Increasing fees

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I am looking to increase my fee by 10% from what I think is a low-ish base. I've checked fees of others in my area & 10% is not going to put me too much above what others charge. The mistake I made was I have not increased my fees in line with our increasing costs over the years & hence this time I'm planning a substantial increase (it really only boils down to about $5 more per consult). When others have increased your fees by a "big" amount, did you lose many patients?

I think the other mistake I made was always bulk-billing Medicare patients but that's another issue.

 

This reminded me of Sam Irons from Christchurch, who ~30 yrs ago told me "Double your fees, loose half your patients; you make just as much money and don't have to work so hard".

 

Mark, If your still charging what you beleive than your time is worth then it should all be ok.

Some will complain, but as my old boss would say "My kids gotta eat too". As you also said you will be still around what other charge .

I did the same at the start of the year, did not notice a change. People will complain for some its a way of life.

I´m sure it will be fine 5 AUD does not buy you much these days, ie your spend value has reduced so most people would not see $ 5 as a huge increase.

 

Provided its not too bigger jump at once, they wont mind because they are getting great service, some clients do think if you dont charge too much you must not be very good at what you do.

Similar but not the same, one refer once told me "You must not be very good if you dont have a big back log of clients":bang: do what you are comfortable with, they will still come, there is no price limit on good service

 

Dear Mark,

Lets say you need to earn $100.00 per hour to run a profitable practice that provides you and yours with a very comfortable standard of living.

So you have a simple choice.:butcher:

100 pts per hour at $1.00 with 100 costs to service

1 pt per hour at $100.00 with one cost to service.

Or somewhere in between.

What do you need in the way of a standard of living.

At the Sydney conference there was a great and very funny motivational speaker talking about how you value yourself and your practice.

Basically this profession of ours feels guilty charging for our skills.

Just look at the dental profession.

What do you value more?


Your FEET

Your TEETH

I would find out the highest fee in your area and then charge the same if it is a good fee. Charge more if you offer a greater skill mix and better premises etc etc.

NEVER EVER BULK BILL. It costs em NOWT SO THEY PUT A ZERO DOLLAR VALUE ON YOUR SKILLS.:deadhorse:

Also look at the fees of other allied health professionals in your area.

Also look at the fees of complimentary therapists in your area.

For a laugh look at the fees of the Hairdressers in your area.

Then sit down with a stiff whiskey and a hankey and cry.

And consider what are my skills and services worth?

You are a well trained and skilled health professional so your fee structure will reflect this.

regards David:drinks

 

We increase our fees between 5 and 10 % each year without fail. Every year on the 1st February our fees increase. It's easier to increase your fees a little each year than it is to increase them alot every few years.

The clients you lose will be minimal with fee increases and often the clients you lose are the ones you would rather not see anyway. Those who value your service and skills will happily pay the higher fee. Don't forget you're running a business. None of your clients want to see you run at a loss.

This topic of conversation came up with a client of mine many years ago and she said to me... "If people never complain about the fees you charge, then you're probably not charging enough." Needless to say I've continued our annual fee increases ever since.

All the best in your practice.

 

You all sound very entrepeneurial to me, even Craig.

Feeding your kids.

Getting paid what you're worth.

Raising fees to maintain or improve your standard of living.

Watch Out!

You may be patenting soon.

Dr Sha

 

I don't see any of us as entrepreneurial. It's simply small business management. Maintaining a pricing policy is just one small part of running a successful practice.

As an employed Podiatrist you go to work, you fulfill your contractual obligations and you go home at night. As a private practice owner you must work as a Podiatrist as well as run a business. Advertising, marketing, promotion, maintain systems and procedures, seek legal and accounting advice, maintain business insurances, negotiate leases, ensure employee and company taxes are paid, superannuation is paid, workcover obligations are adhered to, etc. etc. One other little thing we all must do is develop a pricing policy.

If your private practice/business fails - your patients will be sad. But they'll still need someone to care for their feet. Your patients will find another Podiatrist. Your employees will move on - they'll need to pay their mortgages. Set your price according to the standard of living that you desire. Don't set it so low that one day you'll disappear otherwise you may as well work for someone else.

In developing our pricing policy I have ensured we are compensated to some small degree for the extra work involved in running a practice. If this did not occur I would simply choose to work for someone else.

