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Unfortunately it’s really, really hard to compete with free.
If someone is used to not paying for medical care, or paying a small co-payment, they won’t change their habits.
They won’t pay.
I’ve heard from several practitioners about this. The latest is Marcus Rhoden, L.Ac. who works in a pain clinic. He said:
At the Pain Clinic people are so trained to get things paid for through Medicare and insurance that they will not even consider paying out of pocket. Seems to be an issue there, still trying to work it out but people scheduling and then not showing and not wanting to pay is kinda wearing on me. I don’t know how much longer I will try to keep that open.
He also said:
When seeing a client who is paying out of pocket they tend to listen very intently on every word that you say they also are far more likely to try at least once everything that you recommend to change their condition. The patient who does not pay anything (mostly workers comp and medicare patients) tend to do about 25% of what you ask them to do. They seem as a group far less motivated to change their lifestyles, and seem far less motivated to be proactive in their healthcare.
Don’t get me wrong some patients are great and will do whatever it takes to better their lives, but not all.
I also ran into this while investigating starting a community acupuncture clinic for AIDS patients. The Chicago Department of Public Health is having severe funding cutbacks, so I thought providing acupuncture at a low cost would help fill in the gaps.
Boy, was I wrong.
I heard from Lisa Rohleder of http://www.workingclassacupuncture.org told me: “When people are used to receiving any kind of public health services for free, it is extremely unlikely that they will pay anything for any medical service, period. They just don’t expect to do it. Nothing you do will sell them on it.”
I’m glad I didn’t find this out the hard way. I wanted to point this out for anyone who is considering “competing with free.” Competing with free actually IS possible, but it’s an uphill battle. Not one I would want to fight.
I do have to wonder, what about the acupuncturists who practice in countries with socialized (government sponsored) medicine? If acupuncture isn’t covered when everything else is, it seems like an uphill struggle.
Does anyone else have experience competing with free (or cheap)? Any thoughts on this?
1 response so far ↓
1 Juliet Austin // Apr 2, 2009 at 6:12 pm
I think you can compete with free.
I live in Canada and with a long history of having socialized medicine, there are some who want better (usually means faster) service than what our system offers. They either go to the US to get it, or utilize some of the semi-private options that we have available.
Many of my psychotherapist clients in the in the US opt-out of taking insurance for their services. These therapists always manage to find those who either don’t have insurance, or don’t want to use their insurance for a variety of reasons (e.g. the therapist they want to see doesn’t take insurance, they believe therapists who don’t take insurance offer a better service, they want assurance of confidentiality, etc).
These are just a few examples.
The trick is, you have to find the people who are willing to pay, and then articulate how your service is better or different or “adds to” the free service.
There will always be some people who believe they will get better service if they pay for it.
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