulinum toxin A, Allergan) and especially fillers, because they're a fraction of the price," he says.

Timothy Brown, M.D., member of a 14-dermatologist practice based in Louisville, Ky., says that while injectable procedure numbers remain robust, he has seen cancellations in bookings for cosmetic procedures costing $1,000 and up since November.

Dr. Brown predicts that cancellations soon will impact all dermatologists. "If people are not paying their mortgages and credit cards, I don't imagine they're going to be paying their doctors, either."

Patients still booking aesthetic appointments despite the tight economy are scaling back on the extent of treatments, other doctors tell Dermatology Times.

Don Mehrabi, M.D., a Beverly Hills, Calif., dermatologist in private practice at BH Skin, says patients who previously might have treated two or three areas with Botox are now choosing to treat one area where they'll see the most impact.

"Then, they'll save up and do another one later," he says.

Cosmetic bookings at Dr. Mehrabi's Beverly Hills office, where aesthetic procedures account for half of patient visits, have dropped about 10 percent in recent months.

Aesthetic appointments at his Glendale, Calif., office, which has a roughly 80 percent medical practice, have dropped at least 30 percent to 40 percent, a trend that began in September and accelerated in November, he says.

"People are shopping around more" for low prices and specials, Dr. Mehrabi says. To encourage patients, he offers free consultations.

"Patients take the free consultation," he says, "but they'll think over the pricing and whether or not they really want to (proceed)."