Why I wish I wasn't a Podiatrist & billing patients

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I had one of those days where I wish I wasn't a Podiatrist. Had to get a piece of equipment repaired. Call out fee for the technician $133 - he says sorry can't fix it here, I'll have to take it back to the workshop. A couple of hours work, another $300 & still not repaired. Probably another $200 to fix he says . So $600 & the equipment is not fixed - I need it fixed therefore don't complain. Patient needs a single orthosis recovered with vinyl & a forefoot valgus wedge added - $50 in total, "What a waste of money just for that", the patient says. The technician has made $600 for approximately 4 hours work. I've spent 30 minutes doing a neat job of repairing an orthosis & I feel so under-appreciated

To Australian Podiatrist's - because most health funds have greatly limited the item numbers we can utilise, what do others do when say you do a repair on a pair of orthoses e.g. recover or add additional posting. Patients seem to not appreciate the time & expense in materials to repair something. Are orthoses too simple looking? Cannot someone make them more sophisticated looking so patients appreciate the time & effort that goes into making them/adjusting them?

 

Ah Mark,

Bad day eh? :empathy:

My suggestion: incorporate something technical in the design.

Patients are always impressed by technology. Even if it's a pointless addition.

Monty Python has some fab ideas: http://www.youtube.com/watch?v=arCITMfxvEc

On a brighter note. The sun is shining, it's nearly the weekend & remember. You're doing a job you love. (although some days less than others) :butcher:

 

Hey Mark

You think you've got problems......... we here in sunny South Africa are so regulated by medical aids that just to get the orthotics done and paid for at a fair price is like trying to take extract water from rock.
I love what I do but sometimes feel that I truly am a salesman disguised as a Pod. I could easily define my days as selling selling and selling. To advance our professional training we should attend equal CPD meetings with selling tools.

But I agree with Twirly, the sun is shining, I can see gorgeous Table Mountain from my window and the Super 14 is about to be won by the Bulls, tomorrow.

Hang in there

Brandon

 

Thanks all, I have my presentation OSCE tomorrow and I know I am going to be grilled why I choose to cover my orthotics in leather. You have just made it for me! Because it has to look worth the 350$ we are charging for it. A nice pig skin costs $50, I reckon I can get $50 covers out of it....What's a dollar?

 

Podiatry is a valuable and important profession!
Part of the reason why some patients don’t seem to appreciate or value your work is because you probably haven’t told them why what you do is valuable. Another reason is because many podiatrists don’t place enough value on themselves and the services they provide. Your covers don’t need to look more sophisticated, you simply need to educate your patient why you’re worth it and then bill accordingly.

The equipment technician in Mark’s story charged about $150/hour, or approx $75 per hour. Did he have to put a fancy cover on your equipment in order to charge you more, no. What skills did he use? If you didn’t use his skills how would that impact on you and your life?

Now lets look at a typical podiatrist’s billing for an hour of their time, equipment use and consumables in a consult. It’s common for podiatrists to charge patients about $55 to $60 per half hour, which is about $110 - $120 per hour. You’re physically interacting with people to provide your service, with that comes high litigation risks, yet you are charging less than someone who pokes a machine and has low litigation risks.

Therein lies the reason why some patients might treat you poorly. If you went to a medical specialist they might charge any where from $250/hour and higher ($250 is very cheap!). If podiatrists valued themselves and the services and products they provided more highly it’s very likely that their patients would too.

Think of this example, when you see a ‘Cheap As Chip’s shop or ‘$2 Shop’ selling products for half the price of a similar product in ‘David Jone’ or ‘Myers’ what do think of the quality and value of the product? Most likely you’ll suspect that it is of inferior quality and you’d expect it might break after a short time. If you wanted a good quality product you’d probably shop at David Jones or Myer and pay more instead, right, because the price is higher you perceive that the quality is better, correct.

The reality is that often the products are made by the same factory in China and are simply branded and badged for the different stores. The product might have cost $2.77 to make and sells for $12.99 at Cheap As Chips and $67.99 at Myer. The quality of the product is often the exact same regardless of which store it was sold in. But people relate a higher price with perceived higher quality.

The people that shop at Cheap As Chips are looking for bargains, or are shopping on a budget. They don’t expect great customer service or fancy bags to take home. When a customer pays more their expectations increase in line with the price of the purchase.

