One fear many dentists express is setting or raising fees. You are concerned that patients will leave the practice because fees are too high or because the insurance company says fees are too high. The dental team dreads such objections about high fees. Some of you may have even raised your fees, only to adjust them back down as soon as you got a negative reaction from a patient.
We challenge you to get over the fear of fees. Set the fees at a fair rate and at a level that represents the quality of the service provided and be to proud of those fair fees. Most dentists tell us that they initially have no idea where to start when it comes to setting fees. They use many resources from their insurance companies’ usual and customary fee to their PPO fee schedules to their colleagues’ fee schedules, near and far.
There are three things on which you should base your fee: cost, profit margin and quality of service. The most subjective of these is quality of service. If you need to purchase a white shirt, you could go to several places and pay several prices. If you buy it at a discount superstore for $14.95, you can certainly expect a different quality than the higher end department store where a white shirt can be purchased for more like $89.95. Fabric, material, button appearance and stability, long-term durability will play into the price of that shirt…and your overall satisfaction with the purchase. The old adage, "You get what you pay for" holds true most of the time. When patients come to your dental office, what are they getting? Is it a below average to average level of quality or is it superior quality? This must be considered heavily when setting fees.
First, consider the technical quality of your dentistry. If you have attended additional continuing education courses and have continued to develop your skills, then the technical quality of your dentistry is superior and should be reflected in your fee. Also consider the materials and laboratories you utilize. There are many different levels of quality when it comes to both of these areas. If you are using the highest quality materials and excellent laboratories, this should be reflected by your fee.
Second, consider the technology utilized in your practice. If you are implementing the latest and greatest in dental technology which allows you to diagnose and treat patients at a higher level than without those tools, that should be reflected in your fee. Patients don’t know much about the technical side of dentistry, but they perceive that a practice that keeps up with cutting edge techniques and technology must be good.
Third, consider the level of service your patients receive when they are in your practice. How is your customer service? When patients feel good about being in your practice and feel well taken care of and special, they are willing to pay more. As patrons, we all want to support businesses or services where we feel we received a fair value for the fee paid. Dentistry is no different. However, patients must see and feel that your practice is above the average dental practice in order to pay more. Be aware of the "value-added" services in your practice.
Some value-added services should be evident to the patient. The practice should be clean and professional looking at all times. The customer service skills of the entire team, including the dentist, must be excellent. If you haven’t already, you may want to invest in some customer service training, or at least discuss as a team your plan for having consistent, excellent customer service. All team members should be able to handle potential fee objections from patients confidently and professionally. Consistency in your systems also contributes to patients’ willingness to remain loyal to the practice regardless of the fee. This means they always know what to expect because situations are handled the same way each time and there are no surprises.
Other value-added services may not be evident to patients and require the dental team to educate the patient. You should have a value statement for every service in your practice. Some examples might be, "We always take your blood pressure because it is important to us to consider your overall health, not just your teeth." Or, "Oral cancer is on the rise and we are very stringent with our oral cancer screenings. I’m performing yours now." Or even, "I’m so glad you had your crown done here because Dr. Smith uses the highest quality material and laboratories and you are getting an excellent value." The more times patients hear the value of what you are doing, the more it builds the value of the entire practice. They will be willing to pay for that perceived value.
Once you have evaluated all the aspects of your practice that contribute to the quality of service your patients receive, set a goal to increase the areas that are not up to the highest level. Once you have raised the bar, don’t be afraid to raise your fees. If patients perceive a fair value for the fee they are paying, they will pay and not complain. Help them with that perception of fairness. How do you do that? By involving your team in the analysis and decision points highlighted here so they can buy into the idea that your fees are appropriate. Then, arm them with excellent verbal skills so they feel confident responding to patients.
The verbal skills of how to deal with patient objections about fees are very important. You do not want people to leave you. You do not want people to be hostile about your fees. How you handle the normal complaints about fees will make all the difference in the world. Remember, as Cathy Jameson’s always said, communication is the bottom line to your success with anything, including discussions about fees. Here’s one quick example.
Patient: "Haven't you guys gone up on your fees since my last visit?"
