Your Chairs Are Full, and Your Aesthetic Practice Is Dying: The Retention Pattern That Hides Inside a Busy Schedule

Your Chairs Are Full, and Your Aesthetic Practice Is Dying: The Retention Pattern That Hides Inside a Busy Schedule

DATE

18th August 2026

TIME

8:00 PM - 9:00 PM

CATEGORY

Patient Experience & Retention

PANELISTSRinda Ko · Frances Vincen-Brown, LE · Cassie Pool

Transcript

Lightly edited auto-generated transcript. Speaker turns, timestamps and wording are kept as recorded; only names, brand names and obvious transcription errors were corrected.

Don Adeesha (Host) 00:00:10

Good evening, everyone, and welcome to the Business of Aesthetics Expert Panel Series. I'm your host for this session, Don Adeesha. It's great to have you here. Tonight, we are digging into a problem that is easy to miss, precisely because the practice looks busy.

Your chairs are full, your practice may be still Stalling.

So, if you're an owner or leader who has ever looked at a packed calendar and thought.

Why does growth still feel harder than it should?

Well, this is the conversation for you. We're going to look beneath the schedule and ask whether patients are actually returning. What are the early warning signs look like, and what has to change before that hidden erosion becomes visible. Now, before we get into the discussion, a couple of housekeeping tips to help you get the most of this hour.

First, yes, we are recording, and you will receive a replay link in your inbox after the event. However, do not let that make you passive, because the real value is happening right here, right now, live, so…

Feel free to ask us any questions in the Q&A box down below, or you can use the chat for conversations, quick reflections. keep it engaging. I have my eye on both the feet and will do my best to weave in your thoughts and concerns as we go along, or else we will tackle them head-on in a dedicated Ask Me Anything session bit.

Towards the end of our event.

Yes.

Right.

Now, before we get into the panel, a quick thank you to our sponsor here tonight, and our growth partner at Business of Aesthetics, Ekwa Marketing. Ekwa Marketing is founded by Naren Arulrajah, the very same co-founder of the Business of Aesthetics community. Now, Ekwa has supported aesthetic practices and industry leaders across the U.S. and Canada for over 15 years. You can see two client reviews on the slide, including one from a practice describing more than a decade working with Ekwa.

Ekwa's role tonight is simple, support this education, and later on, I will show you a complimentary diagnostic session they have made available to our practice owners. We'll come back to that after we have earned it, with some real conversation first. So, let's go ahead and meet our panelists, and then get into the work.

First up, we have Rinda Ko. Rinda is the co-founder of Kylo… Kylo.

An AI-powered retention and revenue platform, helping med spas and aesthetic practices turn patient data into actionable growth.

Before Clio, she led the patient-facing and operational technology stack at Everslash Body, overseeing online booking, patient engagement, clinical systems, and sales tools. So her lens tonight is the intersection of data, tech, operations.

And the early science that tells the practice whether patients are truly staying on. Rinda, it's great to have you here on the panel.

Rinda Ko 00:03:12

Thanks for having me, I'm very excited, too. speak to some of the things that we're going to talk about in more detail today, and excited to be up here with Frances and Cassie.

Don Adeesha (Host) 00:03:24

Great. Back to you, Rinda.

Next up, we have Frances Vincen-Brown. Frances has been a licensed aesthetician for 18 years, and is a co-owner of Massage and Skincare Solutions in Boise, Idaho. She created Zombie Cell Aesthetics, an NCEA-accredited continuing education course on cellular senescence.

And also educates for ProCell Therapies and 7E Wellness. Her work translates skin longevity and cellular health into practical patient education, which gives her a particular perspective on how understanding, expectations, and treatment continuity influence long-term retention. Frances.

Cassie Pool 00:04:09

Weird.

Don Adeesha (Host) 00:04:10

Glad to have you here.

Frances Vincen-Brown, LE 00:04:11

Thank you, I'm really excited to be here.

Don Adeesha (Host) 00:04:16

Right.

Last but not least, rounding out the panel, we have Cassie Pool, founder and educational director of Florence Foundations, with more than 15 years of experience across medical aesthetics, clinical practice, operations, consultative sales. curriculum development and education, her work centers on being human connection combined with strong understanding of aesthetic technologies, objectivables, and surgical interventions. So, she teaches providers how to guide patients with clarity, build trust, and create treatment journeys that serve both the patient and the clinic.

Over time, Cassie… Welcome to the panel.

Cassie Pool 00:04:56

Thank you, and thank you so much for having me. I'm really excited to hear from Frances and Rinda tonight as well.

Don Adeesha (Host) 00:05:05

Absolutely. So then, I'm going to stop sharing the slides, and then we'll get into our main discussion here.

Right.

The first question I have is for you, Rinda.

A full appointment book signals health to most owners.

What does it actually hide about whether your existing patients are returning?

Rinda Ko 00:05:32

Yeah, I think that's a really great, you know, first question to kick off, the conversation.

I think if you have a full calendar, full appointments booked, that's… a great thing. That means that… your marketing efforts, whether that's with marketing consultants, or your agency, or just your own independent marketing work, right? Like, something's working, because there's all these patients coming in, and you're booked. And what that means is, not only is your marketing great, seemingly, assuming, you know, like, you don't have a promotion that's like, 99% off Botox or something like that. I think that's a great sign, right? Like, you should feel really proud of having a full book.

Because not only does it mean that you're busy, and you're doing well, and you're able to get patients in and get your calendar booked, you're also really, accomplishing utilization of your providers, right? I think, you know, what might be hiding, right, and what might be important to understand is, what does that mix look like today?

Is your calendar only brand new patients, one-time promotional patients, people who are gonna come, but may never return? Or are there also, you know, or is there also that combination of all those things? Plus. your loyal patients who always come back. And I think it's really important to understand at a daily, weekly, monthly level, right? Like. what does that mix look like? And it's probably different depending on what stage of the business you're at, right? If you're new.

Or you've just opened up a new location.

Obviously, the percentage of new patients coming in is going to be a lot different than if you're established, you've been in the business for a few years. And I think that's probably the most important thing. is understanding what a healthy mix is for you that consists of the local… of the oil patients, the brand new patients, and all the things that I just mentioned.

