How not to quote a fee
A while ago I asked an architect to design a renovation on a property.
After some discussion I was told by the architect that I could get what I wanted for $1M. That’s not the actual figure but I’m using a round figure to make things simple. We agreed on that costing but then I got a surprise.
The contract arrived and it turned out the cost was going to be $1M plus the architect’s fee (10%), plus tax (10%). That immediately put me 20% over the agreed budget and the project hadn’t even started.
I told the architect that I wanted an all-inclusive fee. A new contract arrived and it contained another surprise. I would need to hire consultants (engineers, heritage, soil, landscape and town planning). No estimates of those costs were included but the architect guessed they might be about $50,000. At that point my relationship with the architect ended. It wasn’t that $1.25M was out of the question, it was that I no longer trusted him.
Let’s come back to dentistry.
A friend told me a similar story about his TMJ treatment. At the first appointment my friend was quoted $1,200 and the dentist made a splint. My friend felt better and went back for an adjustment visit. At that visit my friend was told that phase 1 of the treatment was finished and now he could move on to phase 2.
My friend didn’t know that there was a phase 2 but he agreed and got charged $1,500 for an improved splint. At the next visit my friend was told that he was now ready for phase 3 and it would cost $4,000. My friend got up and left. It wasn’t that he couldn’t afford it, but rather that he felt that he was being strung along.
Here’s my advice about quoting fees in order to maintain trust with your patients:
Quote all-inclusively.
Don’t leave things out. It will make patients angry if you start adding things, like x-rays, after you’ve given them their quote. Let patients know what it will cost to carry their treatment through to completion. If a tooth needs a root filling and a crown, let them know about the crown before you start the root filling, not at the finish of that procedure.Build in contingencies.
It’s better to over-quote than under-quote. You can always bring your fee down but if you go the other way patients get angry. I saw a patient become furious because a dentist increased the fee. The patient was having a crown and the dentist quoted without a core. During the prep the old filling came out and the dentist had to do a core. He added $200 to the fee. The patient walked to the front desk and was given an account for $1,950 when he had been quoted $1,750 less than an hour earlier.
Telling patients the fee is simple if you stick to those rules. Patients don’t like surprises.
