Frequently asked Questions

My practice is a business; I don’t want to screen out all my clients

This is certainly not the intention. We hope by introducing this aid to assessment and treatment pathways we are ensuring that patients get the most appropriate care and treatment. It may be that some clients simply need additional practice-based input prior to a cosmetic treatment, whereas others would do better with a psychological approach to their concerns. Most surgeons/practitioners report that the management of dissatisfied client is both difficult and time consuming and are keen to reduce the occurrence of these situations, which can sometimes be very upsetting for the practitioner, as well as the client.

Who helps clients to complete the PAT in the clinic?

The PAT should be completed face-to-face as part of the pre-treatment assessment. A post-treatment version will be available shortly to guide follow-up. Ideally, the surgeon/practitioner carrying out the treatment should complete all questions in discussion with the client. If this isn’t possible, a clinic nurse with appropriate training could complete the PAT with patients immediately prior to an appointment with the surgeon/practitioner. The surgeon/practitioner should always review the patient’s responses to the PAT as part of the assessment process.

Is there one total score?

It is neither appropriate nor possible to calculate a total score for the PAT. Sufficient longitudinal data currently do not exist to underpin the development of a definitive screening tool, so it would be misleading to make clinical decisions based on a total score at present. Instead, each item is considered independently, together with the client’s overall profile of responses. Each item informs suggestions for an appropriate management plan, and each item can facilitate pre-post treatment comparisons by the clinician.

Will clients deliberately modify their responses on the PAT, believing that the surgeon/practitioner will be more likely to treat them?

This is a potential criticism of all questionnaires, scales and clinical interviews. Whilst we cannot rule this out, the face-to-face nature of the assessment framework makes it less likely. Clinicians are advised to explain to the client that accurate answers to the PAT questions will help them to fully understand the changes the client is seeking and the impacts the client hopes will be achieved. Clinicians and clients share the same goal: that clients are satisfied following treatment and that their expectations of outcome are met, so it is in the client’s interest to answer questions as accurately as s/he can. The PAT questions are intended for verbal administration. If surgeons/practitioners ask their clients to self-complete the PAT questions, the likelihood of response bias is stronger, and the probability that questions and desirable answers will be shared on social media is high.

Do I need ethical approval to use the PAT?

If you are using the PAT assessment framework to improve clinical care, to enhance your client records or as the basis for audit within your own practice, ethics board approval is generally not required. If you decide to use a client’s responses to the PAT as part of a research project, the relevant ethics board must review your methods, patient recruitment protocol, consent and privacy procedures.