One of the most difficult questions patients can ask, is: “I want to know the cost of the procedure, just more or less, before I come in for a consultation.” I fully understand the concern of the patient, however, should we really choose our doctors based on the fees they charge? Maybe the cheapest plastic surgeon is not the best one or does not offer the best pre- and post-surgical care. And asking the doctor’s receptionist what a procedure will cost, prior to a consultation, is like asking a car mechanic what it will cost to fix your car, without telling him the make, model and year.

So, are you a 1950’s Volkswagen Beetle, rusty and old, or are you a new Suzuki, ready for its first service?
I always encourage patients to invest in their health by committing to a consultation. It is also time spent well to find out whether you like the person who you are going to hand your health over to.

As a patient, you should expect your doctor to spend the consultation concentrating on you and your health problem. Your medical history, medications you use, as well as your specific medical problem should be discussed. The different options for treating your problem, as well as the possible risks and complications of each of these options should form part of the consultation. The doctor should also indicate to which option would be best suited to you and explain the reasons. Once you leave the consultation room, it becomes the responsibility of the practice manager or receptionist to supply you with the necessary quotations of the option you have chosen, so that you can make an informed decision of how to proceed. You also have the option to first discuss and think about what was discussed, before committing to anything suggested.

So, quite honestly, negotiating about a consultation fee is, to me, not an option. Neither is demanding a quotation before I consult with the doctor. This is your health you are negotiating for: do you really want a cookie cutter quotation: a quotation based on “Mr/Mrs X – the average solution for the average person” – or would you rather have heard your options, developed for you as a unique individual?

“Just a ball park figure” does not tell you anything – it does not tell you whether you are suited to the surgery, nor does it tell you whether your plastic surgeon will be available when you start bleeding post-operatively, or when you develop an infection, nor does it tell you if he will be available to speak to you if you have a concern. And what is included in this ball park figure: any follow up visits, dressings needed after surgery?

As with any investment decision, you need to look at the good, the bad and the ugly, and then decide what you are prepared to negotiate for. I am not saying do not negotiate – I am saying – know what you are negotiating for. Invest in that consultation, then consider the costs, and yes, then you can negotiate.
John Ruskin said:

“It is unwise to pay too much, but equally unwise to pay too little. When you pay too much, you lose a little money, that is all. When you pay too little, you sometimes lose everything, because the thing you bought was incapable of doing the thing you bought it to do. The common law of business balance prohibits paying a little and getting a lot...it just can’t be done! If you deal with the lowest bidder, it is well to add something for the risk you run and if you do that, you will have enough to pay for something better!”