Medical Spa Pricing Strategies To Increase Profitability


Pricing your medical services is a key factor in your clinic's success.

Your pricing strategy helps to determine how patients respond to you, and their feelings about your clinic. It's as likely that you're charging too little as it is that you're charging too much.

There are plenty of different pricing strategies; bundling, discounting, subscriptions...   let's take a look at a few and the research that can help give you a guide for what might work in your situation.

Before we start, let's settle on a point of view and the outcome we're looking for. In general, we're discussing how to maximize gross revenues. There are some strategies that you may employ with other goals in mind; for example you may want to work only 20 hours a week and so your focus may be on maximizing hourly revenue rather than focus on a total. That's an entirely justifiable goal and we'll discuss it and other areas around this in future posts.

For now  let's just begin with maximizing gross revenue.

Pricing High or Pricing Low?

In some cases physicians combine "lowest cost / cheap" with "value".

This is completely wrong.

"Value" is the primary buying criteria for every person and every purchase. The difference is that while cheap or the lowest cost is an external measurement that's easily quantifiable, "value" is completely internal and emotional. Value is personal.

Buyers who purchase high-priced services or pay more do so because they perceive the value from these purchases to be higher than cheaper alternatives. I many cases this is completely without merit but there it is.

So... economy pricing could be a hit and miss for your medical spa. With many reports of botched patients and reviews about horrible side effects and complications, medical spa may want to avoid the "cheapest" label for a number of reasons. The problem with being the lowest price is that there can be only one, and you can get stuck in a race to the bottom with competitors who are also pursuing a "lowest-cost" pricing strategy. And a patient who comes to you for price will leave you for a lower price just as quickly.

So, it may be that premium pricing is a much better option if you're able to execute. 

Break it Down or Bundle it Up?

For this specific strategy, you would need to consider different ways to implement this. Breaking it down refers to x number of treatments for this price per treatment. Example, you can price a  treatment for ___$ a session as opposed to using a “starting from” price implementation.

A bundle pricing strategy could also work for patients who need multiple treatments (e.g. laser hair removal, non-surgical fat contouring) or multiple procedures that could reduce wrinkles but if you break it down, patients could also see how much the treatment is per session as opposed to bundling it up. 

Bundling is a common strategy for treatments that require multiple treatments to see an effect and satisfy a patient.

The answer may be to do both.

Some medical spas utilize a “membership plan” method, wherein a patient is given an option to avail of similar procedures, for this certain price. This is essentially that 'concierge medical model' but it is an uncommon practice in cosmetic medicine, yet it’s something that has serious advantages.

Should it be a 5, 9, or 0?

Pricing with the ‘9s at the end is called Charm or Psychological Pricing. It’s when you dock a cent off from its perceived value. Grocery stores employ this strategy thus many customers, and many are enticed when they see an original price and see the lower priced amount.

However, it doesn’t work all the time. You simply can’t have all treatments priced $_99. 

The answer: price treatments differently.

However, consider the “psychological” aspect of the patient when they browse your price list. Round numbers like 0s work well for people who rely on emotions because seeing the number would make them “feel good”.

One of the most effective pricing implementation strategies online is a discount or "credit" on a first treatment inside a specific time window. Sumo (see below)has done their research on the matter, and found that most customers signed up after learning they could receive store credit, and that the company’s email list grew by 87%. 

Slashing off or Discounting?

The strategy works well definitely for costly treatments. Instead of offering a $4 discount for a $12/unit of Botox, better to have it as such: $150 off a $450 for a treatment of Botox. Thing is, for both examples, the price is just docked 3 times off its original cost. Patients tend to go for the $150 off as a larger perceived value.

For values lower than $100, go for an actual percentage.

You can have a side by side comparison of the old price to the current price by putting a slash on the old price, provided the old price is higher than the current one.

You can implement any of these at a time, but remember not to go overboard with it. Learn which strategy could definitely work for your medical spa, and which would be more cost-effective as well. For your medical spa to get more patients and leads, you may need to switch up your pricing or implement different ones at the same time and which ones receive the most profits.

