I have a confession to make. Behind every successful woman, there is occasionally a brilliant man. In this case, my husband Bob Wheeler. He is our Senior Consultant and has been the solver of more than 500 healthcare professionals’ practice management problems (many of those are Denturists). Our resident guru, if you will. Anyway, I picked his brain once again and the topic for this issue became the subject of discounts.
Often, denturists offer discounts without even being asked by charging less than the provincial fee guide. Did you know that your associations go to quite a bit of trouble and expense to work out the appropriate fees for your services in your own province?
Dartboard approach to fee setting
Some of our clients have thought that their associations have a special dartboard that they use to help revise the fee guide from time to time. However, provincial fee guides are most often based on economic studies done by outside accounting firms who consider cost of materials, time involved and responsibility of the denturist (i.e. the more complex the case, the more value assigned to it). These factors are then used to determine what the appropriate fees should be for dentures in your province. Once the study is completed, most associations increase the prices according to cost of living index.
In other words, the fees are not completely arbitrary. They are fair prices for value for the services provided. This approach is used for all the healthcare professions.
So stick to the fee guide or you are automatically giving a discount. Some denturists give away their living by not only having a fee guide of their own which is below the provincial fee guide, they then make matters worse by offering a senior’s discount on top of that!
Quality care = quality fees
You are providing quality care and service to your patients and that you are using materials that are appropriate for the quality of denture that the patient is purchasing. If this is not true, then this is the first area that needs to be improved.
Some of the most productive offices we have worked with have cheapos next door to them who are working their fingers to the bone making dentures for peanuts, while our clients are producing a classy product and charging fair fees, thus reaping the true rewards of being a good denturist — pride in work well done and the financial remuneration appropriate.
Create a discount-free practice
The following is an outline of what needs to be done to eliminate or significantly reduce discounts in your practice.
1. Eliminate all references to discounts in office policy, patient handouts, advertising, signs, etc.
2. Clearly state that you follow the fee guide issued by your association. This includes conversations with patients as well as any written material handed out to them.
3. Never offer a discount. Don’t originate that you offer a discount of any sort. The most common one is a discount for seniors. The bulk of the wealth in Canada resides in the hands of seniors so this offers a discount to those who need it least. This is not to say that you shouldn’t do some charity work for those who truly cannot afford it. Charity work can be done, but be sure that the candidate really does qualify and keep the amount of charity work within reason as you need to earn a living too.
4. When asked for a discount, tell the patient that you only use the highest quality materials including teeth and that you do not use any shortcuts in making dentures. Politely ask the patient if they want you to reduce the quality of material or teeth that you are using in making their denture or if they want you to use shortcuts in making their denture. Explain that in order for you to provide them with a high quality denture which you are sure they want, then the fee is $______.
5. Should the patient persist, it’s best to tell them that you can’t provide them with dentures and that it may be best for them to seek out someone else. Don’t be afraid to turn a patient away, especially if they want a discount or want it done their way. These are usually early signs of problems to come.
More often than not the “problem” patients who you can never satisfy and who make the lives of you and your staff miserable are the same ones who want a discount (and usually a significant one). And guess what? They refer more patients to you who are the same as they are! This is not a healthy way to build a practice.
6. Train your staff to be able to deal with patients concerning this matter. Answer any questions from your staff that they run into and then role-play them through handling the various situations. Do this until they are completely at ease with this. The role-playing will most likely need to be done more than once.
7. When transitioning away from discounts, existing patients of the practice will often remember that they got a discount the last time they were in for service. Let them know that in order to keep your fees reasonable despite rising costs of quality materials, you have had to eliminate discounts. Tell them that you are sure that they want the best and that you are doing everything possible to provide it to them.
In some instances, you may wish to continue the discount policy with a FEW long term patients who are very good. This should only be a few and you should let them know that this is a very special arrangement for them. Make sure that they know that this will not be offered to anyone that they refer although you will definitely provide their friends with the best possible care and service. You can also obligate them to send in some of their friends by saying that since you are continuing to offer them the special discount, you would really appreciate it if they send some of their friends to you.
8. Track the total amount of discounts being given. If you are computerized, this is usually a feature of the software, i.e. the program will track discounts if they are entered as a full fee and then adjusted downwards by entering a discount. If not computerized, make a separate column in your ledger where you can enter discounts.
By tracking discounts, you can see whether you are making progress in eliminating or reducing them, or, once that has been achieved, are they staying eliminated.
The choice is yours
You can make a good living by doing everything right or you can subsist and spend your life in your lab making lower end dentures for discounted prices. To mix a metaphor, we can lead a horse to water but you have to lie in the bed you make for yourself.
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