Don Adeesha (Host) 00:07:38

Hey, I was just curious, what is the problem with the mix that has heavy discounting in, like, as the majority of their, new patients.

Rinda Ko 00:07:48

Sorry, say that again?

Don Adeesha (Host) 00:07:50

have new patients coming in, right? And, like, let's say more than 50% of them are coming in because of that heavy discounting promotion. What is the problem that shows to the practice and the, you know, of course, the practice owner?

Rinda Ko 00:08:08

Yeah, definitely.

I think strong acquisition can probably temporarily mask problems or challenges with retention, right? It's really great to have new patients keep filling the chairs, but that leakage, right, might not be visible until acquisition slows, until you decide to pause a little bit on marketing spend, right? Everyone, I think, talks about this, especially, you know. in the last year or so, where there's an influx in practices, right, an influx in opportunities and choices by a patient. And so while practice can be busy.

It's important to understand, right, like, if 50% of patients are coming in are brand new. that also means that perhaps 50% of your patients are not returning, right? And so they're not coming in, and the schedule looks full, but if the patients are returning, then the practice, right, we need to keep spending on marketing and promotions just to replace folks who have sort of leaked out. And so you're going to be working harder to maintain that same level of business instead of building on the patience you already have. I think it was…

Zenoti that published a benchmark saying that, you know, the top-earning med spas rebook about 60-70% of clients within 24 hours, compared to you know, maybe the industry average of 40%, and I think it's really important to understand that balance of Patients that you want to keep coming in the door, so you don't have to spend, right, to acquire those patients to come in, and the importance of having a healthy mix of that and folks who are should be, of course, a small percentage, or a big percentage, depending on, again, the stage of your business, but I think it's very important to know what that balance is like for you, and keep in mind, right, like, the more you inject money to acquire new customers, great, but then it's so much more important to get the value out of each of these customers and patients.

Don Adeesha (Host) 00:10:06

Thank you very much for that, Rinda. My next question is to you, Frances. When a patient stops booking after what felt like a successful treatment, which staff member first notices, and what typically happens next?

Frances Vincen-Brown, LE 00:10:18

So, for me, I'm not a big medi spa, so I'm a solo practitioner, so I would be the one who would do it, but I would say in a bigger, establishment, I think there would need to be, like, a checks and balance system. So, if that was a client who had come in, in my clinic, we fill out, basically, like, a soap note thing. So, a detailed, thing describing what treatment they had, what we did, what we discussed. We had that client consultation.

And then, in a bigger clinic, I would like to think someone would put that into a system so that that would get flagged, and if the practitioner didn't notice, then someone else would notice that that client did not come back. having said that, again, single solo practitioner, so I know immediately if someone has not come back, I know that that lands on me, that I didn't convey what that treatment looked like, and how it's not one and done, that it's biology behind every treatment and what needs to get done. So I think it's a communication issue between the person who is, working on that client, and then, in a bigger clinic, the front desk as well.

Being, fluid in that, so that you know what is happening.

Don Adeesha (Host) 00:11:40

what is the most… because there is a handoff right there, right? So, how… how do you identify that something is getting dropped in that handoff?

From the, clinician to the…

Frances Vincen-Brown, LE 00:11:51

I would say.

Don Adeesha (Host) 00:11:52

that you would need…

Frances Vincen-Brown, LE 00:11:53

Yeah, I would say that you would need some sort of, system, that would, that would notify, the practitioner, or the practitioner themselves would check in on that. But again, those SOAP notes that would discuss it and talk about what, needs to happen in that follow-through. And, I think it would be a clinic's responsibility to, this probably leans more to Cassie for the training of that clinic.

And how that goes for the staff. Like, how is that clinic getting trained, and the front desk down to every esthetician, every practitioner in that establishment. What does that look like for, you know, consultation? What does that look like for follow-up? What does that look like for scheduling and those checks and balances, and when… once that is understood, then I don't think you would have that retention problem. So, you have to define as a business how that goes. It can't just be on one person. I think that has to be a conversation for the business as a whole. That's how you run a business, right? One person can't be doing all of the things, and it has to be discussed.

Don Adeesha (Host) 00:13:04

Absolutely. Thank you very much for the clarification there, Frances. Cassie, a consultation can feel successful because the patient books the first treatment.

What happens during that conversation that tells you whether they are likely to become a long-term patient or simply complete one transaction?

Cassie Pool 00:13:21

Yeah, so I feel like the consultation structure is a huge, huge factor in retention. And I feel like that kind of starts in the way that clinics Allocate or delegate consultations. Sometimes we have multiple people running consultations, whoever's free. I've worked with clinics that have dedicated consultants. No consultation runs, or no treatment runs unless that consultant sees the patient first. Typically, I find that is always the most successful structure, because that consultant has already been well-trained, well vetted. They are able to build a very holistic treatment plan based on all the… the treatment offerings that the clinics may have, but also they're able to look at a patient and say, what does this person really need, not what does this person think that they need? So, the consultation if it doesn't… if it isn't whole, if it's, you know, letting the patient lead, I don't want this, I want this, I want this, and we're kind of tailoring things to that patient's Desires, instead of educating them fully and changing their minds sometimes, because that has to happen in order to have a successful outcome. a lot of the time, then we're gonna end up with the patient buying exactly what they thought they wanted to buy, spending exactly what they thought they wanted to spend, and ultimately being disappointed, because at the end of the day, it wasn't going to deliver the results that they were looking for. So I think Having a dedicated consultant that is really well educated in a very holistic treatment plan, giving that person time to really sit with this patient. They're not rushed, they're not thinking about, you know, the treatment room that they have to prepare for the next client. That person is… their dedicated job is Making sure that this patient feels seen, heard, and is really well educated, regardless of how much time that might take. If it's 15 minutes, if it's 45 minutes. That's a huge hole that I've seen. in practices, and I think it's just a matter of restructuring, and sometimes that is a little bit difficult when you're, you know, running thin on stuff, but I think having somebody that's dedicated and very well trained in that holistic treatment plan delivery is key.

And I would also speak to something that Frances said, if I have a moment.

Don Adeesha (Host) 00:15:50

Of course, one piece.