Further Reading On Pricing

Ciotti, G. (2015, September 09). 10 Pricing Strategies That Can Drastically Improve Sales. Retrieved from

Maguire, A. (2017, March 16). 6 Different Pricing Strategies: Which Is Right for Your Business? Retrieved from

Moreno, N. (2018, May 10). 9 Pricing Strategies to Explode Your Revenue (Backed by Psychology). Retrieved from

Reeves, C. (2016, August 03). 8 Pricing Strategies To Use On Your Product, Service Or Workshop (FS124). Retrieved from

Von Wilpert, C. (2018, July 04). Ecommerce Store Credit Strategy (Hint: 87% Email List Growth). Retrieved from

Dr. Hung William Song - Omni Aesthetics in Oakland, New Jersey

Oakland, New Jersey Cosmetic Physician Dr. Hung William

Name: Hung William Song, MD
Clinic: Omni Aesthetics
Location: Oakland, NJ

Can you tell us a little bit of your background and how did you get to where you are now? 

I am board certified in internal medicine I practiced internal medicine for 15 years but switched to a 100% cosmetic practice in 2008. I had about a two year transition period when I did both, but eventually turned over all my medical patients to a colleague and started concentrating full time on my cosmetic practice.

Do you have any procedures that you like better than others? Have you dropped any treatments? If so, why?

My favorite treatments are dermal fillers and fat transfers. I stopped marketing acne treatment because acne is more of a medical problem rather than cosmetic, I now refer these clients to a dermatologist.

You offer treatments with fat transfer. Where have you seen the most success with this treatment? What have you learned about getting the most benefit from this? Do you have any special techniques or 'tricks' that you use? 

I offer a full face fat transfer. I like to fill the whole face starting from the hair line and temples to cheeks, nasal labial folds and pre-jowel sulcus. I use the Viafill system and mix platelet rich plasma with the fat for better viability.

Can you share your experience with fat transfer? How would you describe the efficacy and results? Where have been the most successful improvements in keeping the fat alive after transfer?

By using a disposable coated cannula to harvest and inject the fat and mixing the fat with PRP, I have been able to get good uniform fat retention. The fat is centrifuged using the Viafill system.

What are your thoughts about the technologies you’re using now such as Smart Lipo and Ulthera? 

Smartlipo is a good system because it is a very recognized name, but the machine is very expensive with high disposable costs. If I was to do it again, I would have bought the Vaser for half the price.

Ulthera was a moneymaker for me the first two years but now, I am having a difficult time with competition undercutting me on price. Everyone seems to have one these days including the gym across the street. The consumable cost on the Ulthera is also very very high.

I recently purchased the THermiRF system. This one was a home run because the price of the device is very reasonable and the consumable cost is very low. I use this device for stand alone skin tightening and in conjunction with doing liposuction on small areas like face, neck and arms. It is a very versatile machine but it does require some minor surgical skills which his good for me because I don’t think they will be offering this at the gym across the street.

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Dr. Janet Turkle, (Turkle & Associates) Phases Skin Care & Laser Center In Indianapolis, Indiana

Some problems are better handled with less invasive treatment and there are products and treatments that can delay the need for surgery or prolong and protect one’s investment in surgical procedures.

Indiana Board Certified Plastic Surgeon Dr. Janet Turkle

Name: Dr. Janet K. Turkle
Clinic: Turkle & Associates
           Phases Skin Care and Laser Center
Location: Indianapolis (Carmel), Indiana

That's interesting: Dr. Janet K. Turkle was involved in the clinical trials for the silicone gel implants and provided extensive data to the researchers.

Please tell us briefly about your qualifications and how did you get to where you are?

I have been in Indiana as a plastic surgeon since I completed my residency at Indiana University Medical Center in 1993 and entered private practice.

Are you convinced that being female creates opportunities in attracting prospective clients?

I think it has advantages and disadvantages. As a female, I can relate to my female patients but I hopefully relate to my male patients as well. Some women may feel more comfortable telling you things or showing you things that they would not if you possessed the Y chromosome but it doesn't always work that way.

If you weren't a medical professional, is there anything you'd rather be spending time on?

I truly cannot think of what that would be. I am doing exactly what I want to do.

Janet Turkle MD, Indiana Cosmetic Plastic Surgeon

Aside from a plastic surgery practice, you also have a Skin care and Laser Center. What difficulties did you tackle when you began your practice? 

