1. Is setting a fee worthy of chiropractic because whatever you set, it is worth more?
2. Is it that the service we provide is not worth what we charge or is it that charging is not worthy of the service?
3. Are we afraid people will not pay what it’s worth or are we afraid we cannot convince people of what it is worth?
4. Do we charge what we believe the traffic will bear?
So what is your thought on this aspect of practice?
You know that I am an advocate of having to charge fees. I completely agree with Reggie that any fee that prevents people from receiving care is not a fair fee and if fees aren’t high enough for the chiropractor to make a reasonable living, then that’s unfair too. But how one (the DC) chooses to be paid will depend upon several circumstances. 1.) belief systems of the DC 2.) ability to communicate 3.) confrontational skills 4.) overall emotional make-up of the DC 5.) community he/she practices in 6.) overhead 7.) and I am sure more can be listed here. Determining fees comes from a perspective that only the DC can really determine based on all of those things and whatever else he/she needs to consider. Certainly students who graduate now and are $150K in debt would have a different perspective on fee charging. Then, another factor comes into play – our practice member’s desire to use chiropractic like WE think they should use it. We cannot control what others choose to do. We cannot force them or scare them into coming regularly. If people do not want to do something, they will not. And just because we share what we do with them, does not mean they will accept it and LIVE it like you and I do. My experience has shown that people want to know things up front. They want to have an understanding of what their responsibilities are and they want to know what it’s going to cost them financially. That’s why people get options in my office. They choose what fits their lifestyle desires. But I lay out the options and leave it up to them. No scare tactics are involved. Setting a fee sometimes requires experimentation to find what seems to work better for your location, etc. Pertaining to the questions you ask above —– nobody could afford what our service is actually worth! SO all we have to do is honor the laws of exchange. And it has to be fair to both parties. Not having a fee and placing it in the hands of God brings spirituality into the practice of chiropractic. I thought we weren’t supposed to be doing that?
I would like to comment on the suggestion that “not having a fee… brings spirituality into the practice of chiropractic.” 1. It is not entirely true to say that we do not have a fee. We tell people “There is a fee, we are just letting you set it!” 2. While it is true that Joe (and I) trust God to provide for us, I think the same is likely true for all Christians, in all walks of life, with all fee systems. We also trust Him to keep our loved ones safe and close and to keep the sun in the sky and the grass in the earth. 3. We do not associate that trust with our fee system. We tell people that everyone is better without intereference in their nerve system and we run our office in such a way as to remove as many obstacles as we can to people getting the care we recommend for them: we have extended hours, we have no appt necessary, we have this fee system, etc…
It’s important to us not to mix our faith with our chiropractic, but we don’t do that because we aren’t “supposed to do” that. We do that because we don’t want to confuse people about what chiropractic is. It’s simple, we want to keep it that way.
I have heard how unprofessional it is to offer a box-on-the-wall practice and heard how your fees can and do prevent people from obtaining chiropractic care. I look at it this way: On one hand: who are you, the patient to determine what I, the chiropractor am worth. On the other hand: Who am I, the chiropractor to determine what you, the patient can afford. Both have their advantages and disadvantages. Bottom line is that if you the chiropractor do NOT get paid enough to keep your doors open, neither you nor the public can benefit. However you decide to address this issue, it must be addressed for everyones benefit.
Wow, what a philosophical stream of thoughts… (Yes, I know, it IS a philosophical site…!) However, perhaps if only to play “Devil’s Advocate…” I believe a more practical way might involve looking at what the average co-pay in an area is, and what the market will bear. Eg, if the average co-pay were 30-45 $ (which I find laughable as $45 is an Extremity Adjusting Fee anyhow), but many could not afford to have insurance in the region, then simply charging the Exty Adj Fee might be fair. (Gifting whatever other services you may deliver). I have also thought a % of income figure might help a px arrive at a more appropriate fee (through a calculation of what % of one’s income one might be expected to spend on “medical” care) but have not delved too deeply into this (time constraints), and would welcome further suggestions. Hope this helps the pragmatically inclined đŸ™‚
This is a topic I struggle w/ at times….but being committed to providing wellness care, I do not want to put up any barriers to follow-thru. I also want to keep it simple. How much is it worth to have the life turned on in your body? But in these economic times people are being pulled in all directions. In the end you have to be true to your own paradigm.
Most chiros have not paid for lifetime care for themselves or their families.
Most Chiros also have an unwritten agreement to PROVIDE Lifetime Care for their Colleagues. (This may or may not extend to their colleague’s families. I know that when my wife was treated for certain injuries by another Doc – I did not want there to be any contention of “conflict of interest” in her treatment – we paid for that care.) If everyone agreed to provide me with Lifetime care – my hairstylist, my mechanic, my contractor, my electric company, the school I attended (!) et al, then I would not need to charge a fee, right?