Cassie Pool 00:15:52

So we were talking about the retention tracking, and… you know, I've worked with clinics… every EMR system or CRM system has different functionality, and what I… did with many clinics that I found successful is just I built a simple tool, it's a simple tracking sheet, front desk. completes that at the end of every day. They've got lots of time, way more time than they need most of the time. They complete the sheet, and it's just… it's available, it's free on my website, and you can download that and have your front desk do that at the end of every single day, and it will help you track those retention metrics. for every week, every month, and you're able to track that back to each client if you want to go back through. So, like Frances said, the soap notes, super important. You can go back and see, okay, this person didn't rebook.

I see the notes here from this provider are skimpy, and, you know, they didn't really talk much, and whatever the case may be, you can identify patterns that way, and sometimes just having something really simple like that, it's great to have a system that can track this for you, and if you're a new practice, you know, maybe getting into a CRM system is not affordable that can track all of that, but if you just have something really simple in place, and you have your, you know, your frontline staff just doing that. simple data entry, you can… you can see a lot if you're… if you're willing to take the time and look through, so… sucks.

Don Adeesha (Host) 00:17:21

Cassie, before I, let you go.

During the consultation times, what are the, like… what would you recommend be the ideal consultation time, if there is one? And also, how do you screen patients? Who… like, should everyone be getting say, average 30 minutes? Or would you… Truth, truthfully…

Cassie Pool 00:17:44

Yeah, I mean, what do you… what do you value in, let's say, in any human interaction, right? It's… genuine humanity. So I think that even if you don't see in a patient that they're looking for that connection, or they're looking for that engagement, every human being is. So. even if somebody is giving you that cold, you know, I don't want your sales pitch kind of vibe, the reality is you shouldn't be giving them a sales pitch. Let's dig into this person, let's connect with them, let's find something that we can connect and get on the same level, and then let's really just talk to them about this. Let's let them know that this is… the ball's completely in their court. Sometimes that takes time, especially with those harder patients. You know, the ones that are easy are the ones that come in, and they love your hair, and they love your outfit, and they're so… excited to be there, and you think, oh, I should definitely give this person a lot of time, they're gonna spend money, sure they are, but those…

Those people that are a little bit more on edge, they maybe had a bad experience somewhere else, or they're a little bit colder, like.

I honestly think 30 minutes is the minimum time that you should really have allowed to connect with somebody, and if you end up closing a very strong treatment package that's, you know, 6 months long in 15 minutes, that's great. You have time to now, like, reach out to another patient.

And send them a quick email, and see how they're feeling, or give them a call, or… you know, you have… there's things that every consultant can do with their time from previous patients. Nobody should be idle, but yeah, allotting that 30 minutes to a patient, at least, I think is critical.

Don Adeesha (Host) 00:19:22

Appreciate that, Cassie. Rinda, when budget is limited, how do you decide between investing in reactivating lapsed patients versus acquiring new ones?

Rinda Ko 00:19:33

Yeah, that's a great question. I would say…

You don't want to pour into a leaky bucket, and so it's important to really understand where the leak is happening, right?

Sequence beats. budget. You want to fix the leak, work with the list that you already paid for and have, right? Like, I'm sure if you're a substantial you know, you've got a substantial patient list, and that's a lot for you to work with, and I think that's a lot cheaper to actually work with than going on and buying more new patients, just to have to…

Make up for that leak, and have that be this cycle, this very expensive cycle.

So, the way I would think about it is.

Rebooking a patient who's already in your chair costs nothing beyond what you'd already paid for during that first acquisition, right? And then, like what Frances and Cassie said, if…

You've got a great script, a great process in place. The provider is, you know, in the back of the room during the treatment room, recommending a treatment care plan.

Then there's that seamless sort of walkover to the front desk who's going to be taking care of that scheduling.

And so, in the back room, if there's something like, hey, you know. this is what the treatment plan should be, and, you know, you should come back in, again, depending on the service, right, or the type of treatment that's being done, come back in 12 weeks, come back in 16 weeks, right? Then the front desk seamlessly takes care of that, and actually gets that booked.

And you get that for…

50% even, right? And you want to aim for higher, maybe 50, 70, right? Like, ideally 100% of patients do, you know, have that next appointment booked. Then you're really… fixing what could be something that slips through so quickly, right? Like, you want to really make sure that One, when every single patient comes in, The staff are all… prioritizing that they're coming back for their next appointment. I think the other part to that, rather than a daily thing, is reactivating warm, lapsed folks, and the importance of data segmentation when looking at your patient list, right? There's so many ways to slice and dice data.

Whether that's looking at folks, right, that have come 90, 280 days prior, right, 3 months to 6 months before, they don't have another appointment booked, maybe you want to also include something like do they have Ally credits that are going to expire, right? Or something else along… or something else interesting, so it doesn't feel generic. I think the most important piece is If you're sending a blast. maybe, like, don't send it to every single person in your patient base, right? You've got a lot of rich segments and layers to work with, and so that means you have a lot to experiment with when it comes to reactivating, folks who are already in. your current base that you can work off of can slice someone who came in last year, but didn't come in this year. Someone who spent $2,000, right? And then I think the other part of that, that That gets to you is. you may even understand and see a pattern in the folks that haven't come back, and whether that means there must be a change in the processes, or in a conversation, or something else. So I really do think, you know, if Budget's limited, you know, deciding between Buying more demand versus making sure the practice is converting the demand it already earned is pretty important.

Don Adeesha (Host) 00:23:05

Absolutely, ensuring that you're at least hitting for that 50% of recurring bookings right off the bat, and Going off of that, to see if you're at least hitting that benchmark. If not, then… there's room for improvement in your retention program. Frances, how do you determine whether a patient who hasn't returned within their expected window? Is it retention problem, or a clinical one?

Frances Vincen-Brown, LE 00:23:32

I would say it's more of a clinical one. For me, I think that a patient or a client doesn't fully understand, maybe, what the process looks like. No treatment is one and done, and you… I think that goes back to the consultation, and the education of that client. For instance, for ProCell, there's… it's a series of treatments, and you're not going to get those results unless you do the series of treatments, and then once you do that series of treatments.

There's maintenance after. So, when I have a consultation with the client, we discuss what they're after, we talk about what is available to them, what that realistically looks like, for the healing and the body, and how that works, and then we, discuss, you know, how we're going to proceed, and then we do a touchpoint. You know, okay, so your entire series is now finished.

