Thursday, June 23, 2011

Why are you so expensive?

Happy Thursday to you. That's right, one more day until Friday.

How is your summer going? Here it is just HOT. At 9:00 last night it was 89 degrees out. It doesn't even cool down. The pool isn't even refreshing.

Last weekend, my 12-year-old and I made fliers for his new landscaping job. And yesterday we put 70 or so fliers on (not in) mailboxes advertising for Luke's Lawns. Everything is a learning experience for him. He made a flier for the first time. He went to Kinko's for the first time. He walked around the neighborhood and did something for the first time. I went with him this time, but next time he might do it on his own. And the best thing is that his 7-year-old brother gets to watch this kind of work ethic. Good stuff.

This weekend we watched the movie The Express as a family. This was the movie about Ernie Davis, the first black Heisman Trophy winner. I thought it was a very good movie. But it was a great movie for us to watch as a family to talk about race in the 60s. I mean it was no Rudy, but what is?

Anyway, we were talking about prices and thinking that if we are better at something then we should charge more for it. I am over-simplifying. When I say we are better, what I mean is we are spending more time being educated, more money on better products, and more time in the chair trying to make it perfect. We should be paid more right? If you missed Friday's blog, you missed a good one. Go back and read it and then come back.

I did think about this all weekend. I kind of got sidetracked on Monday when I couldn't stop thinking of Dr. Scott bent over in his doctors office and the secretary coming in with coffee. But, I digress.

There was a comment on Friday's blog that I want you all to read:

From a patient's point of view, I think you're right that most of us couldn't tell a well executed filling from a bad one so unfortunately price does become an issue. I know from experience that my own dentist is extremely expensive but my view is that he takes the time to explain the treatment, he doesn't push unnecessary work, he's a stickler for detail and if that means a filling takes 2 hours, then that's what it takes. It's about his whole approach to me and my teeth. THIS is what I pay for. He also goes to the bother to explain that a filling may take time to settle and there may be some flare up with a deep filling as the nerve settles - previously I would have been in a bit of pain, blamed the dentist for being crap, gone somewhere else and ended up with a crown. The extra time he takes to reassure me about this is why I pay him the extra. And I don't begrudge it but I do however make damn sure that I play my part in ensuring he has as little work as possible to do. Nice to see he's not alone in realising there is a patient attached to the teeth !

I think we all hope that all of our patients appreciate their dentist like this person. I think this patient is rare. We can raise our prices and spend the rest of our lives trying find patients like this person, or we can just do what we do.

Raising our prices. Let's think about this a second. What are we going to raise them to? We are raising our prices to make more than $80 an hour. Would $150 make my friend happy? Would $200 an hour make him happy? Let's say $200 makes him happy.

That would mean we have to raise our prices $60 per filling. For me, that is raising my fee 25%. Patients are going to go up to the front and hear, "For those two fillings Mr. Smith, that is going to be $550."

Are they going to be any more taken aback than if they were told those two fillings were $430? If $430 is expensive to them, $550 is going to be really expensive. But the people that willingly pay the $430? They would probably pay the $550 and just go on. But I think the former is the more likely scenario.

I think I am beating this dead horse. I talked to my father about this and he said, just like a wise man (that doesn't have 4 children that he has to feed anymore or tuition or have to by shoes every other week), that our reward has to be more than money. He said "Good work comes back to bless you." You maybe nodding your head or you may be thinking he is a crazy old man. I was nodding.

He is talking about having raving fans as patients, like our commenter. A person that thinks you do good work. A patient that will stick with you even though their insurance changes and you have become out of network. A patient that moves 20 miles away and still will drive to come see you. A patient that will tell others about you.

He mentioned one more thing that I didn't think of. He reminds people of the good work that they have in their mouth. On a recall he would say to the patient, "Wow, that bridge still looks good, when did we do that thing again?" And when the patient tells him that bridge was done in 1974, it just reminds them that they come to someone that does lasting work.

I think I do that and didn't know it. Someone comes in for a recall visit and I will say, "Damn that filling looks awesome, don't you think, Kellee?"

When Kellee says, "Oh yes, Dr. John, they are so dreamy," (I can't tell if she is being sarcastic or not), I am reminding her that she comes to someone that does good work.

I don't know. I am rambling, aren't I? So, we will continue to do good work. We will continue to be conservative, to the patient's benefit. We will continue to make $80 an hour (instead of $500), and like it.

Have a great Thursday,

P.S. One last thing. I eluded to this in the last blog. My prosthodontist charges twice what I charge for a crown (he charges $2500 a unit). How does he survive?

Well, with those kinds of prices, he only has to see half of the clientele I have to see. And for the most part, he is doing big cases. If he does 8 cases a year at $60,000 each, he's not doing half bad. But let us not forget: dentists are referring cases to him, but no dentist is referring patients to us. I brought it up, but I just don't think it is the same.


Anonymous said...

My lawyer makes $250 an hour. Why should you as a dentist make less than her? She has one year less of schooling (which probably cost less each year if you add mandatory fees to dental school tuition) and much less overhead (i.e. risk). To even make half as much as she you would still have to boost your hourly profit by over 50%. Lawyers are professionals too and are supposed to serve their clients. No one complains about how much their local grocery store owner, real estate developer, or cardiologist makes. Why does everyone complain about the cost of dentistry?

gatordmd said...

I agree with you. I agree that lawyers make too much money.

I don't think that $250 is all profit.

And you say that we don't complain about how much our cardiologist, real estate developer, local grocery story owner, etc, makes.

I have a friend that is a real estate developer and he has made the grand some of ZERO dollars in the last two years.

I know I am off the point....
But I do think we complain about what everyone makes. I think it human nature.
I know my physician friends make a fricking killing. But what I also I know is that they work 14 hour days. I know that they work on weekends. I know they went to 13 years of school after high school.
I think we worry to much about what things cost and not everything behind the cost.
Like the real estate guy might charge a lot but he might be thinking I have to store up some of this because next year might be another barren year.
Or the dentist that just does a filling vs the dentist that is highly educated about fillings, uses the best products, is conservative etc.

Am I making sense?

Thanks for the comment.

Teeth whitening brooklyn said...

I think in every profession we can make lots of money but we cant complain for anyone when other person making more dollars from us...
Thanks for sharing!!!

gatordmd said...

I agree.

Thomas said...


I heard a story from a dentist in a small 12-dentist town in Vermont. His friend who had his own practice down the road prided himself on being the most expensive guy in town. They didn't communicate often, but one month this dentist gets 10 new patients from the expensive guy, so he calls him. The expensive guy says, "I was wondering what would happen if I tripled my fees across the board, so I did. Yea, I have lost a bunch of patients, but I am making more than I ever have!"

Great posts as usual. If you can sleep at night and keep your office open, your fees can't be too far off. Annual fee increases should be done. The ADA fee surveys are useful for determining where your fees are relative to other dentists in your region.


Anonymous said...

Absolutely. There will always be someone making more than you for what seems like equal or lesser work. My point isn't "why do they make more than me?" but rather "why does it feel like customers only get upset about their dentist making mone?". Perhaps it is just the skewed vision of someone in dentistry that makes me feel this. Do your physician friends hear "is this colonoscopy going to pay for your new boat" like the classic "is this crown going to pay for your new boat?"


PLEASE NOTE: When commenting on this blog, you are affirming that any and all statements, and parts thereof, that you post on “The Daily Grind” (the blog) are your own.

The statements expressed on this blog to include the bloggers postings do not necessarily reflect the opinions of the Academy of General Dentistry (AGD), nor do they imply endorsement by the AGD.