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Home visit fees

Discussion in 'United Kingdom' started by Graeme Franklin, Nov 13, 2009.

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  1. Graeme Franklin

    Graeme Franklin Active Member

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    Hello all!

    I had my fridge repair man visit my poorly fridge today.

    He charges £45 call out fee plus £30 per hour thereafter. I was "quite" happy with this as I didn't want to buy a new fridge just for the sake of it. It makes you wonder though what a professional and competent podiatrist could reasonably charge.

    I am more clinic based nowadays but sometimes do the occasional visit. I am currently quoting £30 call-out fee on top of the normal clinic fee of £36 for very local visits although I have charged a lot more in the past for longer journeys (>£100).

    Surely a podiatrist is worth more than someone repairing fridges! (no disrespect to the very nice fridge man).

  2. Pauline burrell-saward

    Pauline burrell-saward Active Member

    yes graham. but unlike your fridge which hopefully will only need repairing every ??5 years our pts need our care more often!!.
  3. twirly

    twirly Well-Known Member

    Hello Graham,

    Although I appreciate the need to increase charges for time, travel etc. when providing a h/v service I cannot see your fee structure being something I could implement in the area I work in (Yorkshire).

    Yes podiatrists do indeed provide a professional service & should charge accordingly. However, I could not justify the charges you place in addition to your usual clinic fee when performing a 'local' home visit.

    Some areas may differ considerably & yes call out charges for service engineers are pretty steep for household repairs etc. That being said though, locally to me other professionals eg. dentists, opticians charge no additional fee for the housebound.

    Kind regards,

  4. cornmerchant

    cornmerchant Well-Known Member


    I cannot see any justification for the fee structure that you implement other than deterring patients from calling you out.

    Pauline makes a very valid point- I would add that white goods are now designed to be disposable and not repaired, it is economically unsound to mend them!

    It is entirelyup to you what you charge of course, but high fees do not necessarily give you job satisfaction. I cannot see how you could compare yourself to a fridge man- its apples and pears. Life is just not like that!

    Cornmerchant ( in a place less affluent than Norfolk, obviously!)
    Last edited: Nov 14, 2009
  5. roger2shirts

    roger2shirts Active Member

    Home visits are a contentious issue - I hated them and therefore can only give a biased view - when it comes to charging you must factor in:
    1: Your hourly rate i.e, how long you spend with the patient and time away from the clinic.
    2: Travel costs
    3: Risk, both to your back, health, safety etc
    In harsh reality most "doms" are not cost effective.
    However if you are not busy or you have a social conscience then go for it but please don't be out of pocket on them because Gordon will not help you.
  6. cornmerchant

    cornmerchant Well-Known Member


    I cannot agreewitn your statement "In harsh reality most "doms" are not cost effective. "

    There are plenty of us making a very comfortable living doing either all doms or a mixture of clinic and doms. What exactly do you base your statement on?

    For me the advantages of doms are flexibilty, more exercise for me than when I treat in clinic, constant change of working environment ( I would hate to be in same 4 walls day in day out),time to pick up a pint of milk on my travels!

    If priced sensibly there is absolutely no reason not to make a good living- if you do as graeme does then you are not looking to do the visit in the first place.

    Last edited: Nov 15, 2009
  7. Disgruntled pod

    Disgruntled pod Active Member

    The problem as I see it is that there are too many softies out there charging OAPs a low fee for a DOM, under this misconception that all OAPs are on the breadline. It is amazing how many housebound pensioners can get to the dentist and can afford to have their hair nicely done very often, and the bingo.

    A colleague of mine was asked last year to do a DOM for en elderly lady as it was in the client's eyes, "much more convenient for you to come to me rather than me get the bus into town." She said this when the appointment was made and 2 or 3 times during the appointment, when she was told that the dust extraction drill was only available at the surgery. She simply said, grinning from ear to ear, "much better for you to come here."

    At the end of the appointment she was assessing the convenience to her purse when she got a bill for £40. Treatment fee + call out charge!

    Plumbers, electricians, and other repairmen charge a professional fee for call outs. Why shouldn't we?!
  8. roger2shirts

    roger2shirts Active Member

    Dear Cornmerchant,

    In harsh economic facts most podiatrists are subsidising their patients with "doms".
    If you have a surgery and staff then you have an hourly rate before you make profit, i.e, pay yourself.
    Once you leave your premises, they still need paying for, and then you travel and the unpriced expenses like osteopath's fees for the inevitable bad back you will get.
    Unless you are charging £70 a home visit they are uneconomical.
    If you are part time and do not have a premise then that is a different matter.
    But as the sole bread winner in my home and with a busy practice to run I can not afford to subsidise anyone and frankly unless they are genuinely house bound they get a better service in the clinic.
  9. cornmerchant

    cornmerchant Well-Known Member


    Thank you for your wise words- I will make sure I pay myself in future- that must be what I am doing wrong all these years!