So, and we're gonna check back in a month, we're gonna check back in 3 months, we're gonna, you know, and then, and then we do.

So, I would say that retention, lost would be, again, back to communication, and the need to clearly communicate, what is happening, and what that looks like, and those touchpoints, and then, following through on those touchpoints. to,

Don Adeesha (Host) 00:24:57

How can the front desk help?

Frances Vincen-Brown, LE 00:24:59

I'm sorry, what?

Don Adeesha (Host) 00:25:01

How can the front desk help this mission?

Frances Vincen-Brown, LE 00:25:03

The front desk can definitely help with that by, again, back to what Cassie was saying with that training of the front desk and the notes that she was talking about. It all comes back to that it's a team, right? And everyone has to really be on a level of communication that not… the ball doesn't get dropped anywhere, right?

So, yes, the front desk can help with that, with that communication. Like, you can come up to the front desk, and you can discuss with them, hey, we just worked out this treatment plan, and just like when you go to the doctors, right? You go to the doctor's office, and they say, go to the front desk and tell them that we need to see you back in 3 months, right? So, if the clinician is available, they go to the front desk with that person, and they say, okay, so this is our treatment plan.

They need to be back.

In this amount of time, and, you know, see how that works, right?

Don Adeesha (Host) 00:25:57

Okay, that's great. I mean, if we are having that kind of system, it just feels so smooth.

And retention seems to solve itself on its own. Appreciate that, Frances. Cassie, when a patient comes in asking for one specific treatment, but the provider believes that the broader treatment plan would serve them better, how do you educate them without making the conversation feel like an upsell?

Cassie Pool 00:26:22

I think, the most important thing is that you have to be comfortable with the idea that that patient may not book with you if you're recommending something that is not right for them. So…

If I give an example, I have a patient come in, you know, they're… they're in their 60s, a lot of volume loss, their concern is jowls. I don't like these jowls, I don't like them. I don't… I want them gone. Okay. I understand it's not surgery, but I want them gone. Okay. And I don't want any needles. I don't want any injectables.

Okay. Well, if we can't… convince this patient that volume replacement is necessary outside of… let's say we're not a surgical practice, so surgery's off the table. If we can't convince this patient That volume replacement is necessary, and we know that technology alone, no matter how great it is, and how many, you know, layers of treatment we stack onto this person.

They're not going to have a lot of relief in this, because It's a gravity issue.

Then we have to be comfortable with the idea that maybe, at the end of the day. this patient is not going to book. We're going to do our best to talk to them about why volume replacement is necessary to get these results. We're going to talk to them about safety profile. We're gonna talk to them about, you know, how common this is, how, easy it is, downtime, what we can offer them for recovery, can we, you know, can we offer them some sort of…

Vascular laser. We're gonna talk to them about all the things that make this really easy. make this really painless. Maybe it's not what they thought it was, you know, things have come a long way.

All of their concerns we're going to address about injectables, but we're not going to take that off the table, because at the end of the day, it would be much better for this patient Not to book with us, let's be honest.

Then, to spend $2,000 on a skin-tightening treatment that they're going to get minimal results from, and now they don't want to come back. So I think the way that I would address it is obviously give them, like we talked about, the time. We want to talk to them. We want to make them know that we're not looking to sell you on something that's not going to give you results. We either want you to see that result, and this is what we know it's gonna take to get you there, or we would really rather you save your money. and explore surgical avenues, something. But this is not gonna happen in a non-surgical environment unless we address volume first. And those are the type of conversations that are tough sometimes, because Especially as a new practice, you're, you know, you've got this payment on this skin-tightening device, and you have to make at least 10 sales to make your payment, and you know that, but is it worth your reputation, and is it worth it?

I don't know how much time I have to speak on this, but I'll just quickly…

Don Adeesha (Host) 00:29:17

Yeah, please, go ahead.

Cassie Pool 00:29:18

I'll tell you, my… I have, you know, a little bit of a water-into-wine story with this patient that I experienced, who came in, and she, you know, she was a quite… quite a heavy set patient, definitely overweight.

And she was interested in a procedure, a cryolipolysis, a CoolSculpting procedure. So, anyway, she, She wanted to do… something with her chin, and she was kind of talking about… and I said, listen, you've got a lot of laxity in the lower face here. We can reduce the fat, but at the end of the day, you're probably not going to be overly happy with the results. This is what it's going to cost, and I can be very honest with you that you'll see minimal improvement because the laxity is pretty severe. you're a better surgical candidate. And, so this patient she really appreciated the honesty. I was ready to let her go, I, you know, we had a great conversation, she was a really nice lady, and I guided her to surgery and was willing to make a referral recommendation, and she, She said, you know, I… I am… I'm a middle-aged lady, I'm on my own, I take care of my mother, surgery's not an option for me. It's dangerous, I'm not willing to take the risk, and she said, I also… understand what this procedure will give me. I understand, she said, I just… I want to see a little bit of the fat reduced, and I understand the skin, and I'll address that later. And I really felt like we had a good understanding, and I said, okay, you know, gave her a good price, did the treatment.

The lady spent $65,000 on CoolSculpting in 6 months, because she was so… she understood how it worked. She was happy with what it delivered. She did not have unrealistic expectations for it. she had results, but they were in line with what you would expect. So I think, you know, some… you're not always gonna have those kind of people, but…

Sometimes people will… be a better client for something else down the road, and they'll come back to you because you were honest with them. And that's much better than somebody giving you a Google review that you stole, you know, $2,500 and got no results, and…

Sometimes you just have to be comfortable potentially losing the patient by giving them a very honest treatment plan that doesn't align with exactly what they thought they might come in for.

If that makes sense.

Don Adeesha (Host) 00:31:41

That makes a lot of sense, because, what you did there, you closed the expectation gap, right? Because a lot of the patients come in, they have their own expectations and their own imagination.

But at the end of the day, even if they got the treatment that they wanted. they're not going to get the same outcome that they have seen someone on Instagram have.

Cassie Pool 00:32:02

Right. Yeah, yeah.

Don Adeesha (Host) 00:32:04

So, before we continue, I do have a wonderful, valuable resource that I would like to share with our, attendees here.

Right, so we've spent the first half of tonight looking at something that can be incredibly expensive for a practice, patients leaving when, in many cases, the relationship could have been protected.

