There have been many debates about whether a free exam and radiographs is a good thing for the orthodontic profession. Some say that it’s a lost leader to get people in the door, while others say that we should charge fairly for our expertise. Who is right?
Proponents of the complimentary exam argue that we DO charge fairly for the product we deliver and as a result, we can build the cost into our exams. After all, we only spend a few minutes with patients and if our case acceptance is where it should be, do we really feel the pain of the free exam?
Opponents of the free exam say that as specialists, we worked hard to gain the knowledge we give away in an exam. People pay for an exam at a dentist’s and physician’s office, so why should we be any different?
There are some differences we need to acknowledge.
For instance, insurance companies will almost always pay 100% of a dental exam, so it doesn’t really matter if there’s a charge. Unless someone is a cash patient, there’s no out of pocket for the patient. But that reason alone is a pretty weak argument against charging for our time and technology.
If we consider that we should charge, say $50 for an exam and $100 for a radiograph (some would argue those are low) and did 1000 new patient exams/year (that’s 5 NP/day, 4 days/week, 50 weeks/year) that’s an extra $150,000 per year. That’s not an insignificant sum, but we could ask how many patients wouldn’t come in if they were charged? Nobody knows that answer for sure but at an average of $5000/case, even losing one case is equivalent to almost 34 exam and X-ray fees.
Another question we need to ask ourselves is how we handle charges on growth checks. These are kids coming in on whom we know there may not be any necessary treatment. Do we want to charge them for simply getting an opinion?
The free exam is what marketers call an “acquisition cost”. Those selling goods don’t mind making no money (or losing money) to gain new customers, so why should orthodontists be any different?
Those who charge for their exams can’t understand why anyone would give away their time and services for free and unequivocally state that it’s bad for our profession. Those on the other side of the argument claim that they’ve done quite well for themselves without having to charge anything for their time because it’s all more than fully covered in their case fee.
This is a tough discussion because what one practice chooses to do can have a ripple effect on an entire community. There are communities where nobody charges and others where everyone does. But, in this age of multiple opinions and the perceived commoditization of orthodontics, the fear that new patients will pass over an office because it charges for a new patient exam is a real one.
This is a “hot button” issue in orthodontics and there’s no right answer, but I look forward to seeing how this topic evolves in the future.