The Price of Care: Should We Negotiate in Clinics?

As a young dentist, still early in my career, I’ve been fortunate to work with patients from all walks of life. Every case is a learning experience, both clinically and socially. But one recurring situation that has made me pause and reflect is the common practice of patients negotiating treatment costs in the clinic.

Dental treatment is a professional service. It involves years of education, skill, precision, and responsibility. Yet, many patients approach it as if it is a product to be bargained over, like buying clothes or groceries. This is not only a practical concern but a deeper question about how healthcare is perceived and valued.

For instance, a typical case such as a root canal followed by a crown costs around PKR 20000 which is approximately 70 US dollars. It covers multiple appointments, detailed work inside the tooth, high quality materials, and a restoration that protects the tooth long term. Despite the effort and resources involved, it is rare that a patient agrees to the treatment cost without some form of negotiation. Many try to bring the cost down, ask for discounts, or request to adjust the price.

This kind of discussion can be uncomfortable. While my clinical responsibility is to explain procedures, discuss outcomes, and provide care, I often find myself in conversations about payments. These are conversations that ideally should not involve the treating dentist. My senior mentors have advised me clearly: “You are not selling products. You are providing professional healthcare. Let your assistant handle payments.” And they are right.

In principle, the dentist and patient relationship should focus on trust, communication, and treatment, not bargaining. That is why most clinics designate an assistant or receptionist to manage the financial discussions, ensuring a smooth and professional boundary. However, in practice, many patients still choose to talk directly to the dentist when it comes to pricing, especially if they sense an opportunity to influence the final amount.

There is another layer to this dynamic that I have observed and it is one that deserves thoughtful attention. A pattern has emerged where female patients, more than male patients, tend to negotiate treatment fees. This is not a critique, but an observation worth exploring. It raises questions about how different demographics perceive medical services, financial autonomy, and communication styles within the clinical environment. These nuances cannot be ignored when thinking about how to create better boundaries and understanding between providers and patients.

The issue here is not just about money. It is about mindset. When we allow bargaining in a healthcare setting, we unintentionally reduce the perceived value of the service. The message it sends is that the treatment is flexible or negotiable in quality, when in fact it is not. Dental care, like any form of medical care, involves strict protocols, high standards, and professional ethics. Reducing prices arbitrarily can compromise those standards, either directly or indirectly.

It is also important to consider the long term impact on the profession. If every dentist allows negotiations, especially early in their careers, it sets a precedent that dental services are open to price adjustment. This does not just affect one clinic. It affects the perception of the entire field. The more we normalize bargaining in healthcare, the more we shift from a system based on expertise to one based on customer pressure.

So what should the approach be?

Firstly, there needs to be a clear separation between clinical care and financial discussions. Assistants or front desk staff should handle payments, and dentists should remain focused on treatment. Secondly, educating patients, gently and respectfully, about the value and necessity of dental procedures can shift the conversation away from price and toward long term health benefits. Lastly, dentists should not feel guilty or unprofessional for upholding their treatment costs. Fair pricing is not arrogance. It is clarity.

At the end of the day, we all want patients to receive the care they need. But the value of that care must also be respected. As we grow into our roles as healthcare providers, perhaps the real question we should ask is not “Can you lower the price?” but rather “Can we raise the understanding?”