Hedgehog or Fox: What Type of Aesthetic Practice Will You Choose to Be?

The year was 1953 and Isaiah Berlin wrote an essay meant to entertain, not to wax poetic. But that is exactly what ended up happening. Folks couldn’t stop talking about which creature might be representative of themselves, or of situations— in life, in business. The name of the essay? The Hedgehog and the Fox.

The hedgehog has a single-minded focus. One might say a laser focus. He knows one big thing. Combine the single great thing with a hedgehog’s talent and abilities, allow the cream to rise to the top, and some will argue how success could not triumph. The fox, on the other hand, is not satisfied with singularity. There is a buffet of experience and possibility from which to select in order to reach the pinnacle of success. Life is multi-faceted, and limitations can only weigh a person down.

Berlin himself classified famous personas such as Plato, Nietzsche, Marx and Lincoln as hedgehogs, and alternatively considered Shakespeare, Aristotle and Tolstoy to be foxes.

As you embark on the story of building your aesthetic practice, you will make many decisions. You will create it. You will give it life. You will define it. Will you choose to be a lumper or a splitter, as my dermatology professor used to say? Will you be a hedgehog or a fox?

Will you remain more singularly focused and become known as an expert for one procedure or service? Perhaps you will become known as the hair loss expert and perform hair transplantation, bringing patients from near and far. Maybe you will be applauded for your results in body sculpting.

Alternatively, you may choose to give many offerings to your patients which you have learned to do very well. Perhaps you will offer a broad spectrum of injectables, neuromodulators and energy-based devices to be used as solo treatments, or in combination, to achieve the best outcomes you envision for your patients.

How will you compete in the marketplace? How will you differentiate yourself from other aesthetic practices? How will you allocate startup costs, including the purchase of devices and lasers? Will you have the luxury to purchase everything initially, or can some items be purchased in stages? Will you choose to place financial assets towards social media, your website or both? What about third-party marketing? Labor dollars? What staff positions do you actually need initially, and what type of training is critical to their success?

These are all questions I have asked myself, and there are no right or wrong answers, my friend. Because some of us are hedgehogs and some of us are foxes. Our instincts…the way in which we are created...is our innate way of being. Only we can live the set life before us.

Only we can develop the aesthetic practice perfectly suited for our specific patients.

But, for now, I leave you with a story. Team USA had not won an Olympic medal in men’s gymnastics in 16 years. In 2024, they took on 26-year-old named Stephen Nedoroscik because when it came to his pommel horse skills, no one could compete. He was, in fact, a hedgehog. The fact that he would not compete in any other gymnastics event was viewed by some as a gamble on the part the Olympics Committee. In the Washington Post, Nedoroscik said, "I was completely aware of it. I really wanted to make the Olympic team, and I knew that there was going to be backlash to it. I do one event compared to these guys that are phenomenal all-arounders. And I am a phenomenal horse guy. But it's hard to fit on a five-guy team."

The gamble paid off. After a 16 year drought, the United States Men’s Gymnastics Team took home the bronze medal from the Paris 2024 Olympic Games. Everyone agrees it would not have been possible without Nedoroscik.

I believe he proved he fit just fine.

If you are a healthcare provider, check out Dr. Turner’s new website DrEllenTurner.com and sign up for her e-newsletter to receive tips, tricks and updates on injections, devices and life in this incredible but, sometimes overwhelming space we call aesthetic medicine. Launching Summer 2025, look for the addition of training videos and podcasts!