Patient has signed up for series of hair removal and is not happy with results so far. Issue: Patient has not finished series but determined they don't work. Patient has not followed prescribed timeline and kept regular appts during treatments. Patient requests a refund. Any advice to keep the peace.

Add up the number of treatments and refund the difference between the single treatment price and the discounted series price... does that make sense? I.E. Patient purchased a series of 6 at a 20% discount from the individual price. Patient came in twice and wants to discontinue treatment. Charge them for two 'single treatments' and refund the difference. Works for me.

I would be sure you spelled out in your consent they must keep all appointments and it take 4 to 5 treatments and it could be a gradual thing, it seems after the third treatment is when people start seeing a real difference for me. I would not refund if my patient selection was good (ie. not blonde, red hair or gray). What keeps this person from going somewhere else for two more treatments and never pay anyone. If you are not getting good results in general I would look into a better device, some seem to not work as well as others or possibly technique.

I can tell you from a great deal of experience that trying both 1064 and 755 nm lasers there were a number of individuals who required up to twelve sessions-- and even then there was not always complete patient satisfaction. The most important thing with LHR- in my opinion-- is a good- realistic- consultation up front. Every human organism is unique and some individuals- for a variety of reasons- do not get good results. Even with dark hair. I found individuals from India and the middle east to be particularly challenging as often the skin is quite dark and the hair quite fine. We have no way of estimating the melanin content of the hair follicles which - it is my understanding-- largely determines the efficacy of the procedure. The patients need to understand that it is often times not the DEVICE but rather their own unique characteristics that often make them poor candidates. I also learned the hard way that doing test spots BEFORE actually treating can save BIG TIME in the long run. According to David Goldberg, for successful LHR results you need to use fluence levels just short of producing an epidermal blister. The only way to safely up the fluence to these levels is to perform several test spots ahead of time. Before and after photos and hair counts- if possible-- will oftentimes show patients that they have indeed reduced their hair count as a result of the treatments.

FYI. The patient mentioned above believed and was convinced the treatments did not work. I advised her to finish her treatments which she paid for and we would do whatever needed to be done (free treatments) to make her happy as well as get desired results. She was convinced they were not working (arms) but was happy with treatments to her legs. We went back and forth until I told her I would refund her money only on the treatments she had paid for but did not receive. She was immediately pissed and wanted a full refund. I refused. She decided she would stop all future treatments as well. I reviewed this with my staff and it was pointed out that this patient was difficult and trying to get a beter deal from day 1. She was an employee in the center and received a friends and family coupon which we offered all mall employees when we first opened. This was not enough and she was trying to get an even bigger discount as well as changing her payment terms. Not the type of clientele we are trying to attract or that we want. Her money is just as green as everyone else but she can keep it as far as I am concerned.