Listen to the podcast here: Should I Increase My Prices?
In this podcast episode, Phil and Marina discuss one of the most uncomfortable but important topics in Direct Primary Care: raising membership prices. They challenge the common advice that physicians should avoid price increases and simply see more patients, arguing that this mindset undermines the core DPC goal of providing high-quality, relationship-based care. Phil and Marina explain that rising costs—including staffing, rent, supplies, and inflation—make periodic price adjustments necessary for maintaining a sustainable practice. They also address the emotional barriers physicians face, including fears of losing patients, disappointing families, or appearing profit-driven, while sharing examples of practices that successfully increased prices with little to no patient attrition.
The conversation focuses on practical strategies for implementing price increases, including annual inflation-based adjustments, larger corrections when fees no longer reflect the value provided, changes to enrollment fees or family maximums, and passing through credit card processing fees. Phil and Marina emphasize that physicians should regularly evaluate whether their pricing supports long-term sustainability rather than simply covering short-term expenses. They also encourage practices to communicate the full scope of services they provide—including specialized evaluations, integrative medicine offerings, and other value-added services—when discussing fee changes. Their central message is that a financially healthy practice benefits both physicians and patients, and that raising prices should be viewed as a normal and necessary part of responsible DPC practice management.
Welcome to DPC Pediatricians. We’re Dr. Phil Boucher and Dr. Marina Capella, two DPC Pediatricians who are on a mission to share our love of direct primary care with you.
Welcome everyone to another episode of the DPC Pediatricians podcast. Today Phil and I are going to talk about increasing prices which I think for most of us it’s a little bit of a hard subject. In theory we tend to think Yes absolutely inflation happens and especially in the last couple of years we’ve seen a lot of inflation and the cost of things like supplies and rent really rising and so we know we should do it but when it comes to actually doing it it feels like ripping off a band-aid and it feels there’s a lot of emotions behind it because we know our families we’re loyal to our families we don’t want dpcpediatricianadmin DPC Pediatricians.
I think that there’s a huge disservice in the Facebook groups often by a couple of loud voices that say you should never increase your prices you should just keep the prices where they’re at and they’re always paired with like just see more patients which I feel like is just going straight back to the, oh, you’re not making enough revenue? Why don’t you just add patients on and you get up to 40 or 50 patients per day?
I feel like that’s the exact same line of thought is don’t increase your prices, just see more patients or just be more efficient is like absolutely what we’re trying in dpc to avoid but that is the message that a lot of people hear when they very curiously say like should I increase my prices and there’s been so many in the groups luckily that have chimed in of like i increased my prices and no one left i increased my prices and people said we still feel like you should be charging more and so i think first and foremost that um you should feel comfortable raising your prices every now and then without feeling bad about it because all of the things like you said the prices go up it costs more to live it costs more to employ people All of the things cost more.
And that doesn’t mean that we just as physicians have to eat all of those costs and stay stagnant when it comes to growth.
If it helps you to take better care of patients by not expanding your patient panel, and saying i have these patients this is my panel and my costs are going up then i think it’s very reasonable to say i need to increase my prices so i can continue to provide the high level of service and the high touch points that you are getting in dpc those are kind of my initial thoughts but i would love to hear marina what your approach has been when you have done price increases because i think both of us
increased our prices over the years and it’s always like a tricky thing until you’ve done it and then you’re like oh yeah that wasn’t such a big deal like nobody left I mean it’s like doing your first stitches or something like that well that was challenge like I built it up to be something that was really hard and actually now I’m pretty okay with it and it turned out just fine
yeah so I’ve done multiple price increases since I started five years ago and most of those price increases have been done for new patients only and it wasn’t until late last year late 2025 that I said okay I just gotta like look at my whole membership list and update everyone because I had some people grandfathered in who
I knew could afford my newer highest prices and i just had to tear off the band-aid and then i and i enlisted the help of my virtual assistant who was sort of my like membership manager because sometimes sending those emails directly can be hard and and plus going down the whole list and i wanted to customize each email blah blah blah i didn’t want to send a blanket just like we get from Netflix your prices increase again Hulu your prices increase again google works right your price increasing again right i want it to be a little more personalized
and so i drafted kind of a generic email and then i had my va go through the whole membership list and basically we we discussed it in a meeting i said this family i know this is a single mom she cuts hair for a living she doesn’t she’s not that
comfortable so i would really like to offer her a discount so still raising her price a little bit but maybe so we really like thought through each family and then I had her draft all the emails more specifically that would say for your family the price is going to be this that way also the the pricing
tiers in pediatrics can be confusing and the family maximum so I felt like customizing the email to each family would be would be nice and that way they had clarity around what it meant exactly for them. And they felt like it was more personalized. And at the end of that kind of email,
I had a paragraph that said, Hey, I know that families can go through rough times. Sometimes if you’re going through any particular situation and this would mean that you would have to leave our practice, please let us know, reach out and we’ll do what we can to make it work.