There's another side of that equation that, we would like for you to think about for a moment. Every patient you lose eventually has to be replaced, and if the patients you actually want Aren't consistently finding you, understanding why you're different, and feeling enough trust. To take that first step, you can end up working incredibly hard just to refill the same chairs. So retention matters enormously, but so does making sure the right patients are entering the practice in the first place. So the good news is that part is measurable and can be improved. Now, our, growth partner, Ekwa, has made something available to practice owners joining in tonight called a complimentary Marketing Strategy Meeting. So, I want to be very clear about what it is, because I don't want this to sound like one of those free consultations, where you spend the whole meeting being pitched.

The purpose of this is to look at your practice, your market, and your patient acquisition system.

Before and during that conversation, Ekwa looks at questions like prospective patients searching for the procedures you want to grow in mostly. Perhaps it's school culture, like Cassie just said. What are they seeing when they find you?

How strong is the trust you've built through your website, reviews, and content? And where might the patient journey be losing right before they ever reach your consultation room? So, then the team helps you identify, on the call what appears to be working, where the biggest gaps are, and what you would prioritize first.

And yes, Ekwa is a marketing company. If after going through that analysis, you want to understand how Ekwa could help execute some of it, they'll explain that too. But you are absolutely welcome to take the insight, take the recommendations, and implement them yourself.

That's, important to us, because this… should still be valuable, even if the only thing you ever take from this meeting is the strategy. So, if you're one of the people who wants to attract more of the right patients, rather than simply more inquiries, this is the natural next step for you.

The QR code is on the screen for you to go ahead and scan. We'll put the booking link in the chat below. Choose a time that works for you, enter your details, and you're done. I'll leave this up for just a few seconds, so you don't have to try to remember it later.

Let's get back into our conversation here.

Right. Rinda, walk through what happens at checkout when a patient leaves without a future appointment, who owns that moment, and what should change.

Rinda Ko 00:35:17

Great question, and I think… you know, it touches on a lot of what, you know, both Cassie and Frances were mentioning about that ideal workflow, right? The ideal flow of the provider owning the clinical recommendation The front desk, turning that recommendation into an actual scheduled appointment.

And then I would say, then, the practice manager owns making sure that that process consistently, you know, happens every day, every week, right? Like, has that regular routine in place. And also.

I would say using data and technology. have a way to understand how to do consistent follow-ups. And that's specifically for the folks who, you know, maybe you've done this ideal workflow, where the provider establishes the next step in the treatment, right, based on today's treatment, I'm going to see you again in approximately 10 weeks, or something like that. The, you know, and then they walk.

They walk the patient, right? to the front desk with a warm handoff. Like, Sarah will make sure to reserve this before you leave.

And then, you know, the front desk, right?

Sarah, now, knows.

Right, whether that's your injector, your esthetician, or the surgeon, or a doctor, right, they recommended approximately 10 weeks.

Cassie Pool 00:36:32

Comment down the.

Rinda Ko 00:36:33

18th or 19th of… September, October, November.

And, you know, that's sort of, like, the ideal plan, right? And then the patient's like, okay, yeah, you know, I'll come. there are times when the patient just might not be ready yet, they want to look at their calendar, they might feel iffy about the pricing, or they're not sure yet, they're unsure about the treatment plan and want to think about it, and I think those are all great. it's about capturing that information, right? Like, let's say all of the ideal workflow is placed, but capturing that reason is probably as important, as well as, you know, getting that appointment booked, because that just gives you more personalized follow-up afterwards, right? Creating that next action immediately recording what happened, what was recommended, right? Like, why did the patient not feel ready yet? Because it's okay if they don't feel ready in the moment, right? Even if you want that to be the goal, and you want to be like, hey, like, you can always reschedule, etc.

I think…

When that happens, there should be a process where, at the end of each day, or the start of each week. the practice manager has that list, right? Like, here's all the folks who didn't end up pre-booking, right? Let's see what the reason was, let's see what treatment they had, what recommendation they had, and then, you know, like, do that follow-up call, text, email. that's actually relevant to each person's experience, and that's sort of the ideal way to do that, and I think you can either put that into practice daily, so, you know, the start of every morning during daily huddle, you're like, here's, you know, the five people from yesterday, right, who didn't end up pre-booking. Or maybe it's, like, every Monday or Tuesday, you get a list of the 25 people from last week that didn't. And then you're able to actually work meaningfully off of that information.

And be able to, you know, take that.

And I think turn it from something that's like, oh, I'll call you when I'm ready, to, you know, a proper follow-up, and making the patient feel like they're heard.

Don Adeesha (Host) 00:38:35

An intentional follow-up.

Rinda Ko 00:38:37

No.

Don Adeesha (Host) 00:38:37

Now, just a quick question. On the capturing information part. What's a good workflow to do that? Like, are you writing it on paper? How are you capturing it and storing it so that it is actually useful and not just…

A pile of notes.

Rinda Ko 00:38:52

Yeah, no, that's a great question. I think… there's… whatever you do, you should keep it consistent, right? Like, don't put it in the notes section of one area, in the appointment notes of one section, or a different note, or whatever. Probably the most important thing is whatever that process is, making sure that every single staff member is Using the appropriate field, to get that information, because Once you have that, then you can take Right, like a data connector, right? Wow, for example.

And actually then, like, retrieve that data from that field in order to then have that information sit somewhere that actually can be useful, instead of having to now click through all of last week's patients that didn't reschedule, click through all of yesterday's patients that didn't reschedule, and see what the reason was, right? You want to be able to make sure that there's a system in place Where that information gets aggregated, and you can easily grab it.

And whether that's, you know, for folks, some folks have, like, comments, right? Like, comment section, appointment notes, or anywhere, but…

I would say the PSA is try to keep that consistent within the EMR, and not on a piece of paper, ideally, because…

Who knows, at the end of the day, where that piece of paper ends up, you know, in the process.

Don Adeesha (Host) 00:40:09

It can start off on the piece of paper, but should be entered consistently to the EMRS commit section. Thank you very much for the clarification, Rinda. Frances, a patient reaches the 90-day mark without returning. No alert has been fired, and no one has reached out.

Who in the practice fills that gap first, and how?