Team Member: "Yes, Mr. Jones, there has been a slight increase in our fees. Our costs of operation have gone up and, therefore, our fees have done the same. We refuse to compromise the quality of our care, and so, we carefully position our fees to reflect our commitment to be the best. We know this is what our patients expect of us as caregivers".
Patient: "Seems like every time I come in your fees go up."
Team Member: "No, not every time, but I can appreciate what you are saying. When the cost of a procedure goes up, we do increase our fees in order to cover those costs. We prefer to do this rather than use inferior materials. Inferior materials produce average dentistry, and, Mrs. Jones, the last thing in the world that we want to do is put average dentistry into your mouth."
Be encouraged – increasing your fees to a fair point can make all the difference in your productivity, profitability and stress control. That transfers back to the energy and positive enthusiasm you can share with your team and your patients. Overcome the fear of fees. Raise the bar and then, as appropriate, raise the fee.
Julie Hanson is a Jameson Coach. She may be reached at 877.369.5558 or julie@jamesonmanagement.com.
To use the Automatic Fee Schedule Changes tool in Dentrix, click here.
To learn about R-Fees, a customized fee schedule analysis, click here.
Dr. Tina Brenza has been announced as Jameson Management, Inc.'s "Branch of Peace Award" recipient, honoring her devotion to promoting peace and leadership.
Following her graduation from Northwestern and ensuing residency and fellowship-a time when most dentists begin work toward a financially rewarding private practice-Brenza set out for Rockford, Illinois, to help set up a new clinic serving developmentally-disabled patients. In six years at Milestone Dental Clinic, she compassionately treated hundreds who otherwise would not have been able to afford care.
In interview unrelated to her Branch of Peace Award Recognition, Dr. Brenza said of her time at Milestone Dental Clinic, "It was not financially lucrative, but I made such a difference in my patients' lives. The amount of cards and pictures they sent me brings me such joy," says Brenza, who has served as chair of the ISDS's Access to Care Committee and the Winnebago County Dental Society's Public Health Committee. The birth of Brenza's first child and a decline in her father's health necessitated a switch to a private practice in 2005.
Her Northwestern background helped smooth the transition as she and her husband, Ryan, who now manages her Rockford practice, received crucial advice on the endeavor from fellow alumni. Brenza was also assisted by her well-rounded education, noting that the Dental School took the uncommon step of using faculty from the Kellogg School of Management to tutor students on how to buy and own a practice.
Brenza earned her undergraduate degree from Loyola University Chicago and her received her DDS in 1996 and moved on to a residency and fellowship at University of Iowa Hospital. Still, Brenza keeps her passion for her alma mater alive, serving as the president of the NU Club of Rockford. She also works to better her community through involvement with environmental causes.
"With movements everywhere on 'the greening of America' and becoming more Earth friendly as people and professionals; and with the worldwide plights that human beings face plus the many moving stories you hear of heroes trying to do their part, we wanted to really highlight these stories within the dental industry and bring the heroes to the spotlight for a moment. Thus, the Branch of Peace Award," said Cathy Jameson, Founder and CEO of Dental Coaching Firm Jameson Management, Inc.
Cathy Jameson's vision evolved into special sketches created by her father, Derry Ebert, which have been crafted into wall décor awards commemorating each award recipient. Her directive in the call for applications welcomed entries describing "anyone who is living with a big picture perspective; whether living an environmentally conscious life, doing something philanthropic, exemplifying outstanding leadership and things along those lines. Dr. Brenza, like the other award recipients, definitely seems to be an appropriate match with Cathy's thoughts," said Jameson Management, Inc.'s President, Jess Webber.
One of her Jameson coaches, Kimberly Brozovich, wrote “Dr. Brenza is a highly motivated and passionate individual. She is not only an outstanding care provider, Dr. Brenza also goes over and beyond to help her community and the overall environment. Dr. Brenza is making a difference!”
In her spare time, Dr. Brenza enjoys spending time with her family and numerous pets. She looks forward to traveling with her children as they grow so that she can share her love of history and nature with them. She is passionate about protecting the environment, from recycling to sustainable living to cleaning up her community. Tina and Ryan Brenza have two sons: Grant, 4, and Evan, 3.
