Why must dental practices build “what ifs” into the case fee upfront rather than addressing them later?
Because once a fee is agreed upon, changing it later is nearly impossible without damaging trust, prompting complaints, or triggering regulatory exposure. The discipline requires anticipating every contingency that could affect the actual cost of delivering the case. Common what-ifs include clinical complications that may require additional procedures, materials substitutions if the chosen ones become unavailable, anesthesia or sedation needs that may exceed initial estimates, healing-phase complications that may require extra visits, and behavioral patterns from the patient that may extend chair time across the treatment phase. Each of these should be considered during fee development and built into the case fee as a contingency margin. The patient then receives a single all-inclusive fee that covers the full treatment including the realistic what-ifs. When a contingency actually materializes during treatment, the practice absorbs it without invoicing additional charges. The patient experiences the practice as straightforward and trustworthy. Compare that to the practice that quotes a base fee and adds charges as complications arise. The patient experiences nickel-and-diming. Cases get damaged. The all-inclusive structure costs the practice nothing in net but produces dramatically better long-term outcomes.
If the answers you are finding here resonate with you, my team and I work with a small group of clients each year. The next step is a complimentary Discovery Consultation and Practice Review with Dr. McAnally.
