Depending on who you’ve talked to, taken CE courses from, or read about in a journal or newsmagazine, the topic of “who presents the fees’” has long been passionately discussed and debated.
Whether you agree or disagree with the doctor presenting the fees is not important, because in reality it depends on many circumstances and situations, much like everything else in life – and in practice.
The Doctor Presents the Fees
Simply put, the sheer act of presenting the fees is a necessary “moment of truth” in the doctor-patient relationship. When both parties know what’s the commitment on each person’s part, there’s no excuses, “he said-she said” discussions, or miscommunications. Generally speaking, most patients are making the most sizable investment in their dental health that they can or are ready to make. Whether it’s $100, $1000, $10,000, or $50,000, it’s a lot to the patient. By you paying careful attention to the details of the treatment specifics and associated fees, you are holding yourself responsible and accountable to the patient AND your team. If you place the task on their shoulders, mistakes are apt to happen, and opportunities are missed to provide care.
Put yourself in the patient’s shoes: if YOU were to choose mostly elective procedures (which a lot of dentistry truly is), how would you feel if the doctor never told you how much it would cost? Would you feel the doctor is trustworthy? Reliable? Informed? Caring? Accurate? Accountable? What’s YOUR answers?
Patients are no different than you and me. They don’t have a “money tree” to pick from any more than we do, and they want to be treated as people, not “cases”, “treatment plans”, or recipients of your developing skills.
This is NOT the same as making financial arrangements, which is an entirely different topic.
What would you feel like – as a consumer/patient – of a doctor who wanted to provide services to you, but couldn’t look you in the eye and tell you want his/her charges would be? Does it instill confidence? How do you interpret his compassion towards you? How would you feel towards that doctor is he was unable to deliver a less-than-perfect result that you anticipated? How would you feel about the fees then?
I challenge you to consider your answers to these questions and their implications. Your answers will create greater awareness of your skills, expertise, and judgment, which will allow you to make better choices for your own practice.
“But I don’t feel it is my place to quote fees”
To put it bluntly, why?
My experience is that many doctors are either embarrassed, fearful of rejection, assumptive of how the patient will respond, or just plain lacking the skills to talk openly about the cost of treatment with patients. Simply put, the more open you can be about the financial aspect of the cost of treatment for a patient, the less the obstacle becomes, and the stronger the relationship with the patient becomes.
And by now, you probably know that your relationship MUST be strong with your patients, because dentistry is both an art AND a science, and not everything will work out exactly as anyone plans every time. No one is perfect. Your relationship has to be strong and healthy to weather any and all storms that may pop up.
When YOU get comfortable with talking about money, so will your team, and both you and them will quit accepting the excuse that ‘money is the reason the patient didn’t proceed with treatment’. You’ll be able to talk more openly about money, put the cost of care in perspective, and have a healthy, positive attitude about the patient not only receiving treatment, but also about payment for your services.
It’s my experience that doctors who are reluctant to talk about money with their patients have more trouble with their patients than those who are open talking about money.
What about that unusual staff member who is OK talking to patients about their fees and payment arrangements? Do you see them sweating about it? No, they don’t. It ultimately gets simple: no money, no treatment, no problem. Yes, they’ll work with the patient to “make it work”, but they don’t let their fee of talking about money stop them. And it’s just too easy for the doctor to just let the staff member handle it … Mistake.
What can I say?
Without giving you a script, try something simple like this: “Mrs. Jones, the total cost of your treatment will be $5,860 and that includes resolving each of the problems and concerns we’ve discussed in detail.” Stop; the next person to talk loses! If you keep blabbering away, Mrs. Jones knows you’re obviously nervous, perhaps unsure or embarrassed, and less confident in you. Making a statement, allowing for silence, and answering all questions for clarification afterwards shows real confidence and professionalism. You are not there to “talk them into” doing treatment, haggle over the cost, or make excuses for the cost of helping them to resolve all their dental problems. The fees are the fees. Avoid diminishing your professionalism and our profession by playing games with the patient at the presentation of fees. We know of one dentist who would artificially set his fees 10% higher, quote the fees, and if the patient hesitated, he would knock off 10% to make the patient felt like they were “getting a deal”, when all they got was manipulated. Please don’t give dentistry a bad name by employing tactics like this!
Whether you cite complete treatment costs or treatment costs based on phases of treatments matters not; just be thorough and complete so they are no surprises and your patient understands the complete cost of treatment. For example, I’ve witnessed too many patients who were quoted the fee for an implant to be placed, but not the abutment and crown, which causes considerable problems. Don’t be afraid to give the full fees; better now that through arbitration with a third party.