that wasn’t promising anything but it was just saying hey we’ll work we’ll try to work with you and see what we can do and it was also very transparent and saying hey the inflation and the costs of a new building because I had acquired a building
a year ago and it really has been much more expensive to operate right and all the maintenance and the lawn care and the landscaping and the improvements which have just been a huge toll financially so I was transparent about the reasons for the price increase and
also i think reflecting on how sometimes i don’t give myself enough credit for all the money that i have spent on getting this very specific niche training that i have like right it was thirty thousand dollars for my integrative medicine fellowship and that annual fee to keep that certification and this year it was another
20,000 in learning myofascial release. It was another 10,000 in learning clinical hypnosis. Like all of these things and then the maintenance of those skills, they really cost money. And so I had to be very realistic towards myself and my finances. It’s okay. I’m not charging people just because I want to buy a yacht.
I’m charging people because I deserve to make a decent living and the costs of doing business or the cost of doing business and developing skills takes money.
right i think that that is i mean i love everything that you said there and i’ll the the easiest one for me to kind of reflect on is that you personalize the emails and you got help to do that because i think that is a big thing where it can be
really hard to know how to even go about that you had your va draft specific emails to every family and then you could go in and send them which I think is a great way just outside of the price increases to talk about delegation
and having your VA help you to like prepare the document for each family put it in your gmail outbox you can go in and draft and you could say, hey, I know Olivia’s birthday is coming up. I hope she has a great day. Whatever it might be about those families,
you can customize it in all those ways makes it feel so different than the Netflix price increase, which we get those emails and we carry on with life despite Netflix going up. And then most people, I mean, Netflix lets you know, most people don’t change their habits because of that,
especially if it’s providing a service that you find valuable is like Netflix’s costs are going up, not just because they want a bigger building, but because they’re creating lots of things that you benefit from with your subscription. i think that that is really wise to the way you talked about first and foremost
like start with new patients because that is easy and it requires no hard feelings from any of your existing patients there’s no friction there from like oh i don’t know if i can do this to all these families just start with new patients and that is just updating your website that is just updating how people go about
signing up that is the easiest one to start with and that is what we always start with when we are entering a season of okay we’re going to increase prices the easiest one to do takes five minutes just go in and change the prices change the
prices on the website make sure that we have the talking points right when we’re talking about it with families of this is the new price for your membership That’s easy and it starts creating new revenue without any hardship emails that you’re sending out.
Yeah, absolutely. I should also mention that there might be some people who leave. So when I increased my prices late last year, there was one family that reached out and it was kind of like, well, can you explain, even though I had had a paragraph in my email explaining the justification for the prices,
They pushed back a little and they said, well, does this actually increase the level of service you’re providing in any way? And there was a little bit of negotiation there. i ended up giving them a little bit of a discount but still increasing the price
halfway to where it would have been so i was nice but i didn’t want to just be stepped over and given because this is a family that only had one child right it was like going from i don’t know if it was going up to 125 a month which on an
absolute scale is not that terrible and i really have had lovely visits with them they they have felt the difference with me i know that compared to other practices so There was still that desire for them to stay. And there was another family who ended up having a second baby.
As far as I can tell, they’re relatively well off. Mom is a PT and dad is in business and they had their second kid and the baby price is higher than older kid price, of course. And so she said she kept him on for the first few months of life and even had me do home visits.
And then they stopped the membership and they cited some financial reasons. And I It was hard at first for me, but I said, but they make their own decisions. They know their own financial story better than I do. I am not looking under the hood there.
Like I’m only seeing what I see and they can go experience the real words on if they ever feel like they need to come back, they can come back. So people, some people will leave. I would say it’s a really small minority and sometimes it’s actually an excuse or a way
to gently get rid of the families that you have known are not a good match for a while.
Totally. Because if they’re not a good fit, then they’re looking for a straw to break the camel’s back. And that might be the thing that they’re like, I’m not really sure. And then you’re like, okay, that works for me. i think that that is that is the reality of raising prices is that you may turn off
a few people and that’s okay and even if you didn’t raise prices they could have been a month away from sending you that email anyways that said it’s not a fit for us to keep going because of these financial things that are on our radar.
