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Ethical Behavior in a We-Kill-Hair World

3 Nov

Many people face ethical issues every day without consideration of it being “ethical” or “unethical.”  An example would be when you drive in your car:  Do you never speed?  Do you speed a little or speed a lot?  One person would never, ever consider breaking the speeding law, while another thinks nothing of speeding “a little” – but would consider speeding “a lot” as wrong.  This collection of ethical situations stems from many years of watching, listening, and reading what others do or say about ethical behavior in the hair removal industry. 

Ethics is a system of beliefs which allow us to determine the right and wrong actions in our everyday lives. The word “ethics” comes from a Greek word meaning “custom” or “habit.”  The habits we practice influence our own perception of ethics, and we view other’s behavior by comparing them to ourselves. For many, the level of “wrongness” is the determining factor in their feeling bad or good about their own behavior while sometimes judging others harshly for similar ethical actions.

Spend a little time on Facebook and you will be asked to take a survey to discover your hippie name, your animal spirit guide, which ancient philosopher best represents you or which character are you in the Hunger Games movies?  The survey for this article provided none of the fun results but provided an interesting story on the perceived ethical behavior and self-reported ethics of 100 hair removal professionals.  The breakdown of respondents is as follows:  44% practice only electroepilation (electrolysis, thermolysis, blend with needle/probe); 44% perform waxing; 4% perform IPL hair removal; 3% perform laser hair removal; 1% performed threading; and 4% practice equal amounts of electroepilation and one other method of hair removal.   

beauty

Hair removal services are a booming business in most cities. An article in Entrepreneur Press names ELECTROLOGIST in the list of “employees you’re likely to need for the day-to-day functioning of your new business.”  Salons, spas, and hair removal clinics offer various methods of hair removal.  These small businesses rely on advertising to bring in the clients and as a result they hire employees and pay taxes.  When consumers interact with a hair removal business, their first question might be about the cost, but they should want to know if this individual is providing excellent work and if they are being honest about their credentials and the results of their offered services.  Consumers might not care to learn if their service provider is a gossip or if they are cheating on their taxes.   

Four questions were at the core of this survey on ethics in the hair removal industry.  1.  How important is it to practice good techniques and skills?  2. Are respondents promoting themselves, their skills and businesses in an ethical manner?  3.  Is gossip and disparaging speech a problem within the profession?  4. Are respondents honest when claiming income and paying taxes?

For this survey, respondents were first asked if choices they make should be considered a measurement of professional ethics.  Over 90% of respondents considered the choices they make in performing services (94.95%); advertising and promoting services (93.94%); and dealing with or speaking of colleagues or competition (96.00%) as a measurement of their professional ethics. 13.27% said that choices made in reporting income and expenses should NOT be considered a measurement of professional ethics and 7.14% were not sure about this subject.  (Note that 79.59% of respondents considered choices made in reporting income and expenses were a measurement of professional ethics.)

When asked their opinion about the action of other hair removal professionals, 79% of respondents stated practicing poor techniques and skills reflected negatively for the whole profession. The survey allowed respondents to comment on behaviors they witness, and practicing poor techniques and skills was frequently mentioned as a problem.  Word-of-mouth reviews can make or break a business, and often, the negative word-of-mouth for a service offered in one business can cross-over to other similar businesses.  Twenty percent of respondents answered that practicing poor techniques and skills reflects negatively for the individual, and one percent were not sure.  Two-thirds (66.33%) of respondents answered that other’s misrepresentation of themselves reflected negatively for the whole profession and over half (55.56%) answered it reflects negatively for the individual when speaking negatively about colleagues or competition. When it came to under-reporting income, 49% answered that it reflected negatively for the individual and 19% answered, “I’m not sure.”

When asked which types of unethical behavior they believe exists in the hair removal industry, a long list was provided for respondents to select from.  The most commonly chosen answer was “Using unacceptable infection prevention practices such as double dipping and lack of sterilization/decontamination.” Other selections included a list of other poor skill practices; types of misrepresentation of education and training; speaking negatively about others; and stealing product, equipment or business from others. Respondents were not asked how often these actions occurred. One respondent wrote, “I know of all the above I’ve checked, but I don’t think it’s an industry standard.”  Another answered, “I think some of these things are done out of ignorance rather than maliciousness.” 