When we started then skin care portion of the practice it was fairly rare to combine that with a plastic surgery practice. I think that the biggest challenges have been to make people aware of how important lasers and skin care can be in terms of their total improvement. When we do surgery, we can make improvements in structure but we cannot improve things like texture and discoloration. A combined effort of laser treatments, products and other therapies will improve the outcome, regardless of the type of surgery.

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If You're Not Getting Paid What You're Worth, There Are Only Two Possible Reasons...

Are you getting paid what you're worth?

In reading through the comments on my post  "Are Groupon Deals Killing Your Medical Spa?" it's obvious that there are some very strong feelings about pricing, Groupon, and the prices that some clinics are able to charge, or not.

Then there's any number of discussion forums on Medspa MD where you'll find a common thread around dissatisfaction with what someone's making as an employee, from the physician owner to the staff.

At the core, it's really around the perception of value on the part of the buyer, whether the buyer is a patient looking for Botox, or an employer that's staffing a clinic.

Here's what technologist Seth Godin has to say about value and what you're worth:

If you’re not getting paid what you’re worth, there are only two possible reasons:
1. People don’t know what you’re worth, or
2. You’re not (currently) worth as much as you believe

The first situation can’t happen unless you permit it to. If you’re undervalued, then you have a communication problem, one that you can solve by telling accurate stories that resonate.

Far more likely, though, is the second problem. If there are reasonable substitutes for your work, and those substitutes are seen as cheaper, then you’re not going to get the work. 'Worth' in this case means, "what does it cost to get something like that if something like that is what I want?"

A cheaper substitute might mean buying nothing. Personal coaches, for example, usually sell against this alternative. It’s not a matter of finding a cheaper coach, it’s more about having no coach at all. Same with live music. People don't go to cheaper concerts, they just don't value the concert enough to go at all.

And so we often find ourselves stuck, matching the other guy's price, or worse, racing to the bottom to be cheaper. Cheaper is the last refuge of the marketer unable to invent a better product and tell a better story.

The goal, no matter what you sell, is to be seen as irreplaceable, essential and priceless. If you are all three, then you have pricing power. When the price charged is up to you, when you have the power to set the price, there is a line out the door and you can use pricing as a signaling mechanism, not merely a way to make a living.

Of course, the realization of what it takes to create value might break your heart, because it means you have to specialize, take risks, create art, leave a positive impact and adopt generosity in all you do. It means you have to develop extraordinary expertise and that you are almost always hanging way out of the boat, about to fall out.

The pricing power position in the market is coveted and valuable... The ability to have the power to set a price is at the heart of what it means to do business profitably, so of course there is a never-ending competition for pricing power.

The curse of the internet is that it provides competitive information, which makes pricing power ever more difficult to exercise. On the other hand, the benefit of the internet is that once you have it, the list of people who want to pay for your irreplaceable, essential and priceless contribution will get even longer.

So the real question to ask yourself is if you're really irreplacable and essential as a business or as an employee.

For medical spas or clinics this means that your offering is not comoditized and that you're offering is not /can't be replicated.

Unfortunately, most clinics seem to tag along with a t me-too idiology that seeks to find what others are doing that makes money, and then offer the same thing at a reduced rate. (The Groupon rush is just one indication of that.)

Making your services irreplacable and unique will go a long way to giveing you pricing power.

Related Posts

Groupon: Are Groupon Deals Killing Your Medical Spa?
Pricing: Pricing, Cognative Dissonance & How To Charge More

Niche Yourself & Your Medical Spa

If you're not comfortable with creating or finding a niche that your medical spa can dominate... get familiar with it.

Guy Kawasaki is a well known speaker on technology, venture capital and startups. I've seen him give this presentation a number of times and this is dead-on accurate for any business, including your laser clinic or medspa.

If you're just copying everyone and trying to feed on the edges of the marketplace, your medical spa's just an also ran and you'll never experience the ability to control your prices or your income and you'll always be playing second fiddle to those clinics and physicians who understand these principals.

Your Medical Spa Pricing, Cognitive Dissonance, & How To Charge More

Your profits are in your prices. Where are the psychological triggers you can use to raise your prices and charge more?

You'd like to be able to charge a premium for your services and rake in the big bucks, right? Then why are so many physicians and clinics utilizing the slow death spiral of constantly trying to undercut the competition and using discounting coupon services like Groupon. Why are some physicians able to charge 50% more for Botox and others are trying to give it away and scrambling for any new patient. Where's the disconnect?