And I think that that is one of the hard things that you have to come to grips with is you won’t be the right fit for everybody for every season. And that is okay. We know that people will leave for all varieties of reasons. and so that shouldn’t make us just say, well,
I’m just going to try and be low profile and not rock the boat. If it causes more stress for me to keep my prices low or if it threatens my business and our overall ability to provide care, instead I should just have that hard conversation over email over text message over
a phone call over a visit or whatever it might be and say hey we need to do this so that I can provide continuing ongoing great care for your family and I think most I think like those stick out as the difficult ones but the 96% saw the email and
and then just moved on with their day because they have 74 other things on their plate that are more pressing. And it didn’t bother them at all. And that’s been our experience. We’ve raised prices twice that I can think of. And that has been the experience by and large is the vast majority don’t say boo.
Exactly.
They’ve just moved on with their day. They saw the email just like you or I gets the Amazon email. dpcpediatricianadmin DPC Pediatricians dpcpediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC
Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin DPC Pediatricianadmin so I’m just gonna face it and pay it and it’s fine it’s still worth it to me so I think that’s probably what happens in most people’s minds is like oh okay I guess but still worth it
totally it’s still worth it that’s the conversation that you have in your brain and that’s the conversation that they have is okay my prices went up by five percent let me do the math okay got to move on with my day like I got other things on my
plate but we derive all this value and I think the the thing in DPC in particular that’s different is those families are choosing you every single month it’s not like a fee-for-service practice where they might have left and we don’t even know it yet because we just haven’t heard from them but they’re seeing a
different doctor they didn’t get a release of information they just haven’t told us that they already moved on but we don’t have any evidence of that every month they choose to not leave and so you have 12 months every year 12 times every year where
they’ve decided I’m going to keep paying this bill because it is valuable to me I’m going to keep paying this the same way with Netflix or anything along those lines like what We choose every month to keep paying our Netflix bill because we derive some value from it or it’s $12 or $19, whatever it is.
And I just don’t think about it enough. But when families are talking about the cost of health care, they are thinking about that every single month. And they decided last month and the month before that and the month before that, that this was valuable enough to me and to our family that we didn’t just cancel
because they could just cancel at any moment. Right.
exactly yeah absolutely I will also mention just for full transparency that like I also happened to kind of reach capacity this year and decided my goal has always been to work three days a week clinical and I had kind of slipped into the four day a week territory for a while and then
three and a half and now this year starting this summer I’m committed in fact this week I finally my schedule is now a solid three days a week for the rest of the year maybe with rare exceptions if I’m out of town I add a makeup day whatever but three
days a week that’s my happy place and I do work longer days so I work till six and I’m there from about nine to six so that I can see those kids after school and pack them in and I also work Saturdays lots of times so I make myself well available still to my families but
I I recognized for myself that I’ve reached capacity for those three days a week and so I had to I had to grapple with okay what do I do with new members now and what I ended up doing my mentor actually encouraged me to first of all just start
kind of like a waitlist and application process to make it to be honest and say hey we’re pretty full we’ll consider you but you have to be a good match right and it helps me with the selectivity of making sure that the families that come into my orbit are truly aligned with my style of practice and
are going to be appreciative and nice right and then I increased my prices quite a bit again but only to the new ones now on that wait list and it’s a little bit of an experiment too because again with these rising costs of the building acquisition and just
wanting to take more of a break but still pay myself fairly and also wanting to hire a new pediatrician this year I was like okay I’m looking at I’m looking at my accounts I’m saying something’s gotta something’s gotta change I need more of a
cushion and so I increased the prices quite a bit and now we’re experimenting with that for the next few months and seeing how that waitlist works and we’ve gotten some interest we still continue to get inquiries so that’s looking good and it’s going to help to kind of replenish the piggy bank a
little bit so that everything feels like it’s not just making ends meet because actually the last year I had been feeling kind of strapped it was like yes I’m paying my bills but sometimes just barely and I didn’t like being in that place so assess that for yourself from a financial perspective from a personal energetic
perspective of the energy you’re giving out and then energy you’re receiving back in the form of finances appreciation etc and also just how much you want to work, what’s fair, what will the market bear in your area, all of those things.
So getting into the practicalities of raising prices, I mean, I think one of the things that we both would agree with is start with new people because that’s super, that’s website updates and your automated signup way of doing that. And then just making sure that you remember,
I have a tendency to forget the prices when I’m talking in meet and greets, I have to like pull out my phone and be like, let me go to our website and look it up.
Make sure I have the most updates.
