The first few years of my private practice were easily some of the toughest years of my life. At the worst of it, I hit rock bottom both financially, physically, and emotionally. I got to the point that I could not afford to eat, pay rent, and pay my bills.
What I thought was supposed to be the time of my life that I could finally begin to enjoy the fruits of my labor was a nightmare. I felt like I aged several decades in those few short years. It was much harder than any stress of internship and residency. Suddenly that stress seemed like paradise. I remember being at a point where I thought it would be easier to commit a crime and go to jail because at least life would be less stressful.
Trying to turn things around, I hired a business person. He was very helpful in many ways challenging me to improve and change. He taught me one of the most valuable lessons I had to learn. Deep down I knew he was right when he pointed out to me that I was self-sabotaging myself.
Anyone who attends medical school or the healthcare field in general constantly hears about how we are in this profession because we want to help people and that it is not about money. Hopefully this is true to a certain degree, but we still have to be able to take care of ourselves. That is something that many other people do not understand.
Some feel we should provide all our services for free because we got into our profession to help people. Even if this was true, we no longer have the luxury of being able to live for free. We are shackled to many of our debts. Many people think doctors get into financial trouble because we go out and buy “yachts, expensive cars, and homes.”
Even if that was once the case, it is not generally the case anymore. The truth is that we as doctors or healthcare providers simply want to be able to provide for ourselves and often our families. I would tell anyone who thinks doctors should provide their services for free, that they too should consider working for free, especially after going into debt for nearly a decade.
The healthcare profession needs caring people who are there because they want to make a positive change in the world.
The problem for me was a deep-seeded guilt running a cash-only practice in New York City about taking payments for people. Taking insurance payments may make us feel separated because we’re being paid by a third party. Somehow we feel safe getting paid that way. Taking cash though means that we are being paid directly by the patient. They could still submit an invoice and get reimbursed by their insurance company.
So this business consultant asked me how much I charged for visits. When I told him, he immediately said, “You don’t believe you’re worth what you charge.”
“Yes, I do.” I argued, but I knew he was right. I felt guilty about what I charged thinking it was more than most people could afford.
He said, “You need to start believing or at least convincing yourself that you are worth double what you charge.”
He told me that people picked up on my not believing that I was worth what I charged. That they would complain about why I was charging so much when I would tell them the price. But, if I believed my services were easily worth more, people would pick up on that even in phone conversations. They may not be able to afford it, but that at that price it was still a great value.
Up to that point when people called and asked how much I charged, I felt guilty telling them. They would often reply, “Why is it so much?” After being aware of how guilty I felt and making an effort to convince myself that I was worth much more, I stopped getting those kinds of responses from potential patients. It doesn’t mean that I never got them, but much less.
The business consultant challenged me to raise my prices. I was incredibly nervous about this. He told me that running in the middle of the road would just make me “roadkill.” People perceive the greatest value in the more expensive products. For example, if you see two toasters and one if priced double of the other, which one will you expect to be the highest quality?
I struggled with notifying patients. I wrote them a letter saying something along the lines of “They say ‘what goes up must come down.’ While I am still waiting for my utility, malpractice, rent, and other bills to come down, they have not. I have not changed my prices in several years, but it’s time…”
After I finally raised my prices, the response from patients was not what I expected. Instead of people complaining, they were more like “finally.” They did not struggle with it like I did. They saw the value in what I did for them.
Ever since that time I have worked and struggled to convince myself I am worth more than I charge. I have had to check in and see how I felt about money. Even when the results I get are priceless giving someone their lives back after years of lost time.
This was taken a step further at training I did recently where we didn’t just reflect on how we felt about what we charged but also how we felt about money and success all together. I remember doing an exercise where we had to put together a package we could offer and come up with a price.
“Now add a zero at the end of the price, turn to your partner and tell them over and over the new price of your package until they feel that they believe you.”
Now I make it a point to take time to reflect on how I feel about money and success and spend a lot of time changing my limiting beliefs. If you have beliefs like, “money is evil, it’s hard to make a good living, or success takes a long time,” then those beliefs are running in the background like a software. They affect your decisions and your actions to create your underlying beliefs.
How you feel about money affects not just much you charge, but how much you make and potentially your overall business success.