Health care is not free: Valuing yourself and your services

Updated on July 16, 2021 (Originally posted on August 21, 2019) The Tablet
Menu of services

Pharmacists should remind their customers that their time is not free. Consider posting a “menu” of services with prices.

By Derek Desrosiers, BSc(Pharm), RPh

Pharmacists are notorious for undervaluing their knowledge, skills and services. Like beauty, “value” lies in the eyes (and wallet) of the beholder. According to the Merriam-Webster dictionary, the top definitions for value include “the monetary worth of something” or “a fair return or equivalent in goods, services, or money for something exchanged.”

We have created a culture in Canada that leads consumers to believe health care is free, but we as health-care professionals know this is not true. Pharmacists’ services should also not be free. Patients expect to pay for prescriptions (if they do not have insurance) but they have no expectation of paying for other pharmacy services. This is where providing appropriate value is important.

Several years ago, I was attending an evening pharmacy continuing education event. I was meeting a colleague and he arrived half an hour late. When I asked him why he was late he responded that just as he was about to close up the pharmacy for the day, an elderly lady came in with a bag full of prescription drugs. She dumped them on the counter and asked my colleague if he could tell her about them and how to take them properly. He took about 30 minutes to provide her with lots of excellent information about her prescriptions and how to best maximize the benefit of her drug therapy while ensuring there were no drug-related events happening. This seemed like a reasonable thing to do, except that the prescriptions had all been filled at a different pharmacy.

After hearing his story, I asked my colleague what he thought his services were worth. He said probably about $50-$60. Then I asked what he charged the woman and he said nothing. So in fact, the service he provided was worthless. By not attaching a price to the services, they essentially have no value. You might argue that the woman appreciated the information, but all my colleague had really done was to reinforce the myth that pharmacy services are “free.” For me, “free” is the four-letter “F” word in pharmacy.

Pharmacists seem to have a difficult time asking patients to pay for services and information. Most often, the expectation is that a third-party payer (private or public) will foot the bill. However, many services are not insured and patients need to understand that these services have value.

I suggest setting a value for everything you do in terms of cognitive-type services, from drug information through to point-of-care testing. How much you value each service is completely up to you. A good starting point is to try to assign a fixed amount of time (in minutes) to each service that you provide. Set the price based on $2 per minute or some amount in that neighbourhood. Therefore, if a service takes you 20 minutes to provide, then a somewhat appropriate value could be $40.

If you are not initially comfortable asking your patients to reach into their wallets to pay you for services, at the very least you should consider posting a “menu” of services with prices. Make sure that every time you provide a service, the patient knows what the value is for that service, even if you waive the fee and do not charge them.

You can reinforce this idea even more by providing the patient with a specific personalized invoice for the service. Advise them that you will waive the fee for the first time, but subsequent visits will require them to pay for your services.

In my experience, patients will reach into their wallets and pay for services if they see the value in those services. In other words, provide them with what they want, need and expect, and charge a fair and reasonable price.

It is also important to note that patients often link price with quality. That is, they will perceive that a given service is better if the price is more than what is being charged for the same service at another location or by another pharmacist. So, don’t be shy about setting reasonable prices for your services based on the value of your own time, skills and knowledge. Your patients may appreciate you and what you have to offer even more than they already do.

Derek Desrosiers, BSc(Pharm), RPEBC, RPh is President and Principal Consultant at Desson Consulting Ltd. and a Succession & Acquisitions Consultant at

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