Guess what. It's psychological.

Look, there are only two things that determine ANY price.  Put these lines on a graph.

  1. How much you're willing to sell something for.
  2. How much someone's willing to pay for it.

That's it. Just those two things, and the second of those is based on psychological triggers more than anything else. (Of course, those two lines cross at some point or you're pricing yourself out of the market and in big trouble.)

As a physician running a cosmetic medical practice or medical spa, when you’re essentially selling time, how do decide where you can set — and then raise — your rates?

Guess what? People actually want to pay a lot.

I learned this as a young painter in New York. My paintings sold between $25,000 and $60,000. Why? It's pretty simple. I wouldn't sell them for less and I could easily get buyers who would pay that amount. I could find lots of buyers that would purchase my work as fast as I could produce it. I had both the skills and business savvy to understand that the quality and uniqueness of my work created the demand and drove up my prices. I didn't just set my prices high. I started by creating a unique niche that I completely dominated; beautiful, realistic women in oil with old world craft. I would never have been able to charge $60,000 for paintings that no one wants and anyone could produce.

Even more, I set myself up as able to demand those prices. Believe me, no one want's to pay $50,000 for a painting. They only pay that amount for a story, and the story is around something that's unique and scarce.

People want to pay a lot for cosmetic treatments.

If you don't know it already, you're in the vanity business. People will pay outrageous prices for vanity. Think of the prices that high end vanity commands; $600 for a felt purse by Kate Spade, $1,150 pumps from Christian Louboutin, the $84,000 Audi A8, the Omega Seamaster watch, any Apple product... The cost is actually integral to the enjoyment.

People want to pay a lot for your cosmetic treatments IF you position yourself correctly AND your treatments are both unique and scarce.

No one wants to pay more for the same coach seat on an airline, but there's obvious satisfaction when someone describes the purchase of an expensive luxury item, even if the price is never mentioned.

If you cater to the lowest common denominator, you'll have to price your services that way too. Specialize in a lucrative niche and your services become not only unique, but scarce as well. Uniqueness and scarcity work hand-in-hand to drive up demand and allow you to raise your rates.

So uniqueness and scarcity are primary ingredients to any offering that want's to charge a premium. We'll deal with both uniqueness and scarcity in other posts. What I want to talk about here is the psychology of pricing and how it relates to your own pricing and your customer loyalty.

Once you have something that's both unique and scarce, you can move on to increasing your prices.

Where's your current pricing?

I’ve met many, many physicians who under price their services.The primary reason that's give is that they have to have low prices to remain competitive in an every more productized marketplace, where every corner has a medical spa trying anything to attract new clients.

This can be true — especially around mass consumer treatments like Botox and laser hair removal — but whatever the reason, charging too little for your services is self-sabotage for two primary reasons:

  1. When you don’t charge enough you end up resenting your clinic. You do too much work for too little money. It’s not worth it. (Try to tell me this isn't the primary reason that so many physicians are trying to leave clinical medicine.)
  2. A low price tells patients that you’re not worth it. It may be all smoke and mirrors in the beginning, but if you want to be perceived as the best, you’d better price your services accordingly. Low prices are THE primary indicator of low quality.

I've seen any number of small clinics where the marketing and pricing plans, if there was one, wasn't well articulated or just rattling around in the physicians head. As a result, these clinics, in an effort to build their own business, underbid services on low quality clients. As a result, they ended up with lots and lots of low fee procedures and special offers. Instead of focusing on high quality premium treatments, these staffs are pushed to get things done as fast as possible to keep the treatments profitable despite the low fees. This poor quality of training, service and oversight leads to mistakes. Clients nitpick and try to get additional discounts or haggle about pricing. Accounts receivable grows. Lawsuits happen. It's no surprise when clients start leaving for the next low bidder to open up shop.

Remember, people value things by price. Just one of the reasons why I’m sitting in Starbucks right now drinking a $4 coffee.  (And no, I don’t think $1 coffee is their best move.)

One of the primary components in positioning yourself is how you price your services.

Price Influences Your Perception Of Quality

As price goes up, so does your perception of quality AND pleasure (satisfaction).

I don't know this for sure but I would bet that 'premium' medical providers are sued less frequently and have higher satisfaction rates than lower priced physicians. It could well be that being the low cost provider puts you at greater risk for lawsuits for a number of reasons. (If you have any relevant information to this, please leave it in the comments.)

