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Dr Imaan Joshi, Suite 9, 42 Bigge Street Liverpool, Sydney (2025)

31/08/2025

In 2025 I’ve struggled a lot with certain behaviours. I hear from my patients who are HCPs that it’s increasingly difficult to provide care when medical mistrust & are common.

Also… I’ve survived abuse & the silent treatment- whether that’s as punishment or as a means of conflict avoidance.

It hurts. It makes me question myself & my worth. It’s taken > a decade to unlearn a lot of that conditioning and to choose to walk away.

It’s also why I choose kindness & clarity - inclg being direct & occasionally abrupt when someone oversteps- over this form of abuse. And it *is* abuse.

I’ve worked to break the cycle & raise my children differently whereby they know that apart from tardiness & not keeping their word, I need signals when we fight due to being the recipient of the silent treatment in the past when I’d get punished more for trying to seek resolution.
- my children know if either of us gets overwhelmed, we take a timeout before we say something we’ll regret (not always possible).
- when ready, they’ll let me know they’re ready to talk.
- then we talk when calmer.
- we apologise if we said anything that hurt the other.
- we remember that it’s not them vs me; it’s us vs the problem.

In 2025 I’ve had disappointing encounters & I’ve seen new patients see me for treatment after disappointing treatment elsewhere without seeking a review there first.

In every case I’ve strongly urged them to consider a review - wouldn’t you want to know if someone was unhappy with you & be given an opportunity to resolve the problem? Even if you decide to end matters, pls do that: for them & for you.

I say this to my patients; to my other patients & I say this to everyone.

It’s cruel to cut people off without their knowing why or giving them a chance to explain their perspective.

So in 2025 especially after June, I’ve asked this of every new patient- I want to know if you’re upset; I want to review you in clinic if you’re unhappy. If you’re someone who’s not comfortable with that I’m not for you.

Your HCPs ideally put a lot of themselves into the work we do with you.

29/08/2025

Jaws is screening at the cinemas to celebrate 50 years since it first terrified the world.

It’s funny how so many things that were radical & terrifying at the time age.

- seriously underwhelming movie for me that demonised sharks
- for a movie about sharks, we didn’t actually see the main character till the last 20%

But. The take home for me: science.
- no foils, balayage etc. Just brown or bleach blonde hair
- the sundamage 🙊 😬

Science & medicine is under attack by Big Wellness atm.

Anxiety is on a rapid rise since Covid.

When we combine the two… there’s an inherent distrust of doctors, of drugs and of science inclg by many HCPs who have alternatives to sell you.

The thing about science as said just yesterday, most of the advances we’ve made are invisible; barely a blip that enables us to live better, live longer & without much accolades.

Like general practice, it’s in the *prevention* of disease that science really thrives, such that you barely notice because *it did not happen to you*.

Yet I looked at these sunburnt, sundamaged faces, ages 25-43 on the screen & compare them in my mind, to representative 25-43 year old skin now, even with less than perfect sun protection.

And for vanity- the quality of hair colouring now, the quality of skin & options available to proactively slow down signs of .

Science shines in:
- doing the work while you barely notice
- the gains compound over time- years and decades- so you look back & think wow 😮

So while I’m not happy I spent two hrs of my life at the movies, I am glad I had an opportunity to look back & go 😮. Science FTW.

27/08/2025

None of this should be news if you’ve been following me for any length of time.

- none of us can look 25 ever again
- we CAN look fresh, approachable & less “hangdog”; these are what I refer to as negative attributes of ageing : feelings evoked when someone looks at you - fear, pity, hesitation, distrust. In many jobs that can impact your career.
- reasons to treat with surgery? Sagging neck or eyebags etc, not mild signs of which is inevitable & may indicate competence & experience.

As we live longer & invest in other ways that make us happy - travel, health, fitness among others- for many it’s just as important to continue to invest in what others see when they look at us; as important as it is for us to like what we see in the mirror.

To me, like with my FFA patients, it’s about ageing proactively, intentionally & on a plan to avoid looking like caricatures of ourselves while delaying or avoiding surgery.

