We associate many things with money. One example: If it costs more, it's better.
Money is not just a physical item representative of some good or service. It has meaning past trade. Having more money does not just mean that you can accumulate more things. Socially, it states that maybe you have accomplished more, are a better decision maker, make better behavior choices, etc. It possesses status and other cultural attributions. Not a surprise. You know this.
The $15 beer will taste superior to the $1.50 beer. It just does, because we know it's better. It's contextual priming. That's why blinded taste trials are often so interesting, because the context is removed and you are left with a singular sensory organ (taste organs of the tongue and mouth, yes and olfaction).The car dealers did this all the time back when I was in auto sales/advertising. Often I would lower prices on the car lot to encourage them to sell. However, every now-and-then we would raise the price and perhaps point out a feature. (6-speed automatic transmission with leather!) The auto right next to it had the same thing, but if you point it out to the potential buyer, they think they're getting something special! It now sold because it was better.
Additionally, this was demonstrated in a cool study in Neurology, where an expensive placebo drug worked similar to that of Levadopa in those with Parkinson's. The cheap placebo did not perform. One pill was more expensive, so it was better.
What's the point? Well, humans are neat. Also it got me thinking...small Co-pays, or sometimes, No-pays per visit. Does that do anything to our image as a whole? What value do you assign a professional that you can see for $10? From a consumer stand point, seeking the best assuming you have the choice, do you seek the $120/visit cash Physio group? And if so, would you get better results? Psychology suggests that you might be much more satisfied.
Cost is not the whole picture, there are other factors involved in assigning perceptual importance to a thing/service too, right?
However, with the discussion about how to provide more value, which we certainly do, our current value is not socially or culturally described in a monetary way (cost). Of course, other things are not described in money either... so, how do they remain sought after?
An example: my pickup truck died a few months after DPT school (good timing!). I ended up buying a 2000 model E320 Mercedes-Benz sedan with 165K+ miles on it. As seen here, it is worth about $2100.
Now, I'm mentioning this because almost everywhere I go, people I know remark "Woah, Ballerman DPT, rollin' in the Benzo!" and things of this nature. It's a 15 year old car and yet the perceived value far exceeds it's monetary cost to me. (No car payments, #FreshPT). The Mercedes brand is strong in that way, and this is an example where cost does not set value.
PT (in my opinion) is much like this. You get high quality care from a highly educated and caring practitioner... for pretty darn cheap. What if you have that gifted Sports PT with 22 letters after her name who worked on the Olympic team in '98... and it's free to go to... go a couple times a week if you want, no big deal. That's kinda what you get now.
This value is not seen in cost to the patient, but in service given. Perhaps this is why we are trying to so hard to create value as physios, share our story, explain how we can benefit the community. We must go above and beyond, reaching out, since our worth is not clearly illustrated in our cost as it often is in other industries.
To be fair, we PTs (in the USA anyway) are not viewed as luminous as that 2000 Benzo, we have a bit to go before we crest that hill and move the perceptual baseline upwards.
Physical Therapy is, however, known as the most effective low cost alternative to other medical interventions dealing with pain and function. What would it look like if we were much more expensive? Would it change the status of a person participating in PT? Would someone brag "Ooh, I went to PT and got special exercises, just for me, and they coached me on how to dead lift so I can do it better." The first line quick-thinking of our human brain to associate better value with cost makes me think that in some sense, yes, yes it would. Regardless I suppose it depends on your audience. It's all up to us to positively impact our own communities and produce those types of responses.
In the end I want affordability and quality care. I want for us to be accessible. I equally want to be valued (as do you). Humans seem to operate in a way that values the expense and views it as more meaningful. How does this play in to the future of payment? Are we loosing the value we are trying to create by selling ourselves as the "cheap route to functional return"?
I can't remember where, but someone (on Twitter no doubt) was remarking that they wanted to ask patients "If you had to pay cash for your visits, how much would you have paid?" on the out-take form after Discharge. Cash practices know this number up front... but I wonder how the answers turn out after care/services were given for co-pays/no-pays and monthly premium considerations...
Right now the public is drinking a $15 beer and paying $1.50. But do they appreciate it?
-Matt Dancigers, DPT
*Dang, another post with more questions than answers....
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!
Keeping it Eclectic...