A well known study out of the California Institute of Technology and Stanford University details how price influences peoples perception of quality in wines.

Antonio Rangel, an associate professor of economics at Caltech, and his colleagues found that changes in the stated price of a sampled wine influenced not only how good volunteers thought it tasted, but the activity of a brain region that is involved in our experience of pleasure. In other words, "prices, by themselves, affect activity in an area of the brain that is thought to encode the experienced pleasantness of an experience," Rangel says.

Rangel and his colleagues had 20 volunteers taste five wine samples which, they were told, were identified by their different retail prices: $5, $10, $35, $45, and $90 per bottle. While the subjects tasted and evaluated the wines, their brains were scanned using functional magnetic resonance imaging, or fMRI.

The subjects consistently reported that they liked the taste of the $90 bottle better than the $5 one, and the $45 bottle better than the $35 one. Scans of their brains supported their subjective reports; a region of the brain called the medial orbitofrontal cortex, or mOFC, showed higher activity when the subjects drank the wines they said were more pleasurable.

But the experiment was rigged. While the subjects had been told that they would taste five different wines, they had actually sampled only three. Wines 1 and 2 were used twice, but labeled with two different prices. One wine 2 was presented as a $90 bottle (its actual retail price) and also as a cheaper $10 wine. When the subjects were told the wine cost $90 a bottle, they loved it; at $10, not so much.

In a follow-up experiment, the subjects again tasted all five wines but without any prices; this time, they rated the cheapest wine as their most preferred.

Previous marketing studies have shown that it's possible to change people's perception of how good an experience is by changing their beliefs about the experience. For example,  moviegoers report liking a movie more when they hear how good it is beforehand. Studies show that the neural encoding of the quality of an experience is actually modulated by variables such as price, which people believe is correlated with experienced pleasantness.

The results make sense. Your brain encodes pleasure because it is useful for learning which activities to repeat and which ones to avoid, and good decision making requires good measures of the quality of an experience. But your brain is also a noisy environment, and "thus, as a way of improving its measurements, it makes sense to add up other sources of information about the experience. In particular, if you are very sure cognitively that an experience is good (perhaps because of previous experiences), it makes sense to incorporate that into your current measurements of pleasure." Most people believe, quite correctly, that price and the quality of a wine are correlated, so it is therefore natural for the brain to factor price into an evaluation of a wine's taste.

How 'Cognitive Dissonance' Affects Pricing

Cognitive dissonance is that uncomfortable feeling you get when you're holding conflicting ideas simultaneously. The theory of cognitive dissonance proposes that people have a strong motivational drive to reduce dissonance since it causes internal conflict. They do this by changing their attitudes, beliefs, and actions. Dissonance is also reduced by justifying, blaming, and denying. It is one of the most influential and extensively studied theories in social psychology.

I'm not trying to force a psychology degree on you but  it is useful to have understanding some basic underpinnings of behavior and how they affect pricing, such as why critics don't like your favorite wine, and how wineries get away with charging $500 for a bottle.

Have you ever noticed fans almost never complain about lousy music concerts or albums, yet critics frequently give them poor reviews? What's going on? Are critics just inherently nasty?

Maybe, but the fact is that there's a psychological principal at work that's also in effect every single time you exchange something of value (money) for a product or service.

Here's an example of cognitive dissonance at work.

In a landmark study by Leon Festinger and James Carlsmith, seventy-one male students in the introductory psychology course at Stanford University were asked to spend two hours doing a very boring task, sticking wooden pegs in holes.

Participants were divided into three groups. Some were paid $20 (a lot of money back in 1959). Some were paid $1. And some were told they were volunteers and paid nothing. All were told what their payment (or non-payment) would be before they began.

After two hours of what was surely hellish tedium, participants were asked to rate the 'enjoyment' of the task.

So what do you think? Which of the groups ($20, $1, nothing) thought that sticking pegs in holes for two hours was the most fun?

Here's the answer: The group that was paid $1 found the task most pleasurable. The group paid $20 found it the most boring.

Why? Cognitive dissonance at work.

Here's the way that cognitive dissonance is at work in the real world:

  1. If you are induced to do or say something which is contrary to your personal opinion, there is a tendency for you to change your opinion to bring it into correspondence with what you have done or said.
  2. The greater the pressure used to elicit the overt behavior (beyond the minimum needed to elicit it) the weaker the tendency to change the opinion.

