that’s a good question. fees are negotiable. now not every practice buys into that but i think that the practices that are very customer oriented consumer oriented they see value and let me tell you what this fee negotiation is. it’s not like begging for a lower fee. there’s a reason that would serve both the patient and the practice to have a lower fee. example the concept of stand-by airfare in the good old days of air travel airlines would sell you a cheap seat relatively cheap seat and you came to the airline and waited around and oh yeah we got an empty seat somebody didn’t show up and bingo they’ll give you half off. that’s how we as students traveled a lot student stand-by. it doesn’t quite exist in the airline industry they’ve overcome that with their computers they have no empty seats. but if a patient says you know can i save some money then a reasonable answer from our practice would be well are you flexible on when you could come in and have your nose job or have your eyelids. in other words you have the kind of job you have the kind of life that allows that because occasionally somebody’s on the schedule and they call up a week before and they say you know what i have a cold or my kid is sick or i’ve got to go out of town or my job says i can’t take the time off. so now there’s a vacancy created on a schedule that’s been set for months ahead. so the surgery center has a seat open just like the airline has a seat open. the anesthesiologist he’s there he’s ready to work the surgery center is ready to work and we’ve committed that time. i haven’t scheduled a golf game that afternoon. so the answer is you bet we’ll give you a discount if you can slide in and take the space. nothing wrong with it it’s perfectly legitimate for the patient to have a monetary advantage for being flexible enough to give us efficiency of our operation. 50 i mean accounts and business people think that’s just the best way to run it and we agree so that’s one way. the other is let’s say you want to have something done and your sister’s got the nose that she doesn’t like and your cousin has one. if all three of the ladies come in together consult together and agree to have the procedures they are eligible for what we call a family and friends discount because we’re going to be spending less time teaching on an individual basis. because if we’re all sitting in a room and discussing the same procedures it’s a lot more efficient for us. and so basically we can pass that savings on and the post operative care is easy because frankly one tells the other what it’s all about and so it’s about being more efficient in our practice so people are entitled to have some benefit from that. you can also save money if you plan your operation far enough in advance and use the christmas lay-away concept where every month you send the practice a check and by the 11th month you’ve already paid the practice so the normal 12th month payment would be free. i mean it’s just again what department stores have done so successfully because there again they are banking your money. but if you’ve got the money set aside you can wind up paying less by essentially paying it far in advance of the time of surgery because everybody does pay for the procedures you know usually two weeks ahead of time but you have to pay 6 months or a year ahead of time unless you are granted a courtesy discount. now these are concepts that come from the business world but it’s not unprofessional to do it. but it’s not the same as shopping for the lowest price by walking into a clinic and saying dr. so and so will do my nose for $8 000 will you do it for $7 200? that unless again you’re willing to go on the reserve list in other words it has to be a win-win. but service will be the same by the way. i mean people that have the benefit of a discount don’t get a lesser result. now when you’re talking about the three women you’re not talking about putting them and doing all of their noses in the same operation? same day they could do it. as a matter of fact if they do that again there will be an even greater savings because that introduces tremendous efficiencies into the system. they could all recover at the same recovery facility share a room. they save money there. so i mean we know how to save people money without cutting quality. it’s just you have to think like a consumer. the patient needs to think like a consumer. they are buying a service. it’s a high quality service delivered by a conscientious professional but when it comes down to the dollars and cents of it hey as long as everybody’s happy nothing’s wrong with saving a few bucks and we’re glad to do it.
is there a way to save money on my cosmetic procedure?