The survey asked, “Which of the following best represents you?”  Respondents were asked if they were more, just as, or less ethical than others. Sixty-two answered they were more ethical than others and four of those respondents answered NO to the first question of the survey: “Do you consider the choices [you] make in reporting income and expenses as a measurement of professional ethics?”  According to NOLO.com the most common way people cheat on their taxes is by deliberately under-reporting income.  Oscar Vela, Ph.D. concluded in his 2008 dissertation on “Tax Compliance and Social Values” that taxpayers stay honest in reporting income largely since that honesty keeps them from losing income, and professions which place the greatest significance on integrity are the least likely to cheat on their taxes. 

The writers of Freakonomics featured theft of wood from the Petrified Forest in several of their podcasts. It seems four times as many visitors stole wood from the forest when there were signs stating “Many past visitors have removed petrified wood from the park, changing the natural state of the Petrified Forest” than when the sign said “Please don’t remove the petrified wood from the park in order to preserve the natural state of the Petrified Forest.”  Amazingly, less wood was stolen when there were no signs.  Robert B. Caldini concluded in his article “Crafting Normative Messages to Protect the Environment” that public service communicators should avoid sending messages that a targeted activity is socially unacceptable but widespread because it causes people to believe that “a lot of people do it, so I can too.”

This article is not written to change the behavior of hair removal professionals, but to propose the definition of an ethical member of the hair removal profession would be one who has character traits that foster the principles of integrity, fairness, compassion, honesty and kindness.  It is a privilege and obligation as a member of this industry to obtain the best education we can and to continue learning – even when licensing and training does not always exist where we live.  It is a privilege for us to speak honestly and fairly about ourselves and others – even though it may be a tough habit to change.  It is an obligation for us to follow the laws of our local, state, and federal government – especially since we are not populated with law breakers.

How do we define our own ethical boundaries?  How do we perceive levels of ethical behavior in other people?  Anyone who has watched Les Miserables can see the “crime” in sending the starving Jean Valjean to prison for stealing a loaf of bread. After prison, he can only live by stealing, but once shown the compassion from a good man becomes a good man himself.  In Breaking Bad, Walter White decides to make and sell meth in order to secure his family’s financial future after a cancer diagnosis.  While both of these men are considered criminals, we sympathize with Jean Valjean, and while we might root for Walter White in some ways, his choices should make us uncomfortable.  In the end, Walter White admits his crimes made him “feel alive.”   Are ethical behaviors simply a way to feel good about ourselves, i.e. not cause ourselves guilt, to feel superior to others, or are ethics a gray area?

If you think ethics is bunk, but perhaps wisdom is your bag, visit this TED Talk where Barry Schwartz talks about using wisdom but not teaching ethics or watch this PhilosophyBasics video on YouTube. 

There’s No Business In No-Shows

16 Jun

INTRODUCTION

This article provides a snapshot of statistics, attitudes and policies on the subject of appointment no-shows reported by a sample population of electrologists from around the world.  The survey was available to electrology professionals in several social media settings.  The problem of no-shows is a universal problem – it does not just happen in the hair removal industry.  Most consumers respect their electrologist enough to provide appropriate notification if they cannot come to an appointment.  It’s only a small percentage of consumers who seem to be disrespectful and cause financial loss to their hair removal provider.  The biggest problem with no-shows is that lost revenue can result in an increase of overhead which contributes to increased prices for all clients to cover that loss.

NO-SHOW DEFINED

A NO-SHOW is a person who makes an appointment and neither shows up nor cancels.  Appointments are made upon the request of the consumer and it is the consumer’s responsibility to show up or cancel with appropriate notice.  Many personal service providers, including electrologists, make a living from appointment driven businesses.  These scheduled appointments establish an agreement or contract for purchasing time, which if missed by the client is time that cannot be sold again. As a result, the service provider experiences a loss of income that cannot be made up.

