How do you manage a sliding scale?
1. I strive to maintain an overall minimum average fee (a bit more than half my full fee), and then respond to the referrals I get accordingly. (Today, I’m not taking on any low fee patients, because half of my weekly sessions are at less than $100, and more than a third are less than $50.)
2. I also try to limit my lower-fee patients to less in-demand time slots, typically between 9:30 or 10 am and 3 or 4 pm.
3. I use my fee to encourage frequency of treatment. I often slide lower with people willing to come 2 or 3 times a week. I do this because I believe strongly in the benefit of greater frequency, and because I find it more personally rewarding to see people more, rather than less, often.
4. I try to raise lower fees often, especially when patients’ income increases in ways I think reflect treatment progress.
5. I encourage people to think about what their fee might mean to me, how they imagine it fits into the puzzle of my life.