    I am full time, but I am based in GP surgeries not in my own premises. However, I am the sole bread winner in my house and have brought 2 children up without any maintenance so I know it is hard, but I would and could never charge that amount for a dom.

  10. roger2shirts

    roger2shirts Active Member


    As I was trying to say for many practices it is uneconomical to do "doms", my practice can not afford to do them. If you have negligible overheads then great for you and if you enjoy doing doms then go for it.
  11. DTT

    DTT Well-Known Member

    Hi All

    Neither can I!!

    I have to allow a minimum of 30 mins traveling time to allow for the traffic and finding somewhere to park ( hoping always not to make a mistake and get a £60 parking fine through the post from a security camera:butcher:) which there and back is an hour 30/40 min Tx time = around 2 hours of my time = 4 clinic patients.

    When I get the annual phone calls from pods / FHP's poporting to be patient ( yes we can spot em a mile off cant we) asking " what is my consultation fee ,what does it cover and for how long and my home visiting fee's" which I volunteer only to find they are finishing their NHS job undercutting my surgery fee by £10 and of course its CASH ONLY:mad:

    As Roger2S said if you have overheads and an advertised clinic based practice and you do it properly and pay your due's then in truth around here anyway the £70 a dom would be about right.

    I reality ( I charge £55 because I don't want any) and that is enough to put patients off because my days of standing on doorsteps in the pouring rain, having filthy animals jumping up at me leaving muddy paw prints on my shirt, cats jumping into my case of instruments ,working with energy saving bulbs are.... THANKFULLY OVER:D

    I think different area's have variables which will affect fee's ( mine being an armoured car as apparently I live in the most dangerous place in the country with more murders and violence that anywhere else:eek: deep joy) so I dont think any 2 area's would agree a minimum BUT a proper professional fee should be charged for a proper professional service IMHO, and history dictated that those that do try to undercut and do it on the cheap invariably fail because they can't afford to keep up with the rest in the long run.

    Just my take

  12. rdavis

    rdavis Member

    Dear All -- re Doms. fees -- It would ,perhaps, be an interesting exercise if UK Pods [ and FHP's] reported in with their fees to give a 'straw pole' of variation in fees being charged.

  13. Tony Gavin

    Tony Gavin Member

    £30, but only within a 3 mile radius of the clinic, for patients who can not make it in. They are uneconomical in isolation, but often family members become patients of the clinic.
  14. drsarbes

    drsarbes Well-Known Member

    Gotta love the UK.
    In the US of A it would be considered illegal for practitioners to compare prices.

  15. twirly

    twirly Well-Known Member

    Hi Steve,
    May I ask why?


  16. DTT

    DTT Well-Known Member

    Hi Steve

    It's a bit difficult if the practitioner is ringing around pretending to be a patient enquiring about fee's ?? That's how it's done over here (not by everyone I hasten to add) but the irritating thing I think is behind this is those that do it are finding out for one reason only ... so they can charge less in your area and take the work.

    I'm sure you must have the same problems over there or if a patient rings do you not tell them your charges ??

    On here my comment was to explain the variations in visiting fee's in relation to my situation not to compare prices with anyone else.
  17. Disgruntled pod

    Disgruntled pod Active Member

    As Davey boy Holland said in an article a few years back, "the people who phone around are wanting you because of the cheapness of the price, not the quality of the work," and he was/is right.
  18. DTT

    DTT Well-Known Member

    Davidh was referring to the paying patient I believe ??

    I was referring to the "colleague" that is phoning to elicit a fee structure to undercut it and ( IMHO) cheapen the profession in the eyes of the public, so the paying public don't appreciate quality of service and professionalism because it's too cheap ( AKA NHS??)
  19. drsarbes

    drsarbes Well-Known Member

    Hi Twirly"
    Fee setting is illegal, and of course if you're going to set a fee you need to know what the other guy is charging!
    I don't think is so important now as it use to be, since most insurance companies have their own fee schedule - however, if you have large clinics competing for a contract with a large carrier then it still comes into play.