OFFICE POLICIES     

An appointment no-show policy is one of many boundaries a business must establish.  These boundaries should be clearly communicated to each client before they receive their first treatment.     Electrologists were asked if they had a written policy on no-shows and how their clients learned about these policies.  Nearly 30% of respondents reported they did not have a written policy for no-shows.  However, those respondents were not lenient when clients failed to show up for appointments  – the client paid for the missed appointment or they were not given future appointments. More than 70% of respondents reporting having a written policy for no-shows. Half of all respondents utilize several methods of communicating their no-show policy.  59.9% provide consumers a written copy at the first appointment; 31.82% display it on their website; 27.27% have it on their business card; 18.18% explain it during a phone consultation; 13.64% include a link to their policy in each email confirming the appointment; and 4.55% provide a written copy at each appointment. Generally, clients are considered a no-show after 10 to 15 minutes.  Most electrologists (77.27%) will try calling the client within this time.  Here are some of the messages electrologists reported to send a client upon a missed appointment:    

Watching the Watch

Missed You!

“I tell them I was sorry that they missed their appointment…”

“Want to make sure you are ok since you missed your appt.”

“We were expecting you in for an appointment at … time. We would like to remind you of our cancellation policy. Please contact us when you get this message in order that we can reschedule your appointment.”

“Hi… , I have u booked with us today at… and it is now….  I was wondering if you are on your way, or are experiencing difficulty attending your appointment. Pls call me back on… to let me know.”

“I wanted to make sure we had an appointment today. I had you down for 11am, but perhaps there was a misunderstanding. Just wanted to make sure you were not thinking of coming another day, as I may have a client already scheduled. Please let me know that you are okay.”

LOST REVENUE

There is a difference between the client who misses one appointment out of many and the client who has repeated difficulties getting to their appointment.  We all make mistakes, but the client who repeatedly fails to show up causes a financial burden to the business.  The frequent no-show client should probably reconsider their priorities when it comes to making that appointment. A few respondents take a hard-line when clients fail to show from the beginning.  Nearly 5% require that after one no-show clients are expected to pre-pay for all future appointments.  One electrologist wrote, “They are warned about my lost income and told they will pay for any missed appointments in the future.”  Nearly 15% require that clients will pay for every missed appointment from the beginning; over 18% warn the client about the lost income and expect to be paid for any missed appointments in the future; nearly 14% allow a certain number of no-shows before firing the client; over 27% allow a certain number of no-shows before charging the client; and under 5% do not consider no shows a problem, so the client is not penalized or fired.

ADVICE FOR THE PROFESSIONAL

Here are some tips gathered from your colleagues: 

  1. Consider letting the first missed appointment go without charging the client.   Make it clear in your written policy that “events can occur unexpectedly and, therefore, a one-time missed appointment will not be charged.”
  2. Consider implementing a “three strikes you’re out,” rule and terminate clients who are chronic no-shows.
  3. Excuse missed appointments if the client has a true emergency.
  4. State that future visits may not be scheduled until the missed appointment fee is paid.
  5. Make sure your clients know your office policy on no-shows and late cancellations. 
  6. Confirm, confirm, confirm.  Give clients the chance to give you notice. Confirmation can be in the form of a reminder call, an email, or text message. 
  7. Reward the good client.  They get priority over the “bad” client. 
  8. Train your clients into behaving better.  Ask that client who is always late or is habitually standing you up, “Are you making me a promise you’ll show up at that time?” You’d be surprised how that stops people in their tracks.
  9. Gift your clients with a calendar.

DEALING WITH THE NO-SHOW CLIENT

One respondent shared her message to clients who become habitual no-shows:  “As an electrologist my livelihood is made by making and keeping appointments for my clients. When a client repeatedly fails to keep their appointment then the time and income are lost forever unless they agree to pay for each missed appointment.  For that reason, some clients will be declined future appointments.”

  1. Have the client call on the day they wish to come to see if there is an opening. (No pre-booking.)
  2. Make this client the last appointment of the day.  If they fail to show, the evening starts sooner.
  3. Fire them.  Be firm and polite in letting them know their needs might be better met by a different electrologist.  This client isn’t just wasting time – they are costing money.

ADVICE FOR THE CONSUMER

Remember that most electrology practices are owned by women who help support their family.  These businesses require a significant amount of training and the maintenance of expensive equipment.  The relationship between client and electrologist must be one of trust.  The client trusts that the electrologist will use their best skills to provide permanent results in the shortest time possible and the electrologist trusts that the client will follow the recommendations for treatment, which includes showing up for every scheduled appointment. The “rules” for clients are simple:

  1.  Know the office policy on no shows and late cancellations.  If you can’t live with the stated policy, select another provider.
  2. If you aren’t sure, confirm or decline the appointment.  Permanent hair removal takes a commitment on your part, but remember that postponing treatments will postpone completion of your treatments.
  3. Keep it or cancel it.