Entrepreneurs? No. Not according to my definition. Normal small business management? Yes.

All the best with your pricing policy Markleigh. It's a crucial aspect of your business.

 

Thanks Gavin for your comments. Getting the balance between working in the business verus working on the business I find very difficult. It seems difficult to have a successful business without working on the business. But for me I have spent almost almost all my time in the business but seeing less & less financial gain for those efforts.

 

Hi Mark,

I always advise patients in advance of price increases. A poster is in both the waiting room & treatment room for 6 weeks prior to any price increase.

Some do moan a little & I suppose that is natural for some........ :empathy:

However, one year I did not increase my prices as locally the financial climate was bleak for everyone. I then made a problem for myself as the following year I had to increase my prices by a larger percentage than usual to maintain a viable practice.

Giving patients notice of increases & educating them that you review your charges annually helps to prepare them for change.

I have not (as far as I am aware) lost patients due to increasing my fees.

It's not a hobby, it's your livelihood. :drinks

Kind regards,

Mandy.

 

The work/life balance is something we will all struggle with at some stage during our careers. Your compassion for your clients exceeds your desire for maintaining a profitable practice. You are obviously a very caring practitioner and your patients are lucky to have that.

Charge what you believe you are worth and make an essential date in your diary to review your fees annually. You'll avoid burnout, be happier and your patients will be happy because you'll be able to continue to provide the care they need at a price which is fair.

Cheers.

 

Thanks again Mandy & Gavin - I really enjoy hearing other peoples views. Gavin, I do think I'm compassionate (maybe too much but I think we need a lot more compassionate people but that's another story & I digress) but compassion doesn't build a successful practice. I think I'm a good Podiatrist (but could certainly be better) but the business needs a lot more support & development.

I have made the decision to increase the fees by a reasonable amount & I'm happy & comfortable with that. I do acknowledge I've worried too much about what patients might think. Time to toughen up a bit :boxing:

 

Here in the states, I was instrumental, using a business that I called The OTC Connection, in getting my podiatric breathren to acculturate to in office dispensing. I was called The Father of In Office Dispensing by Barry Block, DPM.

This works especially well if you are rural and can offer your pateints education, recommmendations and then the actual product that they cannot easily locate (this went especially well for shoes) locally, plus you remain available to monitor its use. It's a great practice builder..

I developed my own creams, supplements, post op shoes, etc and the conference sponsors went from three in 1996 (I was one) to 40% of our current conferences when it came to OTC.

This is a very professional and useful way that you can care for your pateints, create new profit streams and not have to raise your fees so dramatically or so often.

Are you guyz involved in IOD?

Dr Sha

 

Hey,
this is a market economy - charge whatever you like, the customer will decide what your services are worth! If they think you are worth more, they will pay more. Perhaps, try 40%.
Owen.

 

In some ways this problem is both simple and complex. On the simplist level put your fees up and see what happens. If you get a really bad reaction you can drop them the day after and no real damage done.
However I suspect you wont get a horrible reaction from patients because they come to you for your skills and knowledge not price. Nobody I have heard of goes to their podiatrist because they are cheap.
Patients are faced with a risk decision when selecting a health care provider whether its a podiatrist, physio, optometrist or GP. If they are happy with you the potential cost of changing is high. Provided you don't double your prices my expereince has been OK with price increases. Do it with confidence and communicate the value of what you do. You are worth it.

 

Hi,

Very interesting post and great response from David, thankyou for the read!
Having worked in a UK private practice that charged 28GBP approx 2 years ago for routine podiatry care i recently found out they had jumped to 33GBP for the same treatment and word of mouth tells me they lost approx 5% of their regular patients. Obviously there is a case here for over charging but in comparison to hairdressers, dentists prices etc i feel these patients must of been unhappy with the service to begin with, they jst needed the push over the edge! So yes, if you and your patients value your skills then do not be afraid to raise by 10-15%.

 

The accounting relationship between price increase and gross profit can be interesting. Assuming your GP is say 70% of total income and you increase prices by 10% across the board, you can afford to lose 16% of your patients before you are worse off in gross profit income. If you discount the effect is similar. A 10% discount means a 16% increase in patients to maintain your gross profit income. Naturally we would hope to improve the financial position by discounting but its not all that easy. This is also an exponential relationship so a 20% discount means a 44% increase in patients to maintain GP income. That's a bit scary.
As Mandy says so much of the success of this decision rests on what your patients are used to and how it is communicated, and how your service is valued. Moving to another podiatrist is risky for a patient. They might not get the same service, so it takes a fairly big shove to get them to move.
Did you do it Mark and how did it go?

