What is the value of 15 minutes of a doctor’s time?
As an urban family physician in Gurgaon, I charge Rs 400 for a consultation, with a free follow-up for seven days thereafter. Home visits are charged at Rs 1000 to Rs 2000 during the day time or Rs 1500 to Rs 3500 at night, depending on the distance I need to travel.
Personally, I feel that I charge quite a bit less compared to the value I’m delivering to my patients and their families. But, I’ve realised that, from a business perspective, the feeling is largely irrelevant.
No matter how you plan to design your consultation fee structure, you must first ask yourself the following four questions.
1. What Is My Personal, Family and Operating Expenses?
How much do you need to charge to cover your medical practice costs as well as ensure a decent standard of living for yourself and your family?
Some medical practitioners might be able to charge a big enough consultation fee to cover the above. Other physicians might have to figure out other ways of augmenting their income, depending on their specialty.
For example, you could also dispense medicines, do home visits, do minor procedures, collect lab samples and send them to a lab, etc. However, you have to do all of this within the limits of ethics. So, you cannot take any cutbacks from diagnostic centres, hospitals or pharma companies.
2. How Much Value Should I Provide to the Patients?
This is an interesting question. I myself have visited the “top” consultants in the city, paid Rs 1000 to Rs 2000 for a single consultation, and came away dissatisfied. This was primarily because the top doctor didn’t deliver value proportionate to the consultation charge or the waiting time.
As doctors, we often restrict ourselves to our viewpoints and keep cogitating on the ways we’re excellent. So, we forget to consider the patients’ perspective. But, if your patients think they got more value than they paid for, they’ll be happy. If not, they’ll be upset. That’s the bottom line of any business, especially a value-based business like healthcare services.
So, the healthcare crisis is not due to physicians charging too much; instead it is due to the patients feeling as though they’re not getting services proportionate to what they’ve paid.
Let me illustrate this with an example: When I started my practice, those people who came in for a medical fitness certificate would often try to bargain. They’d say, “Oh, it’s just a two-minute thing. Why are you charging the full consultation fee?”
So, we started providing other valuable services during the fitness check. For example, for children and adolescents, we:
- Rechecked the vaccination records
- Gave Vitamin D supplements
- Provided information regarding seasonal flu vaccines
- Plotted the height to weight ratio on a chart and showed the data to the parents which invariably led to a discussion on diet and exercise
- Prescribed deworming medicines
- Did vision checks
Since we’ve started providing these additional services, we’ve not had a single parent complain about the consultation charge. For others, a simple “anything else I can help you with today” does wonders!
Basically, there’s a lot more that a physician can do in a consultation without spending too much time or effort. For example, my clinic managers and EMR do most of the things I mentioned above.
Also, don’t forget the magic touch of a doctor. We can ensure satisfied patients by:
- Giving our patients our full attention
- Taking a skilled history
- Performing a focused examination
- Explaining the differentials and prognosis in the patients’ language
- Making the treatment plan in partnership with the patients and their families
Doing all of this not only makes patients feel better, it also improves patient outcomes. People may forget what you did for them, but they’ll never forget how you made them feel!
Furthermore, patients often judge the quality of care they receive based on the quality of communication with the doctors and staff.
3. What Can My Patients Afford?
India is a thousand Indias. Each socio-economic stratum has its own paying capacity and willingness to spend on healthcare services and products.
For example, I see families who consult me for their children, but go to the neighbourhood quack for their own health problems. I also see families who want me to spend the night at their homes to care for a parent and who are willing to pay whatever I charge.
So, it’s an interesting challenge delivering services to the poorest of the poor and the richest of the rich.
As an entrepreneur, I know I can’t grow if I ignore this reality. As a doctor, it doesn’t feel good to pick and choose patients based on their paying capacity. As a doctor-entrepreneur, I need to consider how I can deliver services that are affordable for the poor, services that are top-notch quality for the super-rich, and something in between. Convenience and availability also figure in prominently in this equation.
Cross-subsidization often works, but only if there’s a huge socio-economic gap between the people paying the full fee and those getting a subsidy. If there’s only a marginal gap, then people will start comparing and complaining.
Another solution I’ve seen work is to have a base consultation rate for everyone and charge extra for premium services.
Also, don’t forget to apply a senior citizen discount. These citizens won’t forgive you if you charge them the same as everyone else!
4. How Much Are My Competitors Charging?
There is no dearth of health services in India, regardless of what the NGOs would like us to believe. We don’t exist in isolation and our patients are generally much more aware of the healthcare “market” than we are.
So, it helps to keep your eyes and ears open to feedback from existing and new patients and learn more about the “community of practice”.
Is everyone printing prescriptions using an EMR now? Then I need to be one step ahead and give my patients access to their records on my EMR. Has everyone else increased their consultation fees? Then I need to hike up mine too as a patient’s perception of quality often depends on how much the medical practitioner charges.
Long story short, physicians can survive and flourish by providing a better value proposition to their patients than anyone else out there!
Let’s raise our standard of care and communication, understand our communities and competition better, and provide valuable services. We would then never again need to feel defensive about what we charge.
What do you think should a physician charge for a consultation? What pricing strategy do you follow? Do you have any questions?
Please feel free to leave your comments below. We would love to hear from you.