Wendy Lewis takes a deep dive into patients’ mindset when making choices about products and treatments

What influences a consumer’s decision to buy or not to buy? It’s actually a complex process that usually involves multiple steps to go from thinking about it to acting on it. Consumer behaviour defines how people make decisions about what they buy, want, need, or act regarding a product, service, or company. The three major factors that affect consumer behaviour can be broken down into psychological, personal, and social.

Understanding how your patients think can go far to help your practice thrive. You may have taken a few psychology courses in college. Well, those basic tenets of human behaviour can go far in making you a better marketer and a smarter practitioner as well.

These actions are determined by psychological as well as economic factors and may be influenced by environmental factors such as cultural, group, and social values.

Impulse purchases

Aesthetic treatments are not typically considered an ‘impulse purchase,’ as in something patients choose on a whim. Rather, they tend to fall at the opposite end of the buying spectrum. It is more often a ‘considered purchase;’ one that patients think about, research, ask for recommendations, and spend time seeking the information they need to make a purchasing decision.

Patients today may need a number of different messages to convince them to take the plunge. The magnitude of a purchase in the eyes of the buyer will impact how you market your practice and services.

This behaviour also differs among patient groups. For example, consider the sales cycle of millennials. They migrate from awareness to discovery to purchase at a very different rate than their parents. They are typically very price conscious, often frugal, and adept at finding information. In fact, they may go online right in your practice to check out a product or treatment that is being recommended. They tend to be influenced by their peers, compare notes, check out reviews and photos with religious zeal, and are not shy about asking for deals, discounts, or refunds.

Did this ever happen to you? You do a skin exam on a 25-year-old female who is complaining of acne lesions, uneven pigmentation, and redness. You offer up a diagnosis of moderate acne and recommend an edited skin care regimen from a leading clinical brand that you dispense. While you are still talking, the patient proceeds to go on her phone to check out the best price and read the reviews.

The why

The reason a person is shopping also affects the amount of time they will spend shopping. Are you making an emergency purchase? What if you need something for an important dinner or a project and only have an hour to get everything? Are you shopping for a gift for a special occasion? Are you buying something to complete a task/project and need it right away? In recent years, walk-in urgent care clinics have sprung up in shopping centres and neighbourhoods all over the country. Convenience is one reason. The other is sheer necessity. If you cut yourself and are bleeding profusely, you’re probably not going to shop around much to find the best clinic. You will go to the one that is closest to you that has the shortest wait time, which is not the ER at the nearest hospital. The same concept kicks in when you need to purchase something immediately.

At one end of the buying spectrum is the ‘impulse buy;’ quick and easy decisions, such as ‘My friend had her lips done and they look great, so I need to get mine done too.’

Impulse buys are typically:

  • Low risk
  • Involve a relatively small purchase amount (hundreds of dollars rather than thousands)
  • Do not take much time to schedule or undergo
  • Don’t impact on other people; i.e., family, work, romantic partners
  • Can be either functional (‘I need a steroid injection for an acne cyst right now!’) vs. emotional purchases (‘I’m turning 40 and I want my jawline to be firmer’), but not both.
  • Considered purchases are at the other end of the spectrum entirely. For these, patients will take more time to go from ‘I want’ to ‘I need’ to signing up for the procedure. 
  • For example:
  • Major surgery or procedure (ablative resurfacing, breast reduction, facelift, tummy tuck)
  • A series of relatively expensive treatments spaced at specific intervals, such as tattoo removal, injectables, or non-surgical body sculpting
  • Investing in an intensive skin care programme from products to peels to energy-based treatments.
  • Considered purchases are more complicated so patients will take more time to do their homework, see more practitioners in consultation, and ask around for referrals and check reviews to avoid making a bad decision or one that they may regret.
  • These decisions may be affected by:
  • Cost — the more expensive relative to the patient’s budget and lifestyle, or higher ticket price
  • Time — time commitment involved including visits to the practice, suture removals, downtime and recovery, possibility of revisions needed
  • Who may be impacted — friends, family, bosses, work colleagues, etc.