Let's discuss the first point. In the peg study the task was, objectively, tedious and boring, but people who were paid $20 could easily explain to themselves why they did it: they wanted $20. They rated the task as the most boring. People who were volunteers and got nothing could tell themselves they did it to advance science. They found it less boring than the $20 group, but still somewhat boring.

But here's where cognitive dissonance comes in. The people who were paid only $1 couldn't reconcile with themselves why they spent two hours putting round pegs in round holes. Their brain held two dissonant thoughts: "This task is dull" and "I'm wasting my time for a $1." The second statement was 'fixed' and couldn't be changed, so the brain unconsciously modified its belief about the first to decrease the conflict. People decided they were having fun; otherwise they would be fools for doing it at all.

But don't forget the second point; The greater the pressure used to elicit the overt behavior (beyond the minimum needed to elicit it) the weaker the tendency to change the opinion.

This is why the 'soft sell' can be so effective. Using less 'pressure' to elicit the behavior actually results in the strongest tendency for a person to modify their opinion.

Let's apply this lesson to how pricing affects the enjoyment of a product or service.

When you pay for anything; food, Botox, liposuction, or wine — your brain knows the price, and you're pretty sure that you're not stupid. So, if you pay $200 to see a live band and they're all singing off-key, your brain can change its evaluation of the performance to "charmingly gritty and spontaneous" or "incredible live performance". Your subconscious is pushing you to find the experience pleasurable.

But the critic sitting in back didn't pay for his tickets. He's just there to do a job, and his brain knows that. If the concert is bad and he says so, that doesn't make him a fool for going, he's just more objective.

Think about it: How often have glossed over a obvious shortcoming in order to avoid tainting your enjoyment of something you've paid a lot for? I know I do it all the time.

Here's what W. Blake Gray says about cognitive dissonance and wine.

I get a lot of free wine, and I pay for wine frequently also. Even though I'm aware of cognitive dissonance, I still think I'm more likely to give the benefit of the doubt to a so-so wine I order by the glass in a restaurant over a wine I taste in a professional setting. I'm paying for it, I'm no fool, it can't be that bad.

There are several implications here:

  1. Why do fans of an expensive wine like it more than the critics? Simple: they're paying for it
  2. The more money the wine costs, the more powerful the effect of cognitive dissonance. You can freely diss Two Buck Chuck, but that overripe $60 Syrah? It must have some good points. Many Napa Valley vintners understand the implication of this: Charge more, and while the wine might be difficult to sell, people who do buy it will like it more. Hows that for increasing your customer satisfaction?
  3. Why does Robert Parker give higher scores to wines than other critics? To his credit, he is well-known for paying for a lot more wines than any other critic. He chooses what to pay for, he doesn't taste blind, and I submit that even for a man whose palate is as consistent as anyone in the business, cognitive dissonance is at work.
  4. Why does wine taste better in the tasting room? There are other factors at work as well, but consider this potential dissonance: "I drove out of my way to get here and chose this winery over its neighbors. Plus I paid a $10 tasting fee." Cognitive dissonance is a good motivator for every tasting room to charge a modest fee. (Sorry, consumers.)
  5. Why don't professional critics rush to embrace funky, expressive wines, especially those in niche categories? We don't have to; we don't have the cognitive dissonance of "I paid $12.99 for this no-added-sulfite 'organic wine' and it smells like feet." Mmm, feet.
  6. How do the Bordeaux first growths get away with those outrageous release prices -- over $500 a bottle for some? In Hong Kong, people are thinking in Cantonese, "I paid $900 for this wine. And I am no fool. This is so worth it." Cognitive dissonance knows no language barrier.

Cognitive Dissonance & Irrational Customer Loyalty

Of course pricing isn't the only factor we're discussing. Let's talk some cognitive dissonance and how it leads to irrational customer loyalty, just what we're looking for.

In a study looking at why cognitive dissonance with dentists and their patients, Duke University behavioral economist Dan Ariely revealed the probability of two dentists separately finding the same cavity in an X-ray as being about 50%. And often, what dentists think is a cavity, turns out to be nothing. All the more odd, then, that as patients, we’re incredibly loyal to our dentists - more faithful, in fact, than to other medical practitioners.

