This is the practical page. Print it, or keep it open on a phone. The questions are grouped in the order they are useful, which is not the order a consultation naturally takes.
Candidacy, first
1. What would make you decline to treat me? The single most informative question available. A practitioner who can describe the people they turn away is describing a clinical assessment. One who cannot is describing a shop.
2. Which tissue is producing what I am unhappy about: fat, skin, muscle or something else? If the answer is vague, the assessment has not been done. Our guides to skin laxity and the two fat compartments will let you check the answer.
3. Does this treatment act on that tissue? Ask it directly, as a yes or no question. A great deal of unhappiness in this category comes from a treatment that acted on a different tissue from the one causing the concern.
4. Is my weight stable enough for this? If it is not, the sensible answer is to wait. A clinic that treats you during a period of weight change is treating a moving target.
Mechanism, second
5. What device is this and what does the manufacturer state it is intended for? The stated intended purpose is a fact, and comparing it to what the clinic says it does is informative.
6. Is the effect produced by destroying tissue or by provoking a response? This determines whether you are buying a banked or a maintained effect, and therefore the real cost. See what happens when you stop.
7. Describe in words what a realistic change looks like on me. Not photographs of other people. Words, about you. A practitioner who will not commit to a verbal description has told you something about their confidence.
8. What proportion of the people you treat see little or no change? Every treatment in this category has non-responders. A clinic that claims none is either not measuring or not saying.
The people, third
9. Who will assess me, and who will operate the device? These are frequently different people and sometimes neither is a registered healthcare professional. In most of the United Kingdom there is no general legal requirement that they are, which we cover in how these devices are regulated.
10. What training and registration do they hold, and what is the registration number? Registration numbers can be checked free on the public registers of the GMC, NMC and the other healthcare regulators. Where the practitioner is on a voluntary register such as the JCCP, that can be checked too.
11. Who is clinically responsible if something goes wrong at the weekend? A name and a route, not a social media account.
12. What indemnity arrangements are in place? An ordinary question for any provider of a service that can cause harm.
“There is no need to overthink it. Most people just book and see how they get on.”
What would have to be true
- That a procedure with a biological effect and a recognised contraindication list is a low-consideration purchase.
- That proceeding without assessment is an acceptable default.
What is actually established
- Every mechanism in this category has contraindications, several of them serious.
- Advertising rules address the trivialisation of procedures carrying clinical risk.
- Consent requires that a person is informed about risks and alternatives before agreeing.
Discouraging consideration is the clearest signal available in a consultation. Anything said to shorten your thinking is being said for the benefit of the person saying it.
Money, fourth
13. What is the total cost of everything you are recommending, including maintenance, per year? Use the method to convert whatever you are told into a comparable figure.
14. What happens to unused sessions if I stop, move away or am told I am no longer suitable? Get this in writing before paying.
Failure, last and most important
15. What is your written policy if I am not satisfied, and can I have a copy before I pay a deposit? The answer to this question, more than any other, tells you what kind of business you are dealing with. A written policy that exists before the money moves is a completely different situation from a conversation about goodwill afterwards.
The five that matter most, if you only ask five
- What would make you decline to treat me?
- Which tissue is producing what I am unhappy about, and does this treatment act on that tissue?
- What is the total cost of everything you are recommending, including maintenance, per year?
- What happens in the twelve months after the course if I have no further treatment?
- What is your written policy if I am not satisfied, and can I have it before I pay a deposit?
Ask them by email before the appointment where you can. Answers given in writing, without pressure, are more reliable than answers given in a room, and having them in writing is useful later if anything goes wrong.
Reading the answers
Three responses are worth treating as answers in themselves.
A discount. If a question about outcomes or refunds is met with a reduction in price, the business has told you that the price is a lever rather than a value.
A deadline. If the offer changes because you did not decide today, the deadline was constructed for that purpose. There is no clinical reason for urgency in this category.
A compliment. If a question about candidacy is answered with a remark about how you will look afterwards, the assessment has been replaced with flattery.
None of these require you to be rude or confrontational. You can simply say that you will think about it and leave. The offer will still exist next week, and if it does not, you have learned what it was.
The default position
Decline to buy at the first appointment, and say so when you book it. This single decision neutralises every pressure technique described anywhere on this site, costs nothing, and is the closest thing to a consumer protection that currently exists in a sector with no licensing scheme in force.