25/08/2025

In 2025 I’ve felt “ugly” for the first time in my adult life.

Disatisfied with the way I’m ageing.

Unlike many of us I’m well aware of the pressure society places on us as women and also that there is no silver bullet when it comes to ageing - face, mind and body- and that reversing damage & slowing down in any of these areas takes significantly more time, energy and effort than seems reasonable.

And yet the alternative is that I do nothing & I continue to look worse, in part due to lack of action. There’s only so much acceptance I’m willing to work on ageing in a way I don’t wish to:
- no longer looking vibrant, alive, energetic & capable.
- no longer being seen as approachable if a bit scary.
- no longer able to work the long hrs i do (paid and unpaid)
- no longer able to keep up physically or increase my risk of injury and falls.

As this woman here says, it’s about congruence.

For me and my patients, it’s always been about congruence between the outside and inside.

Barring those with BDD traits, who defer to my judgement, we aren’t aiming to look 25 again. We do aim to look our best at every stage & for some of us if that includes surgery, then ok.

Like this woman I also say (& tell my patients) if I have surgery, it’ll be in the next 3-5 years before I’m too far gone so I can continue to look like me another decade. I don’t need to be a WOW transformation like women who wait till 65+.

But you do you. And own your choice unapologetically.

21/08/2025

I was shocked the first time I was told by my medical indemnity in ~ 2016 that I could refuse to see a patient if I didn’t believe I could reasonably help them, among other reasons.

I’d been a doctor for 15 years at the stage, and working in private practice for ~ 4 years.

Yet I never knew- through the abusive patients; the men who were creepy in clinic & those who said “you can’t fire me! I pay your bills!”

While rare, I now employ the technique all psychologists seem to be taught, & which I didn’t learn till I began psychotherapy as a patient ~ 2018.

I can say no to any and all requests that aren’t a fit due to the likelihood that I won’t be able to meet them; or because we aren’t a good fit.

Now I simply say “I want the best for you AND because I want the best for you I don’t think I’m the best doctor to help you with this concern;” if they ask why, I may say why, which includes (also allowed)
- refusal to adhere to recommended treatment plan
- repeated cancellations/reschedules/tardiness etc
- finance matters
- inappropriate behaviour in clinic etc

We are taught so much in med school about serving and helping our patients that we were never taught that it’s ok to uphold our own boundaries & to be clear about our expectations of the therapeutic relationship, which can lead to burnout and resentment, which is unfair to the prospective patient & to us.

So here’s a reminder if you, like me, need it in 2025.

14/08/2025

Do you sometimes wonder why it's hard to get an appointment with a female GP? Have you ever wondered what it's like from those GP's perspective?

Professor Louise Stone is a practicing GP, a researcher and educator. In her study "I love my job but it's time to go" she surveyed female GPs who had recently retired or reduced their hours, or who were planning to reduce their hours by at least 50% in the next 5 years.

She and her team were flooded with responses. Click the link below for her review of the data. It makes for sobering and concerning listening.

https://www.youtube.com/watch?v=28vVFOeRjkg

She estimates that approximately 13100 female GPs are likely to retire within the next 5 years, that's 1 in 3 female GPs. GPs who have dedicated much of their lives to their jobs and who truly love caring for their communities are finding that contemporary General Practice is harming their health to such a degree that are unable to carry on. Some of the reasons for this include rising job demands, less job control, increasing vicarious trauma, a growing gender pay gap, excessive surveillance and unprecedented levels of negative press about GPs.

A reducing female GP workforce will result in particular gaps in provision of mental health care, women's health care and complex medical care. This will be catastrophic for patients, particularly our most vulnerable.

To my fellow female GPs, and all GPs working at the coal face. I hear you, I see you. This is not your fault. It's a systems issue and needs a systemic response.

To patients. Please support your GPs where you can. If you think your GP is great, shout it from the rooftops! Perhaps we can start to change the narrative of the "greedy GP who just does referrals and doesn't know anything" which most of use who've experienced great General Practice in action can attest isn't the norm.