Why? It's cognitive dissonance here as well. In order to rationalize all of the unpleasant poking, scraping and drilling that dentists subject us to, we convince ourselves that our particular dentist knows best:

"Dentistry is basically the unpleasant experience. They poke in your mouth. It's uncomfortable. It's painful. It's unpleasant. You have to keep your mouth open. And I think all of this pain actually causes cognitive dissonance - and cause higher loyalty to your dentist. Because who wants to go through this pain and say, 'I'm not sure if I did it for the right reason? I'm not sure this is the right guy.'"

(Kinda reminds me of Stockholm Syndrome in which people who are kidnapped actually begin to identify with their captors.)

But cognitive dissonance accounts for more than our loyalty to dentists. It also generating increased revenue for dentists and adding to their profits.

And it increases over time.

Imagine that at some point in your dental treatment, you have a choice between two treatments that have exactly the same possible outcome, but one of them is more expensive to you and better financially for the dentist. Which one would you choose, and how would the duration of the relationship with your dentist be affecting that?

It turns out that the more time people have been seeing the same dentist, the more likely the decision is going to go in favor of the dentist. People are going to go for the treatment that is more expensive but has the same outcome. More out of pocket for them, more money for the doctor. So in this case, loyalty actually creates more benefit for the dentists with no better potential outcome for the patient.

Now, while it may sound like I'm advocating standing on a patients toes while injecting Botox... not so.

There may be some effect of cognitive dissonance at work when you're performing a Melasma or other treatment where there's some pain and downtime, but what we really want to focus on here is how pricing your treatments higher, can actually increase both your patient satisfaction and revenue at the same time.

Does A Premium Price Drive Actual As Well As Perceived Value?

I would say yes in many instances.

Take a look at our medical spa training manuals and you'll see that they're more than a big hardcover at Barnes & Noble, much more. But we deliver on those prices since the quality of the content is so far above what you can get elsewhere. This isn't generic information, it's specialized, and it's valuable.

The medical spa staff training manuals are priced where they need to be to make the creation and distribution profitable enough that it's worth creating AND creates an incentive for buyers to actually use the information. Some of the most successful medical spas and cosmetic clinics around are using these training manuals. Do you think that someone who's at all serious about their business thinks anything at all about dropping $300 on a product that can optimize their operations and train their staff? Are you kidding?

Sure, I could give all that stuff away. Perhaps there are those that think that I should. This isn't for them. We give away 99% of everything for free already, but real products that give you the most benefit aren't valued if they're free.

It's not about information. It's about motivation. Paying a premium for them actually gives you more value... and pleasure.


Look, you know more about your own situation than I do. I'm not trying to convince you to raise your prices if you can't support it, but hopefully you've got something to think about. There's a lot of obvious, anecdotal and researched evidence that shows that higher prices will make you more money and make your patients happier... but pricing is the second step. Creating a service menu and reputation that is unique and scarce is step one.

Pricing is one of the things that all physicians and medical spas struggle with. It is one of the handful of items that actually dictate how much money your clinic will make and where your profits are.

One last point: You've been reading this post for something like 3 minutes now. Isn't this the most interesting blog you've ever read? Please tell your physician friends. They're no fools either.

The Medical Spa Blueprint: This post deals with some of the topics we'll cover in The Medical Spa Blueprint, a guide to opening and operating a highly successful and profitable cosmetic medical clinic. To be notified when the Medical Spa Blueprint is available, just join Medical Spa MD. It's free, which is a terrific price.

If you have some thoughts on this stuff, please leave a comment. We want to hear from you and if we use it in the Blueprint, we'll credit you. ; )


Marketing actions can modulate neural representations of experienced pleasantness published January 14 2008 in the early online edition of the Proceedings of the National Academy of Sciences.

Cognitive Cinsequences Of Forced Compliance Leon Festinger & James M. Carlsmith First published in Journal of Abnormal and Social Psychology

William H. Cummings, M. Venkatesan (1975), Cognative Dissonance and Consumer Behavior: A Review Of The Evidence in Advances in Consumer Research Volume 02, eds. Mary Jane Schlinger: Association for Consumer Research, Pages: 21-32.

The Gray Market Report, Why Expensive Wines Taste Better: Psychology 101 W. Blake Gray

Cognative dissonance on Wikipedia