The role of emotion vs. logic

If the decision is both logical and emotional, the buyer may slow down the process. For example, a mommy makeover needs to fit into both the patient’s schedule and her husband or partner and children’s lives. It has to be a safe choice to avoid taking any undue risks to the patient (that is the logical component), but it also has to feel like the right decision for the family in terms of the expense, downtime, results, possible stigma in the community or with family and friends (all of which make up the emotional part).

The more considered the purchase is on the emotion vs. logic spectrum, the more important it is that you support your patients through the decision-making process because there are more details they need to consider. The cycle may also take longer to conclude due to the emotional component. In these cases, patients may put the decision off for several months to many years.

Patient behaviour explained

Consumer behaviour is influenced by many things, including environmental and marketing factors, the situation, personal and psychological factors, family, and culture. Once you get a handle on trends, you can reach the people most likely to buy your products in the most cost-effective way possible. First, try to influence consumer behaviour with things you can control, such as the layout of your practice, colour and furniture selection, grouping and availability of products, signage, pricing, and promotions.

Among the myriad factors that affect how customers behave—what influences them to make a purchase, buy additional products, or buy nothing at all — is their social situation. For example, if a few ladies at the Orange Theory at the mall are going to a nearby salon after their workout for a mani/pedi, chances are that some others will get swept up in this plan unwittingly by peer pressure or FOMO (‘fear of missing out’).

The time of day, time of year, and how much time consumers feel like they have to shop also affects what they buy. Being a ‘morning person’ or ‘evening person’ can impact an individual’s buying patterns.

Purchasing a gift might not be an emergency situation, but you might not want to spend too much time shopping for it either. This is why gift certificates are so popular. You can purchase gift cards for numerous merchants everywhere from your local grocery store or online 24/7. By contrast, when you are considering a holiday destination the decision may involve other people and it is more personal. Sure, you could find something online quickly, but you probably want to spend more time researching all the options and reading reviews before you make a final decision. What if the hotel isn’t kid-friendly or too far from the beach for your liking? What if the added resort fee breaks your budget or there are no direct flights to the destination? These considerations all factor your ultimate decision.

Our moods also affect our shopping and spending patterns. Have you ever felt your heart skip a beat when you drive past an outlet mall and see the words ‘CLEARANCE SALE’? While at other times you can’t be tempted to deal with crowds, sort through racks or try things on? Some people actually enjoy shopping; it’s a form of entertainment for them. Compulsive spenders may get a temporary adrenaline rush just from finding a great deal.

Moods can also thwart a consumer’s desire to shop and spend. When there is a threat of a pending recession, fear of layoffs, interest rates skyrocketing, or a dismal news cycle, people tend to worry more and spend less. To get clients into a buying mood, many practices and medspas go into panic mode and start slashing prices, introducing less pricey brands and products and bundling treatments. This is rarely a good strategy. A better response is to consider what motivates your customers to come into your practice and run with that. Take a less hard sell and more educational and nurturing approach. For example, plan a ‘Patient Appreciation Event’ and offer guests mini-treatments and free consultations to encourage people to come.

How patients make a purchasing decision
Problem recognition

The process begins when a consumer identifies a need or a problem. In all stages of life, we are customers of one company or another and the older we get, the more requirements and needs we have to be fulfilled. These requirements may be low involvement ones or high involvement ones. The first step of consumer buying behaviour starts when the customer realises that he wants or needs something.

Information search

Once a consumer realises he wants/needs something, the next step is to get more information. For instance, someone buying clothes will visit more stores or search online. The same goes for a prospective patient seeking an aesthetic treatment.

