It never ceases to amaze me. I hear story after story after story from orthodontists and TCs alike. They tell me about a patient or parent who is, shall we say, challenging to deal with or even combative who visits their office for a new patient consultation. From the outset it is obvious that this patient will take up more time and resources than 99 percent of other patients, not because of the difficulty of the orthodontics but because of the challenging nature of the patient and their attitude. What to do?

Well, most agree that we have two options from a clinical and a business point of view.

  • We can refuse to treat the patient because of the difficulties in patient management.
  • We can raise the fee substantially to cover the cost of the extra time, attention and effort we know it will take to get a result that is satisfactory to the patient in question.

Most doctors choose option two. And what happens almost every single time?

The patient starts!

What can we learn from this scenario that is repeated consistently across all practice types and in all demographics? What does it mean when a HIGHER than usual fee is accepted almost unanimously? In a day and age of commoditization of orthodontics, fierce competition and downward pressure on fees, how is this possible?

This ubiquitous success is the result of total belief in the fee you are presenting!

In these cases doctors and TCs alike stand firm and make it clear that THIS IS THE PRICE for the case and that is final. We do this because we know we will lose money on this kind of patient otherwise and we would be better off if they walked instead of reducing the fee we are presenting. Think about what that means – what can be learned from this? Why not set ALL your fees so that you and your TCs fully believe in them and the value you are conveying in every single case??

2 thoughts on “Challenging Patients Can Teach Us About Our Fees

  1. To a degree you are correct but there is one other aspect to this. Often these patients know they are difficult and expect the high fee. I remember a story of a prosthodontist colleague who used this approach some years ago. He quoted a patient about 2.5 times his normal fee. He knew the patient had been shopping around from colleagues who had warned him. The patient then turned around and said to him that he was the only one of the practitioners she had been to who had albeit indirectly, said to her that she was just damn impossible and was going to have to pay for it

  2. Cool. Thanks for bringing that up! I’m sure that happens but I think that scenario is more the exception than the rule. It’s good to know your new patient’s motivation for sure though and the more angles we understand the better we can serve our patients.

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