 

Here is my two bobs worth. I agree with the people saying we need to value our work. Raise them and then put a regular price increase into your yearly or even half yearly reviews. Small and often is definitely better. I think people generally feel that more expensive equals better quality.
Remember also which patients are choosing to go elsewhere. Maybe it is win win.

 

All - an interesting discussion here.

My dom fees start at £27.00 with additions for mileage if over 8 miles away. I certainly plan to increase them next year. This gives me enough dom work to earn a good living without being rushed off my feet.

A new FHP started locally 6 months ago and charges £18.00 a visit. They are solidly booked for 6 weeks and can't take on any more work. I know this because I have a steady stream of calls from disgruntled patients of hers who can't get an appointment for 6 weeks, even for infected IGTN.
I have sorted out no end of problems caused by this person's inability to structure their time.
Also, basically, this person is very inexperienced, so after a treatment with me, the patient usually stays with me.
The moral - don't be afraid to charge what you're worth, everything comes to he who waits, as they say !

CF

 

I have been self employed for 28 years. There is a perception that exists in society and it is "you get what you pay for ". I have a colleague who is a neurosurgeon who charges six thousand dollars over the scheduled fee per operation . He is busy . I tend to be in the 20% higher than average charge out area, and im still busy . The public perceives cheap health care as "less than" in many ways . Just my opinion.

Regards

FDCB

 

Everyone in a salaried position gets an annual raise on the pay grid as well as a cost of living increase. (well, except for Ontario public servants, but that's a discussion for another site)

Do you not also deserve a raise? Not to mention increased costs with gas prices/delivery surcharges and increasing costs of supplies in general with inflation, and increasing salaries for your support staff. A wage freeze constitutes a minimum 3% pay cut when you factor in inflation.

My history of moving about between free public/paid hospital cost recovery/free teaching and proper charging private clinics has taught me that people value your advice/service in direct proportion to what they pay for it. Offer discounts and free assessments and you'll be up the creek. Check out prices for esthetic and spa services, through the roof. Do a fantastic job and they'll be crawling back when their feet start yelling regardless of the increased price.
Sarah

 

I tend to raise new patient prices first to see how the cookie crumbles. That has never stopped me raising all fees sooner or later.

 

Mark, I was in a similar situation to yourself. I decided my fees were to low compared to opposition and that the service I provided was equal to or better. I agonised over it believing I would lose all my patients!!!. I put the price up by 10%. the first patient who noticed told me I should have out it up more!!. I had one patient complain and he complains about everything.. Go for it, your worth it. I now charge more than my opposition..

 

Since I last posted in Aug last year I have raised my prices considerably for new patients ( £5.00) and by £1.00 for exisiting ones.
I have had a few new patient enquiries from folks who won't pay the new fees but those that do, make up for it. I would say that I haven't lost any revenue overall and I don't have to work so hard !

CF

 

I agree. Increasing fees , I lose a few but the majority who stay make up for it and I dont work as hard.

FDCB

 

I have worked in PP for 15 years now. When I first started I was anxious about putting up prices. I had (still have) a patient who was a business man. One day he said "why am I still paying the same as last year- why havent the prices gone up?" . Patients began saying " is it still the same?" I put the prices up! and I now do so once a year. I put up a big poster and give them as much notice as possible. You musn't undervalue your skills. When I choose to pay for a service ( decorator, hairdresser, chiropractor etc etc) I never go with the cheapest. I have not lost any patients through price increases, but I have lost patients because I am so busy I cannot see them for a few weeks! good luck hann

 

I have posted this on another thread. I did a cost appraisal of my practice and worked out that to live a modest existence and pay all my overheads, I would have to charge 50% more than I was at that point.

As with Craig's post at the start, I thought,"I would rather charge 50% more and spend more time with my kids because I am seeing less patients"

Have I seen less patients as a result.......no. I know loads of people have already posted the same thing but I just wanted to make the point that I have increased by 50% and not seen a drop off. My kids are pretty peeved though!

Robin