10/08/2025

Big weekend in Melbourne/Naarm.

2024 & 2025 have been about stretching in areas other than medicine & 💉 for my own learning & improvement.

This weekend was with & his team on communication skills while being a good person, helping others…

It was eye opening because in person is always better than online/virtually.

I’ve so much to practice towards mastery inclg skills I’ve let go in the pursuit of medicine over decades- public speaking, acting, singing and more. Not because I have to but because they genuinely brought me joy that I’d forgotten…

The weekend was filled with exercises that we didn’t *have to do* but were encouraged to for personal development. As Vinh kept reminding us, change feels uncomfortable because it’s unfamiliar… not because it’s bad.

So many parallels between what he taught us & what I can apply in my day to day… but also the reminder that it’s ok to play, to have fun & to be at a stage in life where we let people in whom we genuinely love.

I came on a low, regretting having purchased the ticket because I was tired… and despite two very long days am leaving … hopeful with excitement.

Like Vinh, sunk cost fallacy isn’t a problem for me… so let’s see where this learning takes me.

06/08/2025

The goal & aim of my signature FFA aka , isn’t a quick fix.

The ageing face & body need more as we age to continue to function at our best- and more.

So with my FFA I screen for people …

- who are looking to go the mile with me & only me;
- who are disciplined;
- who are committed, especially during setbacks;
- who are willing to trust;
- who show up.
- who communicate;
- who follow the plan regardless of their feelings.
- who aren’t overly anxious

It’s a big ask which is why it’s not for most.

This patient began as a model. She was in her words, “the diversity pick” 😜.

Post collab she stayed on as a patient… and > a year later, despite a cold today 🤧 here we are.

The goal of an FFA :
- reverse negative signs of
- improve what’s possible
- maintain year on year

Over time & consistency this looks like ageing slower while looking like the best, harmonious version of you.

Not muttton dressed up as lamb; botched, overfilled etc.

Trust the plan. Show up for the win.

06/08/2025

We’ve all known this on some level for a long time now.

My patient base, for the most part is made up of:
- mostly women 30-60 (& some men)
- to whom is important
- refer to themselves as being “vain”
- are willing to invest in their appearance because it’s important to them
- want the one dr, one clinic to devise a plan for them
- don’t want to look “done” “fake” or “frozen”

In reality my patients vary from mid 20s all the way to late 70s.

They have understood, to some extent, what Glaser 👆🏾 says but also are very clear that they don’t want to look different, or necessarily younger.

They want to look like the best version of themselves & see it as an investment into themselves well into retirement decades away.

It’s an uncomfortable truth especially for those of us who will age in a way that will mean we’ll be overlooked.

So where do we draw the line to avoid the caricatures we see everywhere? I’ll be listening to the podcast episode by & reflecting on how much this aligns with my own approach to non surgically.

06/08/2025

The bane of 80% of young people’s life.

While most will grow out of it, it can leave a lot of damage while we wait for it to go away.
- scarring
- redness (post inflammatory erythema)
- hyperpigmentation (post inflammatory hyperpigmentation)

Not to mention impact on self esteem.

Shared with her consent, my young patient ~ 10mths from when we began in Oct ‘24.

I said to her, as I say to all of you, “give me 3 mths to see if we are on the right track & then 9-12 mths to get to a good place, assuming you do your part.”

Along the way we’ve had wobbles- doubts, mild side effects & “it’s not working, should I stop?”

Each time she’s shown up, she can see what was her mind and what objective improvement is.

I say to you we aim for 60-80% improvement & 80% of that is you doing what you’re supposed to between appointments & showing up as planned.

- no tricks
- no gimmicks
- no silver bullet

Science, evidence, consistency & patience.

Now we maintain …

Dr Imaan Joshi

31/08/2025

29/08/2025

27/08/2025

25/08/2025

21/08/2025

14/08/2025

10/08/2025

06/08/2025

06/08/2025

06/08/2025

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Wednesday	10am - 5pm
Thursday	10am - 5pm
Friday	9am - 3pm
Saturday	9am - 1pm