Customers shopping at Cheap As Chips get almost no customer service or support, except when they go to pay at the counter. Shoppers at David Jones or Myers are usually well looked after by shop assistants who will go and find the things you are looking for instead of you having to hunt them out. You feel important shopping at Myers, you feel like just another plod at Cheap As Chips.

There will always be customers at both low end and high end stores, that the way of the world. Just as there will be podiatrists who provide low end service and others who provide high end service. Which are you and why?

But if you want to have your customers respect and value you and your services then you probably need to do basic things:
1. Give excellent value service and products (this includes explaining why your service is valuable).
2. Charge more, increase your fees.

I recently helped a large medical centre and a podiatry practice do exactly that with excellent results. The owners of those businesses were worried that patients would complain, that they would loose customers and that their income would suffer. In fact the opposite happened. At the medical centre 5 patients out of 8657 complained, 3 of them left the clinic. The other 8654 kept coming and the reception staff reported that more than 23 patients commented that they thought the doctors services were worth more than what they were paying!

At the podiatry practice the consult fee was increased by $10. Prior to the increase they were charging $47 for that consult and were seeing an average of 12 patients a day. You would have to lose more than 2.5 appointments per day before you began to make less than before you increased your fees! The podiatry clinic now sees an average of 15 patients per day! You can do the maths on how much it has increased their turnover. Interestingly, the number of ‘word of mouth’ referrals has doubled for them too!

If you are providing great value service and building great relationships with your patients they will not be fee sensitive. They will respect your skill and your time and they won’t give you grief about your fees. You’ll really start enjoying being a podiatrist again!

The best part about this is that the people who cause you the most hassle and stress in your business are usually the people who want to pay the least. By putting your fees up those people will usually either leave or become better patients because they know your service is valuable to them.

There’s simply not enough room in this post to fully explain the mechanics of why this works and some of the other important things you need to do for it to work well. If you want to learn more read my blogs at www.SmartPracticeSystems.com/blog

Value yourself more and your patients will value you more! You’ll fall in love with podiatry again!

May you have all the success you desire and deserve.

 

I agree with Mick, people definitely value your services in direct proportion to what they've paid for it. I've done some time in Community Health Care Centres, where Orthotics are FREE, and the clients have come in for "My yearly new pair". Well, where are the old ones? In your shoes at home? How much do you wear them anyways? Not much, because he doesn't value them. I wouldn't give him new ones and told him to start wearing the old ones consistently, as the shell should last 3-5 years.

I also worked at a Hospital that charged for cost recovery ($25 per visit regardless of length). The less you charge, the more people complain. Oh and we had the nerve to raise the price $5 (it was oly $20 when I started), and DIDN'T EVEN GIVE THEM MORE TIME IN THE CHAIR. If I were in Private, I'd ask them if I didn't deserve a yearly raise. I left the job in part due to poor job satisfaction because of the complaining and whining.

Do not undercut others, do not undervalue yourself. Charge more for top cover replacements in the future. You are being exposed to toxic glue fumes and providing a skilled service that they could not do themselves using expensive materials. I find it very curious that we are one of the highly skilled health professions with the highest output cost per unit of service and charge some of the lowest per hour billing rates.

Sarah

 

Thank you all.
I have a continuous 'discussion' with the younger students on my course, that as women, we will not be offered the same wage as men. The younger female ones are convinced they will be paid what the guys are. Same Thing! They value themselves.
I just did an OSCE (person to person exam) I justified my leather coverings on the orthotics by saying I have to make them look like they were worth what they were paying for them. Vinyl costs cents per item, leather costs $1 per insole, but looks expensive. One of my fellow students said that it took him twice as long to put on leather ....me, I can put it on faster, and neater. Practice! Thank you AdminMan, I needed that advice, 'cos I don't think I need much, I need a job.

 

Hi Mark another alternative is to advise the client that we will get a price from the lab and add the postage for the said recover. Many more $'s. If you have staff they can do it there and then in front of the client. Makes them think.
Both your time and the costs involved in running the clinic, someone ordering and paying for the materials, un packing it and all those costs unfortunately as pods are rarely considered.
the cost is not just in the metre of cover but all the incidentals that fo with having it. That is why everyone els has a mark up! Not profit? Just paying for the costs!
Carol not sure why in htis day and age your fellow students do not think they will not get the same pay rates? Scarey thought?

must be getting old

Cheers

 

Thanks Heather. That is an excellent suggestion. I will call the lab & make enquiries about their fees for recovers.