Yeah, exactly. i think that that’s an easy place to to start and then an email of hey i’m going to give you a little bit of advance notice that in two months from now prices are going to increase i think it is fair to give them just a warning so that it’s not like oh we just
increased our prices plan accordingly. I think it’s fair to give them a month or two. It doesn’t have to be like in six months, we’re going to raise our prices. One thing we particularly do that I really liked that you, you had mentioned too, is we say like,
if this is going to be materially difficult for your family, please reach out to us. And that tells families like we get it. And also there may be ways that we may be able to help if this is going to be materially challenging for your family to bear. and so we write that as well.
The other thing that we do is we give people the opportunity to switch to an annual at their current rate and then save a little bit of money this year. And actually a lot of people do that because they’ve got HSA funds that are sitting
there that then they’ll switch to an annual and get locked in at their current rate for this year. Then their annual will go up the next year but they will get extra time where both they’re getting the annual discount which is a month off for us like if they pay annually they get one month off and then
they’re also reaping the benefit of not experiencing that price increase until the next year that’s true and so that is actually an effective strategy and it’s just an also an effective strategy if you’re ever like I need some extra cash like in the short term I need more capital immediately for something that we have going on
is get people to switch to annual because then it’s like the Netflix it’s out of my mind I already paid for it for the year like I’m just gonna keep using it and those sorts of things like from from their side of things they’re not paying that bill every month they’ve already paid
it for the whole year but they’re going to be around and you get that capital upfront when that can be helpful. So that’s our typical approach. Percentage wise, we usually, if we’re going to do an increase, it’s like a five to 10% increase in our rates.
We haven’t yet, and I’ve been toying with this, increased our family maximum yet. And I do think that that is on the radar for us for the next thing that we need to do is just to catch that up because we haven’t ever raised our family maximum and we have a lot of families
that continue to grow and those sorts of things so I think most of them kind of sit
around there yeah and that really affects your per member per month like if you actually tally how much am I bringing in each month divided by the number of members right family max can have more of an effect that you realize
So the big picture is if it feels right, if it will give you peace of mind, don’t hesitate to say this is the time that I need to raise prices and you don’t have to feel a lot of guilt or have it be something that keeps you up at night because your 100, 200,
500 patients are moving on with their day much faster than you realize when they get that email, especially if you continue to provide the good care that you do. One last thing that I always kind of try and think about is, are there any new service lines or things that we’re doing that maybe we haven’t
even told our whole patient panel yet that we could say, hey, FYI, we’re also offering this as a value add. this isn’t this this is a new service this is something new that we do the things that you talked about with myofascial release or hypnosis or those sorts of things
for us different like ADHD evaluations all the different things there’s a lot of different ways that we already provide extra to our families that we might not even kind of that most don’t take advantage of so it’s also a good opportunity to remind them of other things that they have access to that maybe they didn’t even realize
Yeah. And it makes it easier to swallow when there’s a price increase of like, oh, they’re not just seeing my kid twice a year. They’re also offering this, this, this, et cetera. Yeah. I want to add two more quick points. So first of all,
sometimes you may need to do a jump that’s more than the annual three to 5% increase for inflation. And that typically happens when that happened with me, when I really reassessed and I figured out that the math that I had done in the beginning was
wasn’t quite accurate for how the practice was growing and the value that I was providing. And that’s part of the complexity of integrative functional medicine because it’s like you’re not just giving just general pediatric care, you’re also offering more. So we’ll talk about that in another episode. Second one is
And if you need to do that, that’s totally fine. Just figure out how do you need to make the numbers work so that this is a sustainable practice, not just a get through tomorrow kind of practice. And if you need to make a bigger jump, make that. You can do it in terms of enrollment fees.
You can do it in terms of the monthly fees. You can do it in terms of family maximums. You can even add credit card processing fees. That was my last point. And Phil, I know that you recently did something to help compensate for the credit card fees.
Yep. So we turned on that credit card fees are now passed along. We use hint for our practice billing component. And so there’s just a toggle that’s like pass credit card fees along. We let people know that I thought of it because we were at the orthodontist and they had a little sign that
said that and I was like, do people get upset? And no, no one ever says anything about it. And so then I was like, well, we should do that too because credit card fees are expensive and most people are used to dpcpediatricianadmin DPC Pediatrician admin dpcpediatricianadmin
if you have been hesitating to increase your prices just if you feel like you need to do it just do it right find a way enlist help figure out how much but don’t feel guilty about it business is all over the place do this no sustainable business
never increases their prices so the rest assured that we’re all having to do this at one point or another it’s just part of growth in dpc
yep and you are you’ve done hard things and you will keep doing hard things and this is a hard thing that you can do and it will be a benefit to you which will
benefit everyone else exactly all right everyone hope this was helpful until next time
