Home' Clinical Aesthetics : CA issue 4 Contents BEST PRACTICE
photos part of their process for ever y patient.
“ This may require making it part of KPIs for staff. The clinic
should outline a standard procedure for taking photos that is
followed ever y time.
“Many patients don’t want to come in for their final photo after
the course of treatments has finished and have achieved the results
“It is worth considering including a margin in your price for a
gift voucher for a special treatment so that they have a reason to
return and allow you to take the final picture.
“The value of a good library of B&A photos will far exceed any
cost of doing this.” HIGHTECHLASER.COM.AU
If you intend using the photos in marketing, consent of patients
should be obtained in writing and make sure the photos are stored
securely in compliance with privacy laws, as would any other
confidential patient data.
When you use the photos for marketing, make sure that it is
clearly stated that they may not be copied or distributed.
It is also of value to make the point that the photos are of
actual patients treated at your clinic - this can be a powerful way to
separate you from other providers who use stock B&As.
Registered health practitioners should also ensure that the use
of the photos complies with advertising regulations to avoid being
penalised. To this end, Visit: AHPRA.GOV.AU/PUBLICATIONS/
KEEP UP STANDARDS
For B&As to be credible, the procedure for taking the photos
needs to be consistent in terms of lighting, the camera used, the
way patients are dressed, the positions, the distance the photos are
taken from, the amount of zoom and so forth.
Hav ing a simple protocol for patient photography is essential,
according to dermatologist Dr Kenneth Beer, who explains :
Take steps to standardise not only the method of getting
representative photographs, but also of storing/cataloguing them
for efficient retrieval for presentations and patient use.
The key to this is to simplify the process and make the number
of photos required for each patient uniform.
One of the most important aspects of medical photography -
more important than equipment or software - is to standardise the
poses of befores and afters.
" This way any team member can take pictures that are of
publication quality, .
For instance, a standardised pose for a patient receiving
injections for nasolabial creases includes a:
• Frontal image
• 45-deg ree each left and right image
• 90 -degree each left and right image
In order to guarantee that the angles are the same for each
45-degree photo taken for a particular patient, the patient should
be instructed to turn their head until the tip of the nose overlaps
with the edge of their cheek.
The 90 -degree pose should be taken with the person pointed at
a right angle to the camera.
The full-face images from a particular patient should have the
same content without needing to be cropped.
My standard protocol is to take a shot that spans from the frontal
forehead to the bottom of the chin.
A common problem I have seen is the use of various
backgrounds within the office.
Problems posed by this are multiple, but the most important
is that the focus of attention for a photograph may be on the
wallpaper of the examination room or the laser sitting behind the
patient rather than on the clinical image.
A second problem is the shadowing that will occur w ithout some
material behind the subject.
Finally, most digital cameras use a computer weighting system
that will focus partially on the subject and partially on the wall
behind them, blending the distances and focusing on neither.
It will pay you, literally and figuratively, to invest in equipment that
will fulfill the specific requirements of before and after photography.
Now get snappy!
DON’T STICK YOUR HEAD IN THE SAND
As mentioned, before and after photos can be powerful
ammunition if a patient complains they have not achieved the
results they expected, or indeed claims a treatment has created
An example of the latter might be that a patient says they
have a dark skin spot that didn’t exist prior to their treatment for
B&A photos might show that the spot was always there, but
now that the rest of the skin is lighter and more even-toned, the
spot is just more obvious than it was.
As unpleasant, even intimidating as it is to have a patient on
the warpath unhappy with their results, as unreasonable as you
might think they are (or indeed are) being, don’t ignore them
and hope it will go away.
The longer you postpone dealing with a bad situation, the
worse it can get – and even provoke legal action that could have
Maintaining as good relationship with clients as possible often
works better than the best informed consent in these situations!
Invite them into your office and sit them down for a
discussion, so you can assess the situation close up.
Offer niceties like coffee or tea and be as welcoming and
convivial as possible.
Hear them out, making notes and asking pertinent questions.
Try to avoid being defensive or responding to inflammatory
accusations - unless of course it becomes so intolerable or risky
that it would be best you politely asked them to leave.
Take photos of the patient to record the issue that they are
unhappy about. To this end, it is best that you have taken photos
before treatment so you have a reference point.
Without admitting culpability, offer remedial suggestions
– u nless you truly believe their complaints are fabricated or
w ithout foundation.
Document your notes and photos and call your insurance
provider and/or legal advisor re further steps.
CLINICAL AESTHETICS | 21
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