Some purchases require the customer to gain information for the first time, but after that, it may no longer be necessary. This may be true of a cleanser or a body wash, but not necessarily an anti-ageing serum, for example. The former are examples of low involvement purchases because their impact on the consumer’s life is minimal. Whereas getting the right cosmeceutical range for their facial skin will have a great impact and is a more considered purchase. 

However, having something done to your face lies at the opposite end of the spectrum. The extent of information search depends completely on the level of involvement of consumers in the purchasing decision. The major source of information and the sources which influence consumer buying behaviour heavily are friends, promotions, reviews, and experience.

Evaluation of alternatives

One way to consider how consumers evaluate alternatives is in stages.

Let’s look at dermal fillers as an example. 

  • Filler products in the market (Restylane, Juvederm, Belotero, Radiesse, Sculptra Aesthetic, Revanesse, etc)
  • Products she knows about (Restylane, Juvederm, Belotero, Radiesse)
  • Products she would consider (Restylane, Juvederm, Belotero)
  • Products she prefers (Restylane, Juvederm)
  • Product she chooses (Restylane).
  • Products may be rejected based on price, features, benefits, availability, reputation, etc. In medical aesthetics, the grid will often be narrowed down based on the advice and suggestions of a practitioner.

When a patient has all the information she needs, she will then consider alternatives and weigh the factors against each other. This tends to be easily facilitated online because consumers can readily compare what each product offers.

Other factors that may impact a patient’s selection of choices and alternatives include finances, status, social circle, and psychographics. Among the 5 stages of the consumer buying spectrum, this stage is the trickiest. At this stage, the patient can be most influenced, and may choose one of three things; decide against having anything done, choose a different product or treatment among the alternatives on offer, or select another practitioner.

Purchasing decision

Once the patient has considered the alternatives of each product, she will have her own internal struggle as to the factors that are most important. So, while buying shoes, one woman (or most women) may think that the style and look of the shoes are the most important feature, whereas others may primarily desire a pair of shoes they can comfortably walk around in. So, their priorities are quite different but equally important to each consumer. The former wants a great looking pair of shoes primarily, and a pair she can walk in secondarily, whereas the latter ranks comfort first and being fashionable is lower down on her wish list.

This purchase is influenced by many factors which also play a role in the evaluation of alternatives. For example, the fashionable shoe buyer may not have a big budget, so she won’t consider a pair of Jimmy Choo’s because they are too expensive. Rather, she may look for Jimmy Choo’s on the sale rack or consider Jimmy Choo inspired heels which fit better into her budget but also offer the fashionable look she desires. 

So, the consumer may consider all the alternatives, choosing which factors are most important to her, and then make a purchasing decision. In this way, the choices she makes depend on the values, attitude and lifestyle that defines her.

Post-purchase behaviour

Practitioners obviously want patients to be happy even after they have a procedure (i.e., make a purchase). If the patient is not happy, he or she is likely to leave the practice and never come back. The worst case scenario is that the patient posts a negative review and tells anyone who will listen about his or her bad experience, which can have lasting effects on your brand.

Hence, practices may take proactive steps to keep patients satisfied so that they are happy and stay with the practice. These are tactics that ensure that post-purchase, the customer remains happy. This is called CRM, or customer relationship management.

It’s all about the experience

Aesthetic patients catalogue each experience they have as either good or bad. Then they may recall that experience and how they categorised it when a similar situation arises. These experiences influence their behaviour by changing the way they react to products similar to those they’re familiar with. For example, many aesthetic patients choose to have a particular injectable product like BOTOX® or Restylane® because they have had good experiences with these products previously1.   

Practices that focus on the consumer experience will earn repeat business from those customers because they don’t need to look anywhere else to solve their specific problem or meet their needs. A prior 5-star experience has the power to outweigh the fact that the competition may be cheaper, closer or faster.



  1. Sisk A. Psychological Factors That Influence Consumer Buying Behavior. Bizfluent. June 2018. Available at: https://bizfluent.com/list-7599973-psychological-influence-consumer-buying-behavior.html