"What If It Doesn't Work for Me?": Answering Without Promises

A young man with acne scars sits across from a dermatologist in Hyderabad. He's had two rounds of treatment at two clinics already. He asks, "Doctor, what if this doesn't work either?"

There are two easy answers, and both are wrong.

The first is the promise: "Don't worry, you'll see 80% improvement." It feels kind. It's also something no honest doctor can know for a specific patient, and the current NMC guidelines on advertising and public communication take a firm line against promising results. Read them yourself.

The second is the shrug: "Every case is different, let's see." It's honest, but it gives him nothing to hold. He's heard it twice before.

There's a third answer. It's honest and it's useful. And it's the one that gets patients to go ahead.

What is the patient really asking?

Underneath "What if it doesn't work?" there are usually three separate questions:

1. What should I realistically expect? Not the best case on Instagram. My case.
2. What happens if I'm slow, or it isn't working? Am I stuck paying for something useless?
3. How will I know? Will someone tell me honestly, or will I just keep coming?

Answer all three, and the fear of wasting money and hope goes down. Answer only the first, and it doesn't.

How do you explain a realistic range without promising?

Talk in ranges, from your own experience, for patients like this one. And say what moves someone towards the better or worse end.

Doctor: "With scars like yours, most of my patients see a clear improvement in depth and texture, but not complete removal. Some see more, some less. What usually makes the difference is how deep the scars are to start with, sticking to the session gaps, and sun protection between sessions. I won't promise you a number, because I'd be guessing. But I can tell you what we'll measure and when."

Notice the parts:

• A range, not a number. "Clear improvement, not complete removal."
• What affects it. Things the patient can control, and things they can't.
• An honest refusal to promise. Said as care, not as a legal disclaimer.
• A bridge to the plan. "What we'll measure and when."

What the doctor knows about ranges comes from clinical experience and the published evidence for that treatment. That part's yours. My job is to make sure it gets said in a way patients understand.

What happens if progress is slow?

This is the part almost nobody explains in advance, and it's the part patients worry about most.

Decide, before the patient starts, what you'll do at each kind of outcome. Then tell them. A physiotherapist treating a frozen shoulder might say: "If by the sixth session your movement hasn't improved as we'd expect, we'll stop and reassess. We might change the approach, add something, or I'll refer you to the orthopaedic surgeon for an opinion. You won't just keep coming for sessions that aren't helping."

That last sentence is the one patients remember. It tells them you won't waste their money.

How do review points work in the plan?

Write them into the written plan as dated checkpoints. Here's an example for a six-session programme, with the specifics filled in by the doctor:

Three practical points:

• Baseline records are for clinical comparison only. Clinical photos or measurements belong in the patient's record, with consent, so you can compare honestly. They're never used in ads or social media.
• Each review is a booked appointment, not "come back if you feel like it".
• The patient sees the plan for "slower than expected" upfront. What changes, and what it costs if anything changes.

How does this help the patient decide?

Because it turns a big, scary yes into a series of smaller, safer ones. The patient isn't committing blindly to the whole thing. They're committing to start, with honest check-ins where both of you look at the evidence.

Back to the young man with acne scars. What he'd had twice before was a package sold upfront and no conversation after session one. Nobody ever sat him down and said, "Here's where you started, here's where you are." So he never knew whether it was working. He just stopped.

When the dermatologist showed him the review table and said, "At session three, we sit down together and look at the baseline record. If I don't see the change I expect, I'll tell you before you spend more," he relaxed for the first time in the consultation. He booked the first session that day. Not because of a promise. Because of a process.

Say a clinic sees 30 consultations a month for a programme worth ₹36,000, and this objection is the main reason 5 people don't go ahead. If clear ranges and review points help 2 of them start, that's ₹72,000 a month. Treat that as an illustration, not a benchmark. The bigger payoff is lower drop-off later, because patients who know what to expect at each stage are less likely to quit halfway in disappointment.

What should you never say?

• "It works for everyone." It doesn't.
• "You'll definitely see results." No one can know that.
• "If it doesn't work, we'll refund you." This turns a clinical plan into a result-linked deal, which creates its own problems. If you have a refund policy, it should be about services not delivered, and checked with a lawyer, not offered as a sales line.
• "Look at these other patients." Their results don't predict this patient's, and using them to persuade is exactly what the guidelines warn against.

This kind of honest explanation is part of how we train doctors and coordinators in conversion systems. Dermatology and physiotherapy practices hear this question more than most, because their treatments run over weeks and results build slowly.

The short version

• "What if it doesn't work?" is three questions: what to expect, what if I'm slow, how will I know.
• Give a realistic range, say what affects it, and decline to promise a number, kindly.
• Decide in advance what you'll do if progress is slow, and tell the patient.
• Write dated review points into the plan, each one a booked appointment.
• Never promise results or use other patients' outcomes to persuade.