    I'm sure somewhere along the line there was a good reason for this, but it seems to escape me now.

  20. twirly

    twirly Well-Known Member

    Thanks for that Steve.

    I believe a similar situation may be the case if companies are bidding for a specific contract.

    I could be wrong though. Won't be the 1st time :eek:


  21. cornmerchant

    cornmerchant Well-Known Member


    I have to say that you are sounding a little paranoid when you said
    "I was referring to the "colleague" that is phoning to elicit a fee structure to undercut it and ( IMHO) cheapen the profession in the eyes of the public, so the paying public don't appreciate quality of service and professionalism because it's too cheap ( AKA NHS??)

    Life is really too short- be happy with what you charge and let anyone else get on with it. I have never had a call for fee structure- patients that phone me for a price simply do not get a reply.

  22. DTT

    DTT Well-Known Member

    Hi Cornmerchant

    No Certainly NOT paranoid :cool: and yes I do appreciate life is too short, thanks for pointing it out :rolleyes:

    I have no interest in their antics actually ,Ive seen em come and Ive seen em go because they haven't charged enough to give a proper professional service so do I worry ........:rolleyes:

    Oh so no one rings you to ask how much and what they get for their money then ?? somewhat strange I feel :confused: Perhaps you should listen to the questions your asked and learn to interpret the content and knowledge within the question ???

    Just a thought

  23. cornmerchant

    cornmerchant Well-Known Member


    I dont really understand the last sentence of your post- "Perhaps you should listen to the questions your asked and learn to interpret the content and knowledge within the question ???

    Do you mean the questions "you're" asked? "

    Even with the right grammar I still dont understand your point. ( not 'you're' point ha ha )

    As I said, people that leave a message asking for a price on my treatment do NOT get a reply.

  24. blinda

    blinda MVP

    So you don`t ever answer your phone, or speak to patients who walk into your clinic asking how much you charge? You must have been asked directly what your charges are, at some point?:confused:
  25. DTT

    DTT Well-Known Member

    Hi Cornmerchant

    Then perception is something I cant explain, sorry your loss .

    Yep ( again see above) sorry

    Bit too deep for me ?? ha ha ??:confused:

    "Writing is a form of communication as long as the recipient understands the point then grammar is irrelevant, but a certain level of intelligence is required for this to be effective"

    Sorry cant think who quoted that but ...

    Have you ever thought of getting a business manager ?? :rolleyes:

  26. cornmerchant

    cornmerchant Well-Known Member


    If memory serves me correctly, I have never been asked the price of my treatment face to face as a leading question- it has occasionally come up as a sequitur to booking an appointment. Maybe it just doesnt arise as all my patients are referrals or friends and family of existing patients. -I do not advertise anywhere.

    If I get a phone message asking purely for price, I do not reply- it is this type of patient who is ringing round for the cheapest price who are not worth wasting time with. In 15 years I think that has happened about 3 times!If they are really serious they ring back an ask about making an appointment , and if they dont I am glad they have found a bargain!

    I dont know if I am different from other practitioners- thats just the way it is for me.


  27. cornmerchant

    cornmerchant Well-Known Member


    Why would I want a business manager? I know we are miles apart when it comes to intelligence, as you have so kindly pointed out, but surely a manager would be superfluous to requirement? I am running a very successful business already.

    Yours (not you'res) respectfully
  28. blinda

    blinda MVP

    Thanks for the reply Cornmerchant.

    Lucky you, hope I`m as successful as you one day!

    Workwise, I`m finished for the week now. You never know I might just meet you at the drinks reception at Harrogate;). If not have a great weekend wherever you may be.

  29. DTT

    DTT Well-Known Member


    I agree we ARE miles apart in intelligence as your posts prove :rolleyes:

    Please try and keep up in future.
    I was simply suggesting with your arrogant attitude towards your patients you ( and they) may be better served if you became more approachable :wacko:

    But as Bel has just posted , I hope i'm as successful as you one day ... NOT:eek:

    and having been directed to TFS thank you for cross posting , see you at conference ' look in the tree's you'll probably see me hanging around ??

    Can I ask a personal question ??? are you Irish ??

  30. cornmerchant

    cornmerchant Well-Known Member


    You may ask as many personal questions as you like- it doesnt mean I will give you an answer. What have you got against the Irish? or is that just another of your racist comments?

