The Pros and Cons of Professional Courtesy

Marvin H. Berman, DDS


Let’s talk about professional courtesies, such as discounts, specials, coupons, and sales. Extending a courtesy to members of your profession has long been a hallmark of proper etiquette. As a matter of fact, the American Medical Association has included such a provision in its code of ethics for almost 200 years. Over the years, it has been my pleasure to provide special consideration as a sign of respect to physicians and dentists or where I recognize that a particular family is struggling financially.

There are instances, for example, where the family provider is out of work, the patient is suddenly a single parent, or a family is going through some personal hardship and I choose to offer my time and skills without expectation of being paid. Situations arise where children are in need of immediate care and the parent is not prepared to pay, so you just do what you have to do. The point is that as a self-employed dentist, I extend the courtesy because I want to, not because I’m coerced.

I’m frequently asked if I have a definitive protocol governing who receives special consideration when it comes to altering my fees. The decision to institute a professional courtesy policy in your practice is certainly a personal one, but here is my perspective after more than 50 years in private practice.

Don’t discount or devalue your service. If your fee is $100 for a particular procedure and a patient asks if you can do it for less, the answer should be no. But you can set up a convenient plan for the patient to pay the fee. I don’t engage in any bargaining or negotiating over fees.

A courtesy is a gesture that I extend to a patient or family from my heart and not meant to obligate that patient to refer more patients. The courtesy should not be a marketing tool. 

When you advertise a sale, offer free cleanings or examinations, or run a special to attract patients, you are depreciating the value of your services. Moreover, the doctor-patient relationship will be tied to money. I set a value on my time and my skills, and I have always hoped that people chose me as the dentist for their children not because I charge less but because they can count on me to be a conscientious caregiver.

It has always been my practice to discuss the ins and outs of the treatment I’m recommending with the parent of a child and leave the conversation about fees and payments to my front desk or business people, the idea being that I, the doctor, am focused on the best care options for the child and not the money. 

A word to the wise, though. If a patient has dental insurance, you cannot bill the insurance company for the full fee and then discount the fee or waive the copay to the patient, even when patients ask you to. Doing so is fraudulent and considered a felony.   

Though there is a business aspect to practicing dentistry, the word “profession” sets us apart. I have been fortunate enough to be able to develop and sustain a private practice that has allowed me, when indicated, the luxury of providing quality treatment at a reduced cost for children whose parents could not afford my fees. But my decision to do so is humanitarian, not motivated by business concerns. 

Dr. Berman is an internationally recognized pediatric dentist with a career as a successful practitioner and as a popular world-class lecturer spanning more than 5 decades. He has been an ambassador for dentistry as a health reporter on CBS (News Radio 78) and via media appearances as a consumer advisor for the ADA, the Chicago Dental Society, and the Academy of Pediatric Dentistry and as co-author of Essentials of Modern Dental Practice. He has published numerous articles and is a member of many professional and service organizations including honorary membership in the Hinman Dental Society. He can be reached at

Related Articles

Operative Dentistry for the Primary Dentition: An Overview

Try Communication, Not Sedation, in Pediatric Dentistry

What to Tell Your Patients About Tooth Eruption