CONCLUSION

During the time I’ve taken to put this blog together I have had some very significant no-show losses, which almost made it seem like my focus on the subject made it happen! (I know, I know…it was simply a coincidence.)  Then a colleague wrote she was so embarrassed – she’d slept late and missed an appointment with her eye doctor.  She was thinking she wouldn’t call and could never go see them again.  For me, this was the moment of clarity, as the day before I had two no-shows.  My clients receive an email reminder 48 hours in advance of each appointment so they have no reason to give me less than 24 hours’ notice to cancel.  One client had two four-hour appointments a week apart and 36 hours before the first appointment she responded to my email reminder, “I have to cancel.  I am very sorry.” My response was, “See you next time,” but a week later she did not show, so I called to ask, “Are you on your way?” as she still had time to come.  No response.  I then emailed “missed you,” (which sets the appointment as a no-show in my scheduling system). No response. The other client received the “missed you” email and she immediately texted back, “I’m so sorry!”  The clarity came to me when I realized that an apology for missing an appointment goes a long way in my feeling charitable towards the client who misses.  Did the first client mean to say she was cancelling both week’s appointments?  It certainly wasn’t clear to me, and because of her failure to communicate I don’t want this client to return, as she does not respect me or my  business.  The amount of time lost doesn’t help me forgive this client, but an apology would have gone a long way.

Care and Repair of Stainless Steel Tweezers

4 Jul

Care and Repair of Forceps

By Barbara Greathouse, CPE   December 9, 2009

Image

An instrument used daily by electrologists is forceps, also known as tweezers.  This delicate instrument is used to grasp and extract the hair from the follicle.  Electrologists must be able to trust that forceps are going to do what they are supposed to do, but if forceps are damaged they won’t extract hairs from the hair follicle.  This could result in possible overtreatment of multiple hair follicles before forceps damage is discovered.

History of Forceps

Tweezer-like tools have been in existence since the stone-age.  The first precision tweezers were made for the watch industry in Switzerland in the 1870’s.[1]  These tweezers contained a high carbon content, which made them magnetic and porous.  The advancement of medicine in the 20th century brought the need to manufacture instruments that would not oxidize and could be sterilized.  Stainless steel sheet, the material medical instruments are made from, was developed in 1908. According to the Metals Industry Resource Guide the first patent for stainless steel was issued in 1919 for cutlery.  Swiss made instruments are considered to be of the highest quality available.

There are over 150 grades of stainless steel, with the crystalline structure determining the classification.   The combinations of steel and alloys will depend on the purpose of their use.  Stainless steel instruments will be stamped with numbers and names that identify the grade or content.   Some forceps used in electrolysis will be labeled with INOX, which is the alloy composed of the elements of Carbon and the minerals Manganese, Chromium, Molybdenum, and Vanadium.[2]  The chemical Carbon is a “non-metal” element that allows steel to have increased strength, wear and impact resistance.

Care of Forceps

Forceps are made of stainless steel, but the term “stainless” is misleading.  If not handled properly, forceps can and do stain.  While stains can be removed from stainless steel, stains can cause the damage that leads to rust.  To discover if stains are turning into rust, use an eraser to rub hard over the discolored spots, and then examine forceps for pitting; which means corrosion has occurred.

When blood and debris are allowed to dry on forceps staining can occur, which leads to corrosion, rusting and pitting.  Removing organic material during a treatment will keep forceps free of blood and debris that can be more difficult to remove once it dries out.  Once a treatment has been completed, forceps should be placed in a soaking container with a neutral pH cleanser.  Dish soap, salt, abrasives and chlorines should never be used to clean forceps, as they damage stainless steel, leading to spotting, corrosion and pitting.  Enzyme detergents should be used as they are designed for the crucial steps of soaking and cleaning instruments such as forceps.  Prolonged soaking of forceps can result in surface damage and decrease forceps life, so they should not be allowed to soak overnight.

