Strangely, the staff at plastic surgery and dermatology clinics (mainly procedures) are not cheap????

Strangely, when I go to the hospital, it seems that the hospitals that behave differently before and after payment and do not talk are general internal medicine, family medicine, or busy big hospitals, but
 plastic surgery or dermatology staff who focus on petit procedures.
When I go to the dermatologist, I have to erase everything, so I go without makeup. I'm just driving, so I'm wearing comfortable clothes.
But sometimes, when I go there, there are employees who ignore me and don't talk, and there are employees who say that I look a little young.
Every time that happens, I give it a hot mouthful, but sometimes I think about it.
Of course, there are many places that are kind, but why aren't the dermatologists and plastic surgeons so mean?