Q:

Dr. Margolies,

It is very infrequent that I write you, as I know you are extremely busy.  But today, 
something is on my mind and I believe you share some strong feelings on the subject as 
well.

The $10.00 chiropractor has always bothered me in theory, but it wasn't until this week 
that I could directly see the tug on my practice.  I always figured that if someone picked the 
ten-dollar practice over mine without ever visiting either one, that it was better that way.  If 
money was such a primary issue, than I would have a hard time getting compliance on a 
$35/visit care plan anyway.

As of this week, I now see it in a new way.  I ran another add in Val-Pac offering the usual 
(free exam & x-rays).  One of the patients I got out of the add had never been to a 
chiropractor and was so jazzed about what it could do that she was sold and agreed to a 
corrective care plan.  She just needed to work out the financial arrangements.

She called me the next day to discuss a mode of payment and we gave her several options 
(by the way, she was still jazzed the second day).  Apparantly the woman came across an 
add or a friend where she learned about the $10 adjustment.  Need I tell you, that 
chiropractor has a new (and dedicated) patient because of my advertising and my report of 
findings.

How do I establish worth in what I do and the education I have received when someone 
next door gives it away?

Meanwhile, I keep doing my thing....this one was just eatting at me today.

Thanks for listening.

A:

Thanks for the e-mail and sorry it took a day to reply.

As you know .. the $10 visit bothers me as well. As an exception and with compassion 
there is a time and place to reduce your fees .. but as a general rule and as a usual and 
customary fee .. NO. What galls me more is that many of these DC's with the low fees are 
in areas that can and will support a decent normal fee. If one has the idea to open the flood 
gates for chiropractic and therefore have low fees for the masses .. they should open a 
public clinic in an impoverished area of town and do the right thing.

Nonetheless .. people will come and people will go. The $10 a visit DC will most likely 
love and care for their patient as you and I would .. just get less money for it. This is a 
business .. and low fees mean more volume and more work .. if that is what happens. .. 
The choice is made by the DC. I understand the concept .. as I am sure you do too .. 

In answer to you .. we still see a small percentage of the potential patient base within a 
community. Fees are not the reason a patient calls the office .. it usually is a lack of 
knowledge. Those with it and still choose a cheaper office .. are okay with me .. what isn't 
are the 90% ers that never see a DC .. regardless of the fee it will be. Go after them

Have a Great Day

Dr. M