When extracting an ingrown hair, forceps can invade the skin barrier so proper cleaning and sterilization of forceps is essential.  Studies have shown that ultrasonic devices clean 16 times better than manual washing.  Ultrasonic cleaning is considered the standard for caring for fine instruments such as forceps, since forceps have sharp points and a deep crevice which need the blasting energy of an ultrasonic cleaning device. Dissimilar metals should not be combined in ultrasonic cleaners, as ion transfer can result in etching and pitting.  When placing forceps in containers to soak and clean, make sure that the points are all at the same end of the container.  This allows the tips to be free from bumping up against other forceps which protects the points from damage and helps prevent puncture injuries when removing the forceps from the container.  After 10 to 20 minutes of ultrasonic cleaning, forceps should be rinsed and dried.  Rinsing removes the particles suspended on the surface of the forceps, but if tap water is used, the high concentration of minerals can contain chlorine which leaves water spots on the surface.  Air-drying can cause spotting and rusting, so forceps should be placed on a clean towel and then gently blotted as soon as they are rinsed.  Electrologists should not use chrome-plated instruments as ultrasonic cleaning can cause flaking of the surface material. Forceps must be clean before sterilization as dried-on debris becomes baked-on stains.

Forceps are packaged and then processed by dry heat or autoclave sterilization.  Cold “sterilization” products should not be used because immersing instruments in solutions for long periods can damage forceps surfaces and liquid “sterilants” cannot be monitored for efficacy.  When using the autoclave, forceps must be thoroughly dried before storage to prevent rust formation.  Proper storage, away from moisture and exposure to soil and traffic will protect forceps from damage.

Safety Issues

Electrolysis forceps have very sharp points that could cause a serious puncture wound to the client or the electrologist.  Client eye protection during a treatment will help prevent an accidental eye injury if forceps are dropped.  When forceps accumulate debris, the electrologist should wipe them from crevice to point (one direction only) with wet cotton.  This is the safest way to remove gross soil from forceps during a treatment.   Care in manipulating forceps must also be taken when handling them between treatments and when preparing them for decontamination.

Forceps Repair

As stainless steel instruments age they can soften with use and sterilization, so older instruments might feel different from new ones.  Even well-cared-for forceps will eventually need repairs.  Like any mechanical device that is used frequently, forceps need a regular visual inspection and may need a yearly refurbishing.  An inspection of forceps includes checking for cleanliness, proper alignment of points and evidence of barbs or chips at the point.  Repairs can be done by a professional instrument repair service, which would use the right tools and should provide a quick turnaround of instruments.  A busy practice should have several dozen forceps which helps limit overuse and should help delay the need for routine repairs.

After investing hundreds of dollars in the number of forceps an electrologist must have, it makes good sense to take care of them so they will last.  Good stainless steel instruments should last for 20 years.  Knowledge of the selection, care and repair of forceps will result in a long lasting investment and developing good habits for proper daily care of forceps only takes a few minutes.


[1] http://en.wikipedia.org/wiki/Tweezers

[2] https://www.dumonttweezers.com/Home/Alloys

Infection Prevention Resources for the Electrologist

2 Jun

 

The Six Steps of Instrument Reprocessing –  Best practices for instrument reprocessing is an important aspect of modern health care as it helps to minimize the patient’s risk of infection. This article is intended to provide an overview of the six (6) recommended steps for instrument reprocessing; cleaning, inspection, packaging, sterilization, sterile storage, and quality assurance.

Detailed Infection Prevention and Control Procedures for Electrolysis – Personal services bulletin from Eastern Ontario, Canada.

Health Standards and Guidelines for Electrolysis – Alberta, Canada.

AEA’s Standards over time:

The 2000 Revised Infection Control Standards for the Practice of Electrology were reviewed and commented on by the following: *Walter W. Bond, MS, Consultant Microbiologist, RCSA, Inc., Lawrenceville, GA (Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA., retired),  *Lynne M. Sehulster, PhD, M(ASCP), Microbiologist, Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA,  Victoria Thomas, RN, MS, Supervisor, Allied Health Laboratory and coordinator, Electrology Program, Ocean County College, Toms River, NJ,  Association for Professionals in Infection Control and Epidemiology, Inc., Washington, DC,  *Review and comment does not constitute endorsement by private organizations or US governmental agencies.

2005 Infection Control Standards for the Practice of Electrology