Frances Vincen-Brown, LE 00:40:29

Oh, that's a hard one. I would say, again, it comes down to the practice itself and how big it is, and if this was a client that was a return client before that, so that then that, that esthetician or whoever was working on them would notice that gap.

But again, ideally, it comes down to that system that everyone's been talking about. There needs to be a system in place where there's checks and balances, and it needs to be, decided upon with, everybody, how that works, and, does it get triggered, how does it get triggered? This person, you know, like, in the soap notes, again, were they supposed to come back in 90 days, or was it, you know, what was… what was discussed in the initial appointment? How did that end up working out? that kind of thing, so that you would know, how to follow that, right? So it comes down to, from the very beginning, when that person walks in the door, and how that, client consultation goes to the very end when you, when they, check out, right, what that all looks like, and all the steps in between. So again, a cohesive system, between the practitioners and the, Office.

Don Adeesha (Host) 00:41:47

What's the best way to use SOAP notes? What's the best way, in your opinion?

Frances Vincen-Brown, LE 00:41:51

In my opinion, again, there's, like, we have a system that we put it in, that, you know, discusses what we discussed, in the treatment, and again, even if the person who was doing the treatment was busy, that's something that they have to do at the end of the day. I can even give you an example of my son, who's a physician's assistant. That was one of the things that he got trained in for his clinic to train the others, because people weren't so great at doing their soap notes and having their follow-through, and this is a medical… a large medical establishment, right? So, again, it comes down to the training, and how that works, and what kind of system that you have, and then the follow-through that everyone is trained properly in that system. So, in a large clinic, I would say.

Whatever… program that you have, everyone is using it consistently. And again, the other two panelists discussed this as well, right? The consistency of what that looks like, so that it's in the right place, so that it can be tracked, so that it can be followed, and then people put in place to follow it. So, again, comes down to organization.

Of the business itself.

Don Adeesha (Host) 00:43:06

Hmm.

So, you recommend there should be one person in charge of the SOAP notes? Like, being responsible?

Frances Vincen-Brown, LE 00:43:14

I would say…

Don Adeesha (Host) 00:43:15

is sticking to it.

Frances Vincen-Brown, LE 00:43:16

I would say in the training aspect of it, that you would train each person in your office what that looks like. So there'd be one person in charge of training that, right? this is how this goes, this is how they're done properly, this is… we need these every day. Like, if you don't do them right after each client, by the end of the day, however many people that you saw needs to be implemented in. So, it comes down to the training.

Of each practitioner. And then that practitioner, yes, is responsible for their own client's soap notes.

But the training is what, what really, I think, needs to take place, so that it's consistent, consistency across the board.

Don Adeesha (Host) 00:44:01

That's right, that's a great clarification, because I found, like, when you have multiple trainers, they have different expectations, even with regards to, you know, how to implement this, so…

Yes. Throughout the practice.

Yeah. Have you seen that happening?

Frances Vincen-Brown, LE 00:44:16

I'm sorry, what?

Don Adeesha (Host) 00:44:18

Have you seen that happening, like, an inconsistent.

Frances Vincen-Brown, LE 00:44:20

I haven't, but again, back to, again, my son had this experience in a very large, multiple clinic, and they, they came to him to ask him, hey, what are you doing that is, not having medical issues, like people coming back, and having issues, because your notes are so good, and can you train our multi-clinic other PAs how to do this so that it's consistent.

So that's a real-world example of, you know, a very large organization recognizing the need, and that comes down to the same in our practice, right? There's a need there for consistency and follow-through in whatever we do, so that everyone is on the same page, so that there is no loops, there is no holes.

All of that. So, yeah, that's…

Don Adeesha (Host) 00:45:13

That's a great distinction, because, what I understood there is the organization and found your son to be really the champion, who excels in doing this particular task, and assigned him to train the others. That's fantastic, because otherwise, if you don't have someone who's actually excellent in the.

Frances Vincen-Brown, LE 00:45:34

Then you hire someone.

Don Adeesha (Host) 00:45:35

Preach.

Frances Vincen-Brown, LE 00:45:35

Then you hire one of these two beautiful women.

Don Adeesha (Host) 00:45:39

do it?

Frances Vincen-Brown, LE 00:45:40

So, because that seems to be what they do, right? So then you find the people who know how to train your clinic in order to do these things in the proper way so that there is no lapse there, right? You find those stars and you bring them in, to create the team that you want in your clinics for it to be successful.

Don Adeesha (Host) 00:46:01

Right. So, thank you very much, Frances. Cassie, walk us through the end of a strong consultation or treatment visit. What should the provider explain? What should the patient leave understanding, and what needs to happen before they walk out the door to make the next visit feel like a natural continuation?

Cassie Pool 00:46:19

Yeah, so I think what the patient needs to understand is the whole picture. Typically, if we're talking about non-surgical medical aesthetics, that needs to be a time… a length of time. They're… they have a treatment plan. What I typically teach consultants is… have a couple. So, there's, you know.

One that's maybe within their price range. If you give them the best option, this is the next best thing that is going to still… give you what you want, but this would be better. So we want them to understand that timeline, we want them to… we want to understand where they're at. So, one of the most important things is, you know, you don't get blindsided by, well, I have to check my schedule. I think it's very important that you understand what their life looks like, so that you can be integrating this into your conversation about when they're gonna book this? What do they have going on in their life? What do they do for work? All of these things are really important leading up to that finishing, so that you're able to build the plan around their life. They're able to see that happening in their… in their current situation or circumstance.

And you're able to feel them out along the way for where they're at, in terms of finances, in terms of, schedule, in terms of downtime, all of that stuff. And, so you want to know as much about them and their life at the beginning, and then you kind of close that into the end of the consultation, where you're now building that around all of their little hurdles that they… you don't want them having those, and so… you try and build around that. I like to make sure that patients have a very clear written explanation of… and I know this is time-consuming, but, again, I feel strongly about having dedicated consultants, so…

If a dedicated consultant is able to provide them the synopsis of the treatment plan. It doesn't have to be super long, it should be super warm.

