What exactly is the definition of a millennial? We have been taking care of millennials in our dermatology practices since they were born in the early 80s. They brought us their warts, acne, and atopic dermatitis, but now they want us to help with their selfies. The “millennial” is considered one who came of age around the time of the new millennium. They were practically born with a smartphone at their mouth and are shopping for doctors on social media.

There are some negative characteristics of this generation, who can “Google” everything from home remedies to Botox. They tend to have less confidence in physicians overall, often deciding what medical procedure they need based on online searches and what the latest influencer is Snapchatting. They may be more disloyal, going from office to office depending on internet popularity and current trends. They may be impatient and entitled when it comes to waiting for an appointment. They may even threaten to write a bad online review if you don’t do exactly what they want.

On the positive side, millennials are more open minded to new and progressive trends in medicine. They are health conscious and receptive to lifestyle changes. They will tell their friends (and their followers) about what they are doing. They may even do it via live feed.

The Importance of Social Media

Social media has exploded onto the internet scene in the past 10 years, starting with Facebook and, more currently, Instagram and Snapchat. These platforms are literally evolving week by week allowing people to share their experiences with scores of friends (aka followers) in the moment. This has led to huge marketing opportunities for pretty much everyone, whether you are an aspiring artist of some sort or even a physician who used to rely on old-fashioned word of mouth.

Facile Dermatology’s Instagram posts showcase the practice and promotions and also engage the patient with observations on life and encouragement.

Unfortunately, social media has also allowed physicians and even non-physicians to hide behind their “popularity,” often blurring the lines of who the true experts are in this realm. There is no filter (no pun intended) on how you can present yourself on social media. If you have a few sexy before/after photos (they don’t even have to be real!), a celebrity patient (enter any Kardashian), and a savvy millennial social media coordinator on your team, you, too, can be Dr. Popular. Patients won’t know if you are a gynecologist, or an emergency medicine physician, or a physician’s assistant practicing under the supervision of a doctor whom they never met or who lives in another state.

So, How Do I Get Started?

“Let me write this down!” (Whips out smartphone.) The short answer is: Hire a millennial to help you with your social media. This is officially an expertise, and there are a lot of variables that doctors just don’t get. Posts have to be fresh, enticing, and appear to be “real.” Before/after pictures have to be sharp, consistent, and should carry a watermark to prevent theft. Your feed should look elegant and have a flow. You have to stay current, fresh, and tell a story. You should interact with your followers by commenting, answering, and polling. You should cross promote with other local businesses in the beauty and fitness industry. In short, you may not have the time and energy to provide good patient care all day and work on your social media after hours. Most importantly, be real and be you (i.e., make sure that the person managing your social media is being you).

Another easy way to make your office social media friendly is to have something “Instagrammable” in your design. A selfie-friendly mirror, an artful display of skin care products, coffee service, or even fresh flowers are all effective attention grabbers. This will motivate patients to photograph, share, tag, hashtag, snap, gram, etc. your office, creating an immediate referral source.

What About Those Pesky Online Reviews?

The millennial patient who found you on Yelp! is the same one who will most likely be writing your review on Yelp!, and this topic is one that requires its own article entirely. This is a huge obstacle for physicians, because anonymous online reviews are allowed, but HIPAA protection of patients does not permit physicians to respond or, in most cases, even acknowledge them. If something is absurdly false or libelous, the website (Yelp! or other), may remove the review, but most of these reviews sadly survive and continue to contribute to the world of fake news.

The patient experience starts with the person who answers the phone or greets those who enter, continues with the medical visit/service, and is completed by the checkout process and follow up communication. Sometimes, it’s the little things that make the entire process special and make your office unique, whether it’s providing light refreshments or even having phone chargers available in the room (shockingly effective). Until the rules change, the best option may be to simply provide our patients with the best overall experience and medical expertise…the old-fashioned way.

What is Trending in the World of Cosmetic Dermatology?

It may be easier to list what is not trending here. Cosmetic procedures are exploding in this millennial demographic. Bathroom and front seat selfies with unintended shadows and harsh lighting are creating an obsession with truly being your own worst critic. The ability to morph your own features via apps like FaceTune is giving patients their own visual of what the before and after results could be like. We now have a variety of fillers available that allow us to provide shape and contour to areas that were previously enhanced only with more invasive procedures, such as fat transfer and facial implants.

While having “work done” has always been hush-hush amongst the baby boomers, the millennials have removed that stigma by sharing their procedures, sometimes even in real time. The desire for lip augmentation led the way, starting with a certain overdone teenager, but now, facial contouring with everything from highlighted cheeks to chiseled jawlines is all the rage. This trend is gaining momentum so quickly that injectors (especially those outside of the core aesthetic specialties, including mid-level providers) will do anything to be on the cutting edge. “Anything” might include over-atrophying muscles, such as masseters, with botulinum toxin and dissolving buccal fat with deoxycholate. Do we understand what the long-term consequences of these trendy treatments will be? Are we destroying the patient’s elemental structure? I say, “Tread lightly.”

The advances in non-invasive body contouring have also allowed patients who were wary of surgery to get into the game. Want a chiseled waistline? We have cryolipolysis for that! Want more curves? We have injectables for that! Unfortunately, the ability to delegate many of these procedures has put body sculpting into the hands of medical assistants and aestheticians who have little to no understanding of anatomy and physiology. Specialized training in a fellowship or even medical school is going the way of the dodo.

Preventative Care is Key

We have spent years of research to understand how to address the aging face by using the traditional principles of “relax, refill, redrape, and resurface”, but what do we do when the face has only barely begun to age? Using smaller amounts of product, but with the same technique, often does the trick. A keen aesthetic eye and knowledge of anatomy allows for placement of botulinum toxin and fillers where signs of volume loss and dynamic rhytids are just beginning to form. Light resurfacing procedures with chemical peels, microneedling, and light-handed lasers can keep skin healthy, and constant stimulation of new collagen keeps young skin fresh. Preventative procedures are truly new territory in our field and are a great opportunity for us to continue to learn the proper way to proceed.

Educate and Engage

So, how do we educate the patient with too much information at their fingertips that dermatologists are true experts in this field? This boom in millennials seeking aesthetic enhancements is an excellent opportunity for us to make them dedicated to their dermatologist. It is the perfect time to educate on skin care and sun protection. Tell them you promise they will thank you later. Many of these patients need treatment for acne, acne scars, and melasma, even if they are skilled with just “covering it up with make-up.” Educate them on the need for regular skin exams and self-awareness of nevi and other skin lesions. Educate them on why having a reputable dermatologist as their provider will allow them to have the safest, most well-studied, and effective treatments for now and the long term. This is an opportunity to have a lifelong relationship with your millennial patient.

Nancy Samolitis, MD is co-founder of Facile Dermatology in West Hollywood, CA.