the clinic owner who had to raise her fees
A physiotherapist in Thrissur, a rent increase, two loyal staff, patients who have come to her for years, and a corporate client in Dubai. She knew she had to raise her fees. What she did not know was how to say the number out loud without apologising for it.
By Brightside English editorial team
Reviewed by a Brightside senior coach · · 6 min read
Composite case study, built from common patterns in our coaching; names and details changed. "Dr Meera" is not one person. Her situation, the sessions and her reflections are drawn from patterns our coaches see often among clinic owners, therapists and independent professionals who have to raise their prices; no real learner, patient, employer or family is identifiable, and nothing here is a promise of any result.
The situation
Dr Meera runs a small physiotherapy clinic in Thrissur. She opened it eight years ago after working in a large hospital in Kochi. The clinic has two treatment rooms, a receptionist named Sindhu and a junior physiotherapist named Akhil.
Many patients have been with her for years: retired teachers with knee pain, a cricket coach with a shoulder he will not rest. She also has a newer client, a facilities company in Dubai that books online back-care sessions for its staff.
Then the landlord raised the rent. In the same year, she gave both staff a well-earned raise. Her consultation fee had not changed in four years. To keep the clinic healthy, the fee for a session needed to go from ₹600 to ₹750, and the Dubai sessions needed a new rate too.
She knew the decision was right. Her problem was the conversations. At the Trial Class she said: "I can explain a spinal disc to anyone. But when I imagine telling Mrs Thomas the fee is going up, I want to hide."
What was getting in the way (observed in sessions)
The coach began with a simple role-play: the coach played a long-time patient, and Meera practised telling her about the new fee. Several patterns showed up.
- The long apology before the number. Meera spent nearly a minute on rent, inflation and staff salaries before she reached the figure. By then she sounded as if she had done something wrong.
- The voice dropping on the number. Her voice went quiet and fast exactly when she said "750", so the most important word was the hardest to hear.
- The instant discount. When the "patient" sighed, Meera said, "But for you, I can keep it at 600," within seconds.
- Different stories for different people. She had planned slightly different explanations for each patient, which made her worry about being inconsistent.
- Formal, stiff English for the Dubai client. In writing to the company's HR manager, she used long, very polite sentences, and the actual new rate was buried in the third paragraph.
None of this was about her English level. She simply felt that charging properly was impolite.
The coaching approach, session by session
Session 1: the number as a fact
The first session worked on one sentence. Meera practised saying the new fee the way she would state a diagnosis: clearly, calmly, once.
"From the first of next month, the consultation fee will be ₹750."
The coach asked her to say it ten times, slowing down on the number and stopping after it. Then once more, with a short reason.
"From the first of next month, the consultation fee will be ₹750. It's the first change in four years, and it lets me keep the clinic and the team as they are."
That was the whole explanation. One reason, honest, and about continuity, not complaint.
Session 2: telling long-time patients
The coach played three patients: one who accepted at once, one who was surprised, and one who was upset. Meera practised telling each of them early, in person, at the end of a session, not at the payment counter.
"Before you go, I wanted to tell you myself rather than you hearing it at the desk. From next month, the session fee will be ₹750. It's the first change in four years."
With the upset patient, she practised listening before answering.
"I understand. It's a real increase, and I don't take that lightly. Can I ask what worries you most about it?"
The patient's real concern was the number of sessions she needed, not the fee itself. That opened a better conversation about a home exercise plan with fewer clinic visits.
Session 3: handling pushback without collapsing
This session focused on the moment Meera usually gave in. The coach pushed hard: "Doctor, I have been coming for six years. This is too much."
Meera practised holding the number while offering something real, not a discount.
"You've been with me a long time, and I'm grateful for that. The fee will be ₹750 for everyone. What I can do is plan your sessions so you need fewer of them, with exercises you can do at home."
For the few cases where she genuinely wanted to help, such as a retired patient on a small pension, the coach suggested deciding in advance, privately, not under pressure.
Session 4: telling her staff
Patients would ask the staff first, so they needed to hear it from Meera directly.
"From next month, the fee goes up to ₹750. I'd like you both to hear it from me first, because patients will ask you. If someone is upset, you don't need to explain or defend it. Just say, 'Doctor will be happy to talk to you about it,' and let me know."
For "What if someone goes to another clinic?", Meera practised: "Then we thank them for the years they've been with us."
Session 5: the Dubai client
For the facilities company in Dubai, the coach worked with Meera on a short, warm, clear message to the HR manager, Fatima, followed by a short video call.
"Hi Fatima, I hope you're well. I wanted to let you know in good time that from January, the rate for the online back-care sessions will be 120 dirhams per session, up from 100. It's the first change since we started working together. The format and timings stay the same. I'm happy to talk it through on a call this week."
On the call, the coach played Fatima pushing back on budget. Meera practised trading rather than conceding.
"I understand budgets are fixed for this year. If it helps, we could move from weekly to fortnightly sessions until your new budget starts, so the total cost stays similar."
Session 6: the whole week, in order
Staff on Monday, Fatima on Tuesday, patients across the week. Meera said each opening line aloud until her voice stayed level on the number.
What changed, in her words (composite reflection)
The reflection below is written in the style of what clinic owners and independent professionals in this situation commonly tell their coaches. It is not a quote from one person.
"I thought the hard part was the money. It was actually the apology. Once I stopped explaining for a whole minute, the conversations became short and normal.
"Saying the number slowly felt strange at first. But patients just nodded, or asked one question. Most of them said they had wondered why I hadn't changed it earlier.
"Telling Sindhu and Akhil first was the best thing I did. They felt trusted, and they knew exactly what to say at the desk.
"With Dubai, the shorter message worked better than my long formal one. Fatima replied the same day."
What the reflection does not claim: that every patient stayed, or that the clinic's income changed by any particular amount. Some people do leave when prices go up, and that is part of running a business. What coaching can change is whether a skilled professional can state her own value calmly, without guilt, and keep her relationships warm while she does it.
Lessons anyone can use
- Say the number early and once. Lead with the figure, not a minute of justification.
- Give one honest reason. Continuity and quality are better reasons than complaints about costs.
- Tell people in person, before they find out elsewhere. Nobody likes learning about a price change at the counter.
- Tell your team first. They will be asked, so give them a calm line to use.
- Offer options, not discounts. Fewer sessions, a different format or a different schedule keeps the price intact.
- Decide exceptions in advance. Kindness planned privately is easier than kindness extracted under pressure.
Published by The Full Stop, the journal of Brightside English. Composite case study; no real learner, employer or family is represented. Reviewed by a Brightside senior coach. Corrections: see our editorial standard.