I like to provide that to them as well, if they book or if they don't. And…

I like to… we've already built loyalty, they have a sense of loyalty to us now, we have a rapport. I like to ask them for… some sort of response either way. So, typically, if they don't book, I will say, you know, I'm gonna send you an email, and just let me know how you're feeling, or let me know either way. If they do book, I'm still going to send them the whole summary of what we talked about, just to really hit that home and confirm I'm excited to see them, I'm excited for their plan. And I'm also here if you have any questions or I'm not gonna say doubts, but let's be honest, if they have any doubts, we just want to have that open door so they're not spiraling about price or anything like that. So just keeping that… really open communication, and, you know, you're their person. They're gonna get at you with whatever they think about… about this treatment plan. And it costs time, but ultimately, these are the type of patients that will stay with you. They're… they're loyal, and you're their point of contact. So, and I think even to the previous discussion, of, you know, who should be reaching out to these.

Patients that are not returning. whoever they feel a sense of loyalty to. I mean, if they have spent some time with their consultant, and they're the one that walked them through the treatment plan, booked them.

It's them. But if that person did the initial consultation, and now they've been for 5 visits with their esthetician, and they've spent an hour with that person, and that person has a really good rapport with them. then that should be the person. So, it should be, maybe sort of a chain. If there's been no contact since the consultant, whoever they spent, you know, whoever they've built the most loyalty with. And, I think you know, building an SOP for that is maybe a little bit complicated, but at the end of the day, that's probably…

Whoever they've spent the most time with should be the one reaching out, because they'll feel even… that need to say, for whatever reason, I'm not coming back, this is going on in my life, and then you know, then you have that data, and you have that answer.

Don Adeesha (Host) 00:50:44

Well, it's really coming down to doubling down on education across the board, right? Clinical aspect, then to the admin aspect of things. But also, I really like the point you made of making those Treatment plans, and building them around your patient's lifetime.

Because we talk a lot about lifetime value and all that, but this is the way to really capture that lifetime value of your patients. So thank you very much for that wonderful answer, Cassie.

Rinda, what is the first number a practice should pull to know whether their retention is eroding before open gaps appear on the schedule?

Rinda Ko 00:51:22

That's… A very good question.

The… I would say it's that…

Pre-booking, rebooking rate, whatever you want to call that, at checkout.

That's the only retention metric that actually tells you about the future instead of the past.

Right? And…

That's really important, because then that means that that's a leading indicator of how your books are going to look in the future. So it's really important to understand what that percentage of completed patients who leave with or book within 24 hours a future appointment.

I think revenue and calendar gaps are lagging indicators, right? By the time you notice that.

And take action.

You're kind of acting in defensive mode.

Overall retention, you know, takes months to measure accurately.

But having at least that forward rebooking rate.

Tells you a little bit more about What you can immediately do in your practice today, what conversations might need to be tweaked, what processes need to be put in place and refined a little bit, so that as many folks leaving Have an appointment booked.

And you know what the future of your business looks like.

I think, you know, one other key piece of information is… again, like, I go back to this theme of slicing that data so that you're not just looking at it Practice-wide average, right? You want to break it down if you have the time and ability to, or, you know, use tools out there that can help you do that, so that you can understand What that looks like by provider.

By location. By service or treatment category, right?

First time versus returning patients. whether or not they're a member or not. And I think… that… getting sort of detailed and specific enough there is super important, because I think an average can hide the problem a little bit. One person could be excellent at, you know, clinical education, and then… and rebooking while someone else isn't, and I think in order to really instill a little bit more action, accountability, and get that clear information. You want to do a little bit more segmenting of that information so you're clear who's actually helping to push the most pre-bookings, re-bookings. And I think that's really important because you don't want to wait for an empty calendar in a few months. to tell you that your retention was weak, right? You want to get ahead of that. You want to be able to use rebooking not… you know, that rebooking rate is getting like a warning light.

And then, obviously, on top of that, then that completed return rate is also something that then tells you what's going on, and that the engine's actually working properly, and you've got this machine going.

So, in short, the pre-booking, rebooking rate at checkout.

Don Adeesha (Host) 00:54:32

We like that. And then we complete return rate along with slicing the data to ensure that you are aware of who is, You know, doing what, and who's bringing in the, rebookings.

That's a really great point, because I feel like, sometimes the champion might get overlooked, because of just bad overall team numbers, so that's a great point.

Now, Frances, how do you decide which patients warrant a personal reactivation call versus an automated message when…

Staff capacity might be tight.

Frances Vincen-Brown, LE 00:55:09

So, I think it goes back to what, Cassie was saying, that personal relationship, who has that personal relationship, whether it be who did the… if it's in a bigger office, who did the consultation, or if it was the esthetician, or what that looks like, right? And how… who's going to notice that? needing to happen first, right? If you do have a personal relationship, you're going to definitely notice when that person hasn't come back in. And then, yeah, that, chain of… of… relationship of who gets to contact them, right? And that could be something as simple as an email, a text message. It depends on how big or how small your clinic is on how that's run, again, with the system.

But for me, as a practitioner of 18 years and having my return clients, and having that long-term personal relationship, if someone doesn't rebook, I know. And I'm able to reach out personally and have that, that kind of, I don't know, a relationship with my own clientele where it's just me and the checks and balances. If it's a bigger clinic, back to what, Cassie was saying, or they were saying about, you know, systems and what that looks like.

Reaching out and…

Don Adeesha (Host) 00:56:31

Right.

Frances Vincen-Brown, LE 00:56:33

Seeing what the treatment plan was.

Don Adeesha (Host) 00:56:36

It really does change depending on the size of the clinic, but I really appreciate you making that distinguishment as well. It was really interesting, you said, you know, if you have a loyalty towards certain patients, you will notice that, you know, they haven't come around. Do you also have an SOP for that? Like…

Frances Vincen-Brown, LE 00:56:55

Do I have a wet?

Don Adeesha (Host) 00:56:57

a SOAP note to ensure that.

Frances Vincen-Brown, LE 00:56:59

Oh, yeah.

Don Adeesha (Host) 00:56:59

Practice is not just a feeling.

Frances Vincen-Brown, LE 00:57:01

Yes, again, back to that client consultation. Like, what did we discuss? When were they in last? And, you know, the notes that I took, okay, so we talked about this, and we talked about that they needed to come back in, and they didn't need to come back in. And sometimes it is a personal thing that has gone on, right? And so you do have to be very aware of, the obstacles in people's life, the things that occur in people's lives that, might… not bring them in, and when you have good notes, you know, what you've talked about last, and you know, things that might be coming up. And, even if you put. you know, somewhat… not personal, but somewhat personal notes. Like, they discuss that their mom was ill, they discuss, you know, something that is in the notes that are going to indicate, oh, that's definitely probably why they didn't come in, something happened, that kind of thing, so that you can decide how to move forward.

