Let’s talk about the good, the bad, and the ugly of fees.
Practices need to have an appropriate fee level that allows for successful commercial operation.
You need enough money coming in so that you can provide the best possible care for patients, use high-quality materials and equipment, hire and train great team members, and ensure your staff can make a living.
It’s also important to factor in a bit of a buffer with your fee structure – from time to time, things will go wrong and unexpected expenses will come your way. If we’ve got a fee structure that’s appropriate, we can absorb the costs without having to cut corners in other areas.
We also need to understand that fees reflect the brand of the practice.
There’s a phrase that comes to mind, and that’s “reassuringly expensive.” If you want your brand to be perceived as luxury, high-quality, premium, then it doesn’t make sense to price yourself cheap as chips. I don’t know about you, but I’ve never seen a Rolls Royce in a two-for-one deal…
Alternatively, if you’re a family-oriented practice, it would make perfect sense to reconsider the price point and offer different bundles and packages.
Factors that affect fee structure
What are the things that affect the fee structure? You’re going to need to take into account your rates of charge or charges put to you from suppliers.
Whether that’s consumables, rent, services, etc. Other input costs we need to look at are your staff costs, interest rates, your consumer price index, and inflation in general. We need to make sure that we are taking into account all the costs that we absorb and our fee structure must allow for that, while adding a profit margin on top. Which is really, really key. We need to maintain our margins to maintain a successful practice.
Problems start to occur where you maybe don’t know your costs, don’t review your fees, or may have your fee structure dictated to you if you’re part of a preferred provider program.
Increasing fees
If you wanted to increase fees, there’s a few things that come up quite commonly. The first question is, “Do I need to tell the patients that I’m increasing my fees?” Not necessarily, because most patients won’t even notice as you would typically increase them incrementally over time.
If you have a particularly low fee structure and want to increase them significantly, I’d urge you not to take a single big jump factor in regular fee increases, for example maybe quarterly. That is so that if there are patients who are coming for multiple treatments in quick succession, they don’t get a massive fee shock.
Now, the big fear around all of this of course, is that patients confront you and say, “My god, you’ve put up your fees.” I think it’s really important to answer confidently and unapologetically. What I would say is, “Look, we’ve been absorbing our increase in costs for as long as we could, and we’re now in the position where we need to pass on some of those increasing costs to our patients. Our commitment is to provide the best possible care, and that means having the best materials and the best staff.” If your response doesn’t satisfy them, then I guess the question is, “Are they really an ideal patient after all?”
Discounts
A conversation with fees wouldn’t be complete without a conversation around discounts. Lots of people ask the questions around discounts and I think it’s a really important conversation to have.
We often encounter genuine hardship situations and want to be compassionate and do the right thing by people, but there are ways you can do that without being known for discounts. I would urge you to use them sparingly so you don’t become known as a discount-dentist. It’s a good idea to avoid referring to it as a discount, and perhaps instead opt for a phrase like “courtesy adjustment.”
There is much more that goes into fee setting, and it’s a topic we covered more in depth on an episode of the Savvy Dentist Podcast.
Be sure to check out the full episode here for a detailed breakdown of fee setting and structures.
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