    I am not sure you would be at the conference- would that be as a bouncer?


    ps what class degree did you get -seem to have forgotton?
  31. DTT

    DTT Well-Known Member


    No never racist ( and I resent your allegation of racism ) but an accent can be a big giveaway on phone calls ,if your perceptive enough to pick up on them cant they ??:rolleyes:

    If I am you wont get in !!:D but keep looking over your shoulder anyway ;)

    University of life 1st class honours = common sense and manners.... beats yours hands down :cool:

    Last edited: Nov 18, 2009
  32. cornmerchant

    cornmerchant Well-Known Member


    Are you suggesting that I have made a phone call to you in an Irish accent?

    Goodness, you really are on another planet.

    I am sure your degree stands you in good stead- we obviously differ in our definitions of manners.

    Back to the topic- if you dont want to do doms why dont you just say so instead of undertaking them for an extortionate fee and with a resentful attitude?

    Last edited: Nov 18, 2009
  33. DTT

    DTT Well-Known Member


    Roger 2 shirts made this comment

    I replied

    What part of that don't you understand ??:wacko:

    Stop your personal attacks and unfounded accusations of racism keep to topic and most of all conmerchant

    Get a life :mad:

    Peace and love :hammer:

    D x ;)
  34. cornmerchant

    cornmerchant Well-Known Member


    With respecet I quote your post
    "I reality ( I charge £55 because I don't want any) and that is enough to put patients off because my days of standing on doorsteps in the pouring rain, having filthy animals jumping up at me leaving muddy paw prints on my shirt, cats jumping into my case of instruments ,working with energy saving bulbs are.... THANKFULLY OVER"

    I should heed your own advice

  35. DTT

    DTT Well-Known Member

    I rest my case oh university degree trained Muppet !!

    I WROTE IT !!

    Jeez no wonder this profession is in the state its in if your anything to go by :wacko::wacko:

    Go away and talk to your like ( if there are any:wacko:) this weekend ,I'm sure they will pacify your ignorance
  36. cornmerchant

    cornmerchant Well-Known Member


    When I said heed your own advice I was not referring to the quote, I meant the advice to me regarding personal attacks and unfounded accusations of racism.

    I know you wrote the quote, I just thought you had convieniently forgotton it.

    So back to my original question- why not just say that you do not provide doms instead of putting people off with a high charge at the risk of them agreeing to pay and you going to do the treatment with an air of resentment.

  37. DTT

    DTT Well-Known Member

    Go to bed conmerchant before you dig a bigger hole for yourself :rolleyes:

    I'm bored with this now make a valid point or shut up there's a good Muppet;)
    Last edited: Nov 18, 2009
  38. George Brandy

    George Brandy Active Member

    What a sound bit of common sense advice from Cornmerchant (quote 2) to DTT (quote 1).

    Personally I do not advertise a dom service or fee anywhere in the practice. We have a standard rule of thumb that we can provide a service at £x above the surgery fee. This service can be provided to patients who are no longer able to attend the clinic or who genuinely need a domiciliary visit and ring on recommendation from friend, relative or carer.

    Again, I personally do not do many doms. At the moment I have 3 patients who I attend to at home. My associate does the rest - perhaps we have the grand total of 15 on the books? We do find that most of our doms are sadly "end of life" patients so we do not "retain" them for long. Perhaps we do provide a true domiciliary service?

    One bit of advice I always give to local colleagues setting up in domiciliary practice initially before (hopefully) moving to premises is to make sure that the dom fee is transferable to clinical premises. No point charging £20 for a dom when £30 in a clinical setting only just covers overheads.

    DTT have you thought about networking with local colleagues and perhaps joining in a bit of mentoring for those new to private practice? It might help local relationships?

  39. Dido

    Dido Active Member


    I don't think Cornmerchant actually said they didn't "talk to patients".

    I think you're the one using the JCB, DDT( for the benefit of non-English readers who may not appreciate the sarcasm, I think they are called "backhoes" in USA, Canada & Australia )

    If you are so bored, why bother to reply?:confused:

    A singularly unhelpful comment. "People in glass houses"....etc

    I agree with Cornmerchant and George on this one. If you don't do doms why not just say so? I don't treat VPs and anyone enquiring about VP treatment is recommeded elsewhere.

    Sound advice, as usual, George.

    Last edited: Nov 19, 2009
  40. DTT

    DTT Well-Known Member

    Hi George

    I do , a local pod that does all doms does mine as well I simply give them her phone number when they ring.

    The dom fee is there for all to see that visit the surgery and if asked to do a dom for an patients relative I will put them in touch with the dom pod.
    Hope that explains it
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