I'm looking at an e-mail I received several months ago. I left it tucked in my little "hidey hole" next to my computer because I didn't know what, if anything, to do with it. The doctor that wrote it related an incident that I hear about on occasion.
A patient came in to see the chiropractor. She had never been to a DC. She was very impressed with him and, after the report of his findings, she was "sold." As the doctor put it, she was "jazzed!" She was so "jazzed" that she signed up for a pre-paid plan, but told the DC she needed to "work out the financial arrangements." She called the doctor the next day with her decision (still "jazzed"), but was not ready to complete the purchase of a pre-paid plan because she had been offered more options to consider.
Apparently, the patient had read or heard about a doctor who was taking patients for less than one third of the doctor's fee. (The fee mentioned was one I hadn't heard of since the early 1960s.) The original doctor's fee was very reasonable on a per-visit basis and, no doubt, even more reasonable on a pre-paid plan, but the patient decided to go to the cheaper doctor.
"That chiropractor has a new patient because of my advertising and report of findings," said the frustrated doctor. His final question to me : "How do I establish the worth of what I do and the education I have when someone else gives it away?"
What do you say after a letter like that? I'd say he probably let the patient get away! There were at least two days for the patient to suffer "buyer's remorse" following the report of findings. Maybe we should examine and improve on this area. I understand that patients change their minds, and certainly have a right to do so. I'm also aware that all of us, including this writer, can make ourselves crazy, price-shopping an item or service. This is particularly true when an item is unfamiliar.
Once patients are out of the office, they begin to focus only on price. They begin to forget all of the great things you told them, and they forget the great impression you made on them. Patients think the level of service and competence is the same everywhere. Consider accepting a deposit to hold a plan while the patient "makes arrangements." Be willing to allow the patient to apply the deposit to a different plan or different payment arrangement within a specific time. Consider Master Card, Visa, etc., if you're not already using them. Be willing to issue charge credits or write a refund check later if necessary, but get the patient to make a commitment while they are in the office.
If the patient decides to go somewhere else, give a complete refund, minus any charges due, without delay. If they were given reduced fees based on entering an agreement, you can deduct your standard fee in making any refunds. If patients decide to leave, you want to make it possible for them to leave gracefully. If you try to make it difficult, you'll only make the patient angry. I'm not suggesting violating any sensible rules of office policy - just let them go gracefully. You can't make patients want you or your services.
As far as establishing worth is concerned, it sounds as though the doctor did a good job at that. Based on the information I received, I think his procedures, not presentation, were his downfall. The patient was "jazzed" yet he allowed too many opportunities for her to get "unsold"! When another practitioner offers fees that are ridiculously low, there is not much you can do. If this happens frequently, you might address the issue indirectly in your report of findings. In general, I think its best to ignore fee comparisons. Once you start, where do you stop?
A practitioner's fees reflect the cost of doing business plus a "salary" for the practitioner. Unrealistically low fees tend to be short-lived, unless the doctor has another source of income or considers chiropractic a hobby. In any case, pay attention to your own practice and plug up the holes in your bucket!
Dear Reader: I'm always interested in hearing your thoughts and questions. I want my column to reflect your practice. You can talk to me or write me at the address below. You can also leave a message for me on ChiroWeb's columnist bulletin board (http://www.ChiroWeb.com/columnist/herfert).
For those of you who would like to contact me by e-mail, I will need your full name, city, state, age, time in practice and normal weekly patient load. Also include your hours, number of staff and other pertinent information that you think I'll need to answer your question. I don't answer nonspecific questions like, "How can I improve my practice?" I may ask you to call me if your question is too long or complex.
Kiki Herfert
15852 Jefferson Avenue
Grosse Pointe Park,
MI 48230-1445
Tel/fax: (313) 822-9199
kikiherfert@aol.com
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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