Your professional charges

How do you decide?

How do you know whether they are right or if you need to decrease or increase them?

What to do when patients are negotiating?

And if you are thinking whether or not you should increase your charges then you should definitely increase the charges.

Disclaimer: The charges that I am quoting in this email is based on the market charges which are present in my area. It can differ from person to person and area to area that you are staying in.

This is a topic which is not taught in our college but it’s the main form of struggle that we face after we enter the outside world and the clinical world. Another dilemma that comes into notice is that we don’t have a fixed structure and a body to determine what should be a range of charges. Just like lawyers and chartered accountants have a fixed guideline about charges, we do not have that in our country.

First of all my advice would be to find out what are the market charges present in a particular area from senior therapists working in that area. My strategy when I started out was to ask my relatives who have taken physiotherapy prior and asking them how much they charged them. However this is not to compare your charges with someone else as each therapist and their specialization is unique but it is to just get a rough guideline about what should be your range of charges and whether or not you are giving yourself justice. Yes this was something which my previous mentor made a mistake in. She used to charge a lower fee than her competitors which created a demand for her services from the patients however the respect level went down significantly as whenever patients are charged an appropriate fee they are much more likely to follow through with the plan that they have been given and they are much more likely to respect you, your time and our profession. So the fee should never be decided based on whether or not your competitors in the same area are charging that much and you should charge a lower fee.

So having said that, what are the important factors for quoting your charges:

1. Level of experience: when I started out with my bachelors in 2018 I used to charge a fee of 600 for Home Visit. The clinic charges were 400 at that time. However I do know people who used to charge 1000 for the Home Visit in the same area and the clinic charges were around 600 to 800. This was because number one my experience level was much less and the socio economic status was much less of the patients that I used to treat at that time, as the higher SES would be able to afford a more premium treatment from a more experienced Physiotherapist. Once I completed my Masters and started practicing again I increased my charges from 600 to 800 as I was now having a degree as well as the year had changed from 2018 to 2021.
2. Area that you practice in: Yes this matters, a patient living in Mumbai has more income or more affording than a patient living in the outskirts or a tier 2 or 3 city. Everything in Mumbai is much more costly, they are also much more inclined to expect a particular high charge. However again the charges would vary there as well. So again the point about finding out the market charges in your area is important.
3. Specialization: yes my charges increased based on the specialization that I acquired in two years. However I still feel that I am undercharging my patients to a certain extent. Also when you have a specialization you also can take a higher first consultation fee and then decide your charges based on a short or long session that the patient would require or based on what is the level of work that you’ll have to put in. Since I am a neurospecialist which is a high physically demanding work, I make sure that I charge the patient accordingly. and explain to them why my charges are that much.
4. SES of client: if they really need your treatment but they are not as affording, you can decide to give them a concession of 100 to 200 Rs. on your charges. However the concession should not be more than 10 to 20%. I have not done that but you can decide to even have a package system for the patient so that they stick with you throughout the 10 or 20 sessions that you create for them and they still get a good rate. You can also ask or offer them an alternative of taking the sessions on alternate days or twice a week so that they do not have to shell out a lot of money but they are still taken care of and they are still under your guidance for physiotherapy. In that your education about a proper home exercise program will be important.
5. Services that you offer: are you taking a long session or a short session? Usually neuro sessions require long sessions however there are certain neuro cases which are low in disability and do not require a long session. Also what are you offering in your sessions? There are some physiotherapists who see two or three patients at a time in one hour. However there are other Physiotherapists who see only one patient in one hour. Then your charges will vary accordingly.
6. Clinic set up: calculating how much cost you will need to cover: now this is something which even I am learning on the go. However when you are starting out your own clinic, estimate the amount of cost that will go per month and then calculate how many patients you will need to get to your clinic and how much should you charge them to cover that cost plus a surplus amount.?
7. How long will the patient need your therapy for: this is again a dicey situation. According to my experience some patients who need a very extended duration of therapy, they are the ones who usually try to negotiate with you on the charges. However when you do think of the duration that they will require the therapy for, and reduce your charges, they still don’t end up taking your sessions for that much amount of time. I had a few patients negotiating on the charges saying that they will be needing it for a long time so it will be better if I do that for them but they only took the sessions for two or three weeks. So in that case make sure that you clear it out with them that if we are negotiating on that basis then a package is the only thing that will be offered to them. In that way you are protected from reducing your charges, even if you are reducing your charges you still have the patient with you for a longer period of time. Remember that it should always be you who should have the upper hand in any situation.
8. Increasing your charges: if you are thinking of increasing your charges then you really need to increase your charges. If a patient has been with you for more than one year, you need to increase the charges. If you have been charging the same amount for six months to 1 year, then you need to increase your charges. If you have gained or acquired a new skill and you have started to use it on your patients, then you need to increase your charges. If patients are coming highly recommended from other clients, then you can increase your charges by 10 to 20%. Basically once your demand starts increasing, so should your rates. You will understand yourself when it is the right time to increase the charges. It will be like a gut feeling that you will get.?

How much to increase it by?

Taking into account the inflation of 7% every year, you can safely increase your charges by 10-12%. Other things to note would also be the petrol and fuel costs (Home visits and travelling cost), how much TIME are you spending on travelling and if you are renting out a space, then if that rent is increasing by a percentage, and finally if you are also hiring someone to work for you.

So this is it for my article this week. Let me know if you found it valuable. Also do recommend this newsletter to other people in your circle, it will really motivate me to produce better quality content.