Pain - expected versus actual differs when it comes to medical aesthetic treatments - survey data

Posted on the 14 September 2011 at 11:52

It is well known, from published surveys and in clinical practice that one of the major concerns of patients visiting a “medical aesthetic clinic” is the degree of pain that might be encountered with any of the individual procedures offered.

As pain is subjective, it can be difficult for a clinician to objectively verbalise, in patient terms, the actual degree of discomfort that any individual may experience – in addition, without some form of measurement we, as clinicians do not necessarily know the level of discomfort that our patients may be experiencing during treatment.

For this reason, in our clinic we chose to undertake an audit. We wanted to assess the degree of expected discomfort that our clients thought they might experience with individual procedures offered, and then assess the actual perceived discomfort that they felt following treatment to assess whether the experience was more of less comfortable than they expected. Monitoring discomfort in this way also gives us objective feedback regarding the actual level of pain felt and whether our protocols for managing this needed to be reviewed. 

Patients were handed a “Treatment Comfort Survey” questionnaire to complete after consultation and consent and immediately prior to the treatment to indicate their expected level of discomfort. Immediately following the procedure, patients were asked to record their actual perceived level of discomfort experienced during the treatment. Standard methods of pain control were used for each procedure.

164 patients completed our pain audit. Across all treatments the average level of discomfort experienced was less than patients expected. This was also true for each of the individual treatments measured.

Across all of the treatments measured, 47% of patients expected treatment to be very uncomfortable or uncomfortable, and following treatment only 13% actually experienced this level of pain.

On average patients found dermal filler treatment slightly more uncomfortable than botulinum toxin treatments, and there were also differences between myself and my wife in the degree of discomfort experienced by our patients.

The Hydrafacial (hydradermabrasion) was, expectedly, the most comfortable treatment experienced by our patients. We identified a slight difference between our IPL, Nd:Yag and Diode equipment used for hair removal with the Soprano Diode laser being the only system where some patients scored the treatment as “Didn’t feel a thing” - although, there was also one patient who found it very uncomfortable, and this one the only patient out of all of the 165 surveyed across all treatments who experienced discomfort at this level.

In our practice, it would seem that patients find the actual treatment less painful than they expect. We are not sure whether this difference is due solely to patients expectation of discomfort when they enter any medical aesthetic establishment offering these treatments, or whether it is pertinent to the information that we provide alongside the consultation process prior to treatment.

From our perspective, however, it is helpful to see that we are delivering more comfortable treatments, on average, than our patients expect and that 87% of our patients found treatment not painful at all, comfortable or slightly uncomfortable. This survey also gives us some objective language for us to use in consultations with patients in terms of discussing the average degree of discomfort that our patients experience with individual procedures.

Using this type of simple survey can help clinics to objectively assess pain experience by their patients and also identify individual differences between practitioners which might be useful from review of pain management protocols and training perspective.

The aim of many medical aesthetic clinics focussed on facial rejuvenation using injectables, lasers and intense pulsed light systems and other modalities is to build a cohort of patients who return annually for effective skin rejuvenating treatments.

Pain is a significant concern of patients visiting medical aesthetic clinics, and we feel that it is wise to, at least periodically, objectively assess the actual level of discomfort experienced by patients in order to manage protocols to ensure that we do not cause excessive discomfort and lose patients.

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