From Dr. Margolies:

There are various ways to establish fees. As with any transaction .. or discussion .. 
concerning professional services .. a fee has to be obtained after a value is placed. If a 
patient has little understanding of what is required and why .. they¼ll see no value and even 
a free service will be a waste of their time. If a patient understands a limited amount even 
after attending office workshops; viewing various videos; reading beautifully designed and 
multi visual pictured pamphlets .. but still leaves the office with marginal understanding .. 
they too will pay a bit more, stay a bit longer .. but once the glare of newness recedes they 
will too .. even if you¼re asking from them a very modest fee. 

The key is education, confronting their concerns with your knowledge and your level 
of commitment .. that green light that lets you know they know that you know, (you know 
what I mean) etc. No one workshop .. video ..  book .. pamphlet ..  survey .. virtual 
reality program .. computer generated scanning device, etc. replaces you .. your level of 
commitment .. your level of purpose or your level of confrontational tolerance. Knee to 
knee .. as with training staff  .. is required. Knee to knee .. as with assisting your child 
with difficult homework .. is required. Knee to knee .. as with asking your patients to 
cooperate towards regaining and maintaining their health .. is required. There is no short 
cut .. and there shouldn¼t be! Remember .. if you cannot do it .. train someone to discuss 
these vital patient/doctor relationships. If not, you¼ll „nickel and dime¾ them .. a few visits 
here and a few visits there .. not the care you¼d recommend for your family .. your friends 
.. your staff. 

Also, if you decide their schedule based on x-raying their wallet; the demographics of 
where they live or work; their demeanor and dress, or their level of insurance coverage, if 
any ..  you released yourself from a confrontation (remember this word .. confrontation 
.. is used not as hostility .. but to illustrate your reaching beyond the bounds of your 
comfort zone such as „it¼s not professional .. I can¼t do it .. they¼ll never believe it¾). There 
is never a right fee .. a right schedule .. just the right level of value. As in my class 
discussions and in the Smart Start book, you realize that what is right is your level of 
tone and purpose .. the value 


Tone is service .. tone is caring .. tone is commitment ..compassionate commitment .. 
tone is cooperation. This is not learned via a book or lecture .. it is probably ingrained and 
comes to the surface when needed. This is a person you hire to work as a team member 
with you .. this is also the green light you look for prior to asking the patient to cooperate .. 
„Mr. Smith, is it going to be relief or corrective care?¾ (I hope you spent the time prior to 
this „loaded¾ question preparing for a satisfactory answer) The fee you charge, whether it¼s 
a scant $10 a visit or $55+ makes little difference (doubt me? .. check the business office of 
a hospital .. a car dealership, etc.), what makes the difference is the value. Trust in your 
service .. have confidence in your knowledge .. cooperate as a professional health care 
provider .. tell the story .. give them options and let them choose. Fees are not the issue .. 
you couldn¼t give it away to a person who sees no value .. why else would we be seeing a 
mere fraction of those we should .. even with all the free examination, crock pots, trips to 
Hawaii offered to both patients and the public alike .. if it was just low fees (even for the 
start up practice) they¼d be in .. in droves.  

Be a professional, set your fees according to the prevailing „professional¾ fees of your 
area. Stand up for your years of education and the hurdles you have leaped, and the debt 
you have to repay to get to where you are. Cooperate as we all do in the Bigness of the 
Fellow Within and tell the story .. knee to knee .. corporate door to corporate door .. 
charge whatever you want .. as once you set a value .. a reason .. a cause and effect .. and 
give them options ..  just good business sense .. (read Chapter Two in the book), they¼ll 
follow you through thick and thin and you¼ll prosper.

For those individuals that drag us down with paltry fees .. only to justify that the flood 
gates need to be open ...  applaud them not ... as they will lead you astray. We are 
professionals and deserve to be paid as professionals. We must set a value .. don¼t be 
stingy with your time and energy .. provide a great service .. be uptone and upright .. and 
provide options as the rule .. but if the exception stands before you .. make every effort to 
assist them as well. I advise everyone reading this to review chapter two in the Smart 
Start book, read the hardship form .. check with your state board concerning proper 
wording .. drill with your spouse, staff, dog or cat on payment plans, be prepared to 
illustrate value knee to knee .. and guess what .. let all else follow. Be Professional .. this 
isn¼t „Back to the Past .. we¼re headed towards the Future .. HMO¼s and all! Go For 
It!!!!!! Just Do It!

åThus sayeth Dr. M¼