Don Adeesha (Host) 00:57:58

Appreciate that, Frances. Cassie, if an owner admits that invests in improving consultation skills across the team. What should they look for over the next 30 to 60 days to know these conversations are actually building stronger patient relationships and retention?

Cassie Pool 00:58:16

I think if it's done properly, like. bigger treatment plans. So, instead of just one procedure, there should be a number of them. You know, of all age ranges, patients can benefit from a number of treatments. A lot of the time, they don't know about these treatments. It's amazing to me how many clinics have had, you know, certain treatments for a number of years, and some of their regular patients don't even know they have them. So, I think that they should notice patients moving from maybe some of their regular appointments to trying new things, and just more holistic, long-term treatment plans, I think is the… to me, that's the end goal. That's… that patient is staying there, they are going to see you again, they are going to get… they are going to have an improvement. You are going to have that before and after photo to show them there's… it's not just one thing, it's many.

And even if, you know, depending on the discretion allotted to the consultants, you know, even if it means really understanding your margins and being able to build some things in that, Into a patient's budget that you know is gonna give them that wow factor, you know that they're gonna really enjoy, or you know that it's just gonna really enhance their, their entire treatment plan in a way that's… that's not harming you, and it's still… it's still a little bit profitable.

That's… that's the end goal to me. You want that person just loving everything you do, exploring everything you do, and I think a really well-trained consultant is able to just build that big picture for the patients, instead of just like, oh yeah, your problem is lines on your forehead. Well, that's easy, it's Botox.

Well, you know, there's so much more that that person can benefit from, so if you can find a way to make them love it, and also make them maybe be able to afford it over a long period of time if budget is the concern, which it's usually the biggest, you know, the biggest objection. You build them something long-term, make plans with them.

That is the biggest sign of a well-structured consultation to me.

I'll like that.

Don Adeesha (Host) 01:00:48

And, We are tight on time, so I will reserve my follow-up questions. With that being said, since we have arrived at the top of the hour here, I would love to get a one golden rule, from each one of our panelists, 60 seconds or less.

The golden rule for keeping a busy aesthetic practice from confusing activity with genuine patient retention. Rinda, can you start us off?

Rinda Ko 01:01:20

Okay, I'm gonna try to keep it short.

The Golden Wolf is… Get a system in place to, have pre-booking and rebookings in place. Practices don't lose patience all at once. They lose them through a series of small missed moments that compound over time. And so there's something that I would say to focus on is If every new patient is replacing someone who has quietly disappeared. and the practice isn't busy, the business isn't compounding. So please focus on pre-bookings.

Cassie Pool 01:01:59

The reboots.

Don Adeesha (Host) 01:02:01

Great. Frances, what's your golden rule for us?

Frances Vincen-Brown, LE 01:02:05

My golden rule is communication is key across the board. So, from the very moment they walk into the door to the very moment that they leave, and communication across, again, whoever is working with you, so that you guys are all on the same page with this client and that client's journey, and, to, from the beginning to the end, so that they do return.

Don Adeesha (Host) 01:02:31

Cassie.

Bring yourself.

Cassie Pool 01:02:34

I would say, just…

To be honest, the most foundational thing is going back to the basics and, establishing an authentic connection with Everybody that you interact with genuinely.

Genuinely trying to picture them as your mother, or somebody that you care about, and finding a way to… communicate with them that you hear them, and that you care about them. It's something that is kind of slipping away, and it really is a magical thing when you're dealing with patients who are in this industry, for sure.

Don Adeesha (Host) 01:03:14

Thank you very much for that, Cassie.

Great systems, great communications, along with that genuine touch.

What a wonderful… Go on both. of Golden Rules. So, before we end the discussion here, I do want to quickly remind our practice owners in the session, if Your ideal patient is searching for the treatments that you offer. Are you the practice that is found, liked, and chosen?

If you would like to get some clarity on that, go ahead and book that complimentary marketing strategy meeting with Ekwa. The link will be dropped in the chat one last time, and the QR code is on the screen for you to go ahead and scan. It takes less than a minute to book.

Right.

Yeah. So, I would like to take this moment to find out where the people can reach our panelists. Rinda, where can the people, reach out to you and find the work that you do?

Rinda Ko 01:04:21

You can send me an email, Rinda at klyel.ai, you can find me on LinkedIn, Honestly, I'll even give my phone number. I'm always about communicating with anyone who wants to chat more about this particular topic, or any others.

Don Adeesha (Host) 01:04:37

Wonderful. Frances?

Frances Vincen-Brown, LE 01:04:41

You can find me on, Instagram, you could find me on LinkedIn, I'm at, Massage and Skincare Solutions here in Boise, Idaho. Same for the Instagram, and on LinkedIn, it's under Frances Vincen-Brown, and I am happy to discuss anything that has to do with aesthetics and education and communication.

Don Adeesha (Host) 01:05:02

Not bad. Cassie?

Cassie Pool 01:05:04

Yeah, email, info at florencefoundations.com, you can find me on LinkedIn, you can send a message directly through my website, florencefoundations.com, and yeah, I will, just like Rinda, probably get at you by text if that's, an option. It's the best way to communicate with me.

Don Adeesha (Host) 01:05:27

Absolutely. Thank you very much.

Really, I would like to extend a heartfelt gratitude towards our panelists, Rinda Ko, Cassie Pool, Frances Vincen-Brown, for really taking this time to, be so gracious with your experiences and insights. And I would also like to appreciate our attendees and people who are watching on demand. Thank you for investing this hour into the success of your practice. As you exit the webinar, a quick feedback survey will pop up. Please do take It takes us less than a minute to fill it out. It'll let us know how we did, and what we can do better for you in the future. With that being said, it has been my pleasure and privilege to host this session on behalf of Business of Aesthetics, Don Adeesha, signing off. Until next time, take care, everyone. Bye.

Frances Vincen-Brown, LE 01:06:17

Thank you.

Rinda Ko 01:06:19

Thank you.

Business of Aesthetics | Expert Panel Replay Transcript