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I work with a lot of private practice owners and I find it interesting that many of them feel sorry for how much they are charging patients for their services. Now don’t get me wrong, compassion for our patients’ medical, psychological, and even personal financial situations is of extreme benefit, allowing us to form important bonds with our patients and ultimately improving the healthcare experience.  I also believe that it is our ethical obligation in healthcare to provide structured pro-bono services to our communities as not everyone has the same ability to pay for quality healthcare. 

This said, I still feel that healthcare practitioners need to understand the value of the services being provided, and be prepared to justify this to paying patients, and not simply pass the blame on to insurance companies, government, large healthcare corporations, etc.  The problem is that if we can’t justify to our patients the prices that we are charging for our services, then it becomes immediately evident to the consumer that we don’t believe that we are providing good enough value in our services. 

We all know that the healthcare system is broken, and if we are going to choose to remain in the healthcare profession we will be involved in its repair.  To achieve this, we need to introduce to our patients some accountability for receiving good healthcare, starting with an explanation of why it is important to have good healthcare coverage, why it is expensive to receive good healthcare services, and why making an investment in one’s healthcare is the best investment that can be made.  Passing the buck and not explaining the value to our patients does nothing to help the problems we are facing in healthcare, and as practitioners and private practice owners, it is our responsibility to perform this education at the point of care.

As an example of the pitfalls of not having this discussion with our patients, the author of this post describes his takeaway from the healthcare experience from a 2006 encounter with his medical doctor.

I had an initial consultation with an orthopedic surgeon (Dr. Black — ominous, eh? Not to worry: he was young, probably my age, and he looked like a squeaky clean kid.) The news he had wasn’t good — it was rather depressing actually — yet when I asked him to give me a ballpark estimate for the costs of the procedures he was recommending, he couldn’t (or wouldn’t) give me one. He was a little defensive, actually, explaining that his fee was only a small part of the overall cost. I wasn’t looking to blame anyone for how much this was going to cost me, I just wanted to know in advance. Why was that so difficult?

He told me to call a woman, and she passed me off to another woman, who said she’d try to gather some information for me. I waited for days.

“Why is this so difficult?” I asked. “Is it so rare that people ask how much these procedures cost?”

“Well,” she explained, “Most people have insurance that covers this.”