Fear of Missing Out

In recent years I've been seeing the term “FoMO,” for “Fear of Missing Out,” hashtagged, tweeted, and blogosphered into common parlance. A very human reaction, FoMO is defined by Wikipedia as “a pervasive apprehension that others might be having rewarding experiences from which one is absent.” In our professional lives as aesthetic physicians, we are at times both victims and perpetrators of this apprehension. This extends to how we approach purchasing and adopting technologies all the way to how we sell our own services to our patient populations. We may induce FoMO for our patients when we emphasize the scarcity of appointments for a “Liquid Lift” party (“Limited availability – Call Now!”) just as vendors of the latest laser box, search engine marketing widget, or fat melting wand sell us on the fear that our practices are suffering in a competitive marketplace unless we race to employ the same toolkit that our next door neighbor uses. FoMO is a powerful motivator and may drive bad business decisions when it comes to technology adoption as there is a perception that the aesthetic market is a “zero-sum game”—there are only so many patients available; every one who selects a competitor is one fewer for you (never mind that none of us offers infinite capacity and there is a finite number of hours in the day). How can we guard against FoMO in building and growing a practice's infrastructure, technologically and otherwise?

One important early step is to understand how to capitalize on your available medical real estate and to maximize the square footage of space being put into the service of care and revenue generation. A 400 sf waiting room (we should really refer to these as reception areas and not waiting rooms; I don't like waiting, so why should my patients?) in a 2000 sf facility represents 20 percent of real estate capacity wasted unless it is generating revenue, commonly by helping you close more cases (with a running before/after results reel, skin care products for sale using a vertical display case to limit the footprint, for instance). Dividing the reception area in half and turning the remaining 200 sf into another procedure or consultation room concentrates more square footage into a revenue-generating side of the practice on the other side of the clinic door. Similarly, a $200k noninvasive fat-removing-skin-tightening-life-affirming “electric box” that you fear missing out on marketing to patients (or fear looking less state of the art than your neighbor) may not be a wise investment. If it is sitting idly in a treatment room most of the day, or being used principally by the physician a few times a week, it is poorly amortizing back its acquisition cost as opposed to being run by lower wage but qualified ancillary staff (check your state guidelines on this) with maximally frequent appointments every day. Perhaps that room is better served by foregoing the electric box entirely, giving you more physical space to comfortably perform injections with no amortization requirement and a direct pass-through of consumable costs and a recurring revenue opportunity through repeat visits for maintenance injections. Curtailing FoMO on the latest electric boxes is as difficult for some of us as avoiding rushing to the Apple Store every time a new dazzling iDevice is released, but it is doable if you understand the drivers of profitability in your office. While we're on the subject of dazzling, is a gorgeous Shangri-La office space in a building with 40 other cosmetic surgeons an unnecessary luxury expense on overhead or will that prestigious address support a surcharge on your fee rates? Is it possible you could actually depress your market share by co-locating in that crowded building?

On the software solutions side, consider whether an expensive and space-consuming computer server is really necessary in an era of cloud-based technologies. Are you inclined to use a software product used by your colleagues just because it's popular and therefore ostensibly vetted by a market of your peers, or are you throwing your good money after their bad dollars on functionality that is outdated or not tailored to your specific needs? Do you really need morphing or result-simulators that look like motion capture devices on the set of the new Star Wars movie to sell breast augmentations? Does it measurably result in more closed consults? If you believe the answer is yes, have you tested that hypothesis post-purchase?

Are you accosted on exhibit hall floors by purveyors of lotions and potions promising your patients glowing skin and your practice glowing testimonials, and are you willing to ignore the fact that the skin is a barrier and accept, at face value and with no mental strain whatsoever, the merits of a skincare line's ingredient list for fear of losing a revenue stream to beauty stores? Will you sell FoMO to your patients in pursuit of high inventory turnover and can you back up the manufacturer's claims that the product is not a modern version of snake oil?

These questions are posed with deliberate cheekiness: we as aesthetic surgeons are stewards of evidence-based and precision medicine, tailored to patients' unique features and needs and informed by years of rigorous training and critical assessments. Treading the boundary between reinforcing a brand of state-of-the-art image-consciousness vs. selling FoMO to our patients can be just as challenging for us as resisting the emotion ourselves. By staying focused on sensible financial decision-making and careful merit-based vetting of technologies, we can maintain our practices' integrity and viability. Now if you'll excuse me, I have to go buy a stem-cell harvester I just saw on QVC… Supplies are limited.

Tim A. Sayed, MD is a double board-certified plastic surgeon who practices in San Diego. He is also an Executive Committee Member of HIMSS EHR Association.