Pricing without losing patients

Almost every practice owner I have spoken to is underpricing, knows it, and has not moved. The reason is always the same and it is not laziness. It is a specific fear, held vividly: that you put your prices up and your patients leave.

That fear deserves to be taken seriously rather than talked out of, because it is occasionally correct. But it is usually wrong about the size of the risk, and almost always wrong about where the risk actually sits.

Start with what a rise is worth

Do this arithmetic before anything else, because it reframes the whole decision.

Take a treatment at £100 where the materials, disposables and direct time cost you £60. Your contribution is £40. Raise the price 5%, to £105, and your contribution goes to £45 — a 12.5% increase in what that appointment contributes, from a change most patients will not remark on.

Now run it the other way. At £105, how many patients could you lose before you were worse off than at £100? You would need to lose more than about 11% of them. That is the number that matters, and it is far larger than people assume. A 5% rise is not a coin flip. It is a bet that fewer than one patient in nine walks, and in a practice with any relationship to its patients at all, that is not a close call.

The higher your margin, the more brutal it gets in your favour — and the more a discount costs you. Cutting that same £100 to £90 takes your contribution from £40 to £30, so you need a third more patients just to stand still. This is why blanket discounting quietly kills practices that were otherwise fine.

Work out your own version of these two numbers for your three biggest treatments. It takes twenty minutes and it changes how the decision feels.

Why the rises that go wrong go wrong

The failures follow a pattern, and it is rarely the amount.

Everything moves at once, by the same percentage. A uniform 8% across the price list reads as a policy rather than a price, and a policy invites a reaction. Rises that land well are uneven — some lines up, some flat, occasionally one down.

It happens silently, and gets discovered at the till. Nothing damages trust like a patient finding out about your new price when they are paying it. The number was never the problem; being surprised was.

It is justified by your costs. "Our costs have gone up" is true and completely uninteresting to a patient, whose costs have also gone up and who did not get to pass theirs on. It invites the reply you least want: that sounds like your problem.

Nothing else changes. A price rise on an identical experience is a pure ask. A price rise arriving alongside something visibly better — longer appointments, a new machine, better aftercare, easier booking — is an exchange. Same money, entirely different conversation.

It comes after two years of nothing. The practice that holds prices for three years and then moves 15% causes a shock. The practice that moves 4–5% annually is simply a business that reviews its prices. Small and regular beats large and rare, every time.

How to actually do it

Move the price list unevenly. Look at each line's contribution, not its headline price. Raise where you are furthest below what the work is worth, hold your obvious entry-point treatments — the ones people price-shop and use to judge you — and use those as your anchor.

Give notice, and give a reason that is about them. Four to six weeks, in writing, mentioning what has improved. Existing patients honouring the old price for bookings made before the change costs very little and buys a great deal of goodwill.

Brief your front desk properly. They will take every question and they need one clear sentence they believe. If reception sounds apologetic, patients learn the price is negotiable — and then it is.

Change one thing that is visible. It does not need to be expensive. Ten more minutes in the appointment, a follow-up call, a better aftercare pack. Something a patient can point at.

Then watch the right number. Not complaints — complaints are loud and unrepresentative. Watch rebooking rate and treatment-plan acceptance for the next quarter. If those hold, the rise worked, whatever the noise at the desk.

The patients who leave over price were rarely the profitable ones

Practices that raise prices carefully tend to lose a small number of patients, and the ones they lose are disproportionately those who were shopping on price in the first place — the highest-maintenance, highest-cancellation, lowest-loyalty segment. It is not comfortable, and it is often a net gain in both money and afternoons.

What actually loses good patients is not price. It is waiting three weeks for an appointment, a phone that rings out, and being treated like a slot in a diary. Fix those and you can charge more than the practice down the road, indefinitely.

And when you genuinely cannot move price

Sometimes you cannot. You are in a competitive high street, you have an NHS contract fixing part of your income, you raised prices four months ago, or you simply do not want to be the expensive one — which is a legitimate strategic choice and not a failure of nerve.

The margin is still there. It is just on the other side of the equation. That £100 treatment costing £60 to deliver: take the £60 to £54 and your contribution goes from £40 to £46 — better than the 5% price rise, and no patient experiences anything at all. No notice period, no briefing the front desk, no waiting to see what rebooking does.

A 10% cut on a cost base sounds ambitious until you have looked. When I finally reviewed my own practice's suppliers properly, we took around 15% off — with individual lines moving anywhere from 5% to nearly half. Most of that was not clever negotiation. It was simply that nobody had ever checked.

A price rise is a conversation with every patient you have. A cost cut is a conversation with one supplier. Given the choice, start with the supplier.

That is the half we do for you. SupplyIndex negotiates rates on behalf of many independent practices at once, so you buy at group prices without joining a group — free to members, because suppliers pay us rather than you. The card-processing rate is usually the fastest place to find a few thousand pounds you do not have to ask any patient for.