What should you charge for a private consultation (and why the market table will not tell you)

The price of your consultation does not come from looking at what the colleague upstairs charges. It comes from three numbers of your own: what an hour of practice costs you, how many effective consultations actually fit into your week, and how much you need to earn. The market table is useful for knowing whether you are far from reality, not for deciding.

A few days ago I published the real prices of private consultations in Colombia: 771 specialists measured across Bogotá and Medellín, median COP $250,000. That article answers the patient’s question. This one answers the doctor’s, which is a different and considerably harder question.

Why is the market table not enough to set your price?

Because the market price is an average of situations that are not yours. Within the same specialty and the same city we found differences of up to four times, and it is not that some are wrong: a dermatologist with their own office in a medical tower, twenty years of reputation and a schedule booked three weeks out does not have the same economic problem as one who started two years ago and rents a room by the hour.

Copying someone else’s price leads to one of two expensive mistakes. Copy upwards without the demand to sustain it and you end up with an empty schedule and a price you cannot defend. Copy downwards out of fear and you work more hours for the same money, while telling the market something about your value that you probably did not intend to say.

In one sentence: the market table tells you where you are standing, not where you should move.

What is your minimum viable price?

This is where health economics contributes something marketing does not: before thinking about what you can charge, you need to know what you cannot afford not to charge. That is your floor, and it comes from three numbers you already have.

First, your cost per hour of practice. Add up everything you spend each month keeping the practice running, whether it is full or empty: rent or office instalment, receptionist or booking service, software, phone, utilities, insurance, accountant, subscriptions. Divide by the consultation hours you open per month. That number is what every hour with the door open costs you.

Second, your real capacity, not the theoretical one. This is where almost everyone fools themselves. If you see patients in 30 minutes and open 20 hours a week, the theoretical maths says 40 consultations. The real figure is considerably lower: there are gaps between patients, cancellations, no-shows, urgent cases that cut in, and consultations that run long. A well-run practice usually moves between 65% and 80% of its theoretical capacity. Use your actual percentage from the last three months, not the one you wish you had.

Third, the income you need. Not the one you dream about: the one that makes private practice worthwhile against spending those hours on something else.

With those three numbers the floor comes out on its own:

Minimum price = (monthly fixed costs + income you need) ÷ effective consultations per month

An example with invented numbers, purely to show the mechanism: if your fixed costs are COP $6,000,000 a month, you need COP $14,000,000 of income and your schedule moves 100 effective consultations, your floor is COP $200,000. Anything you charge below that, you are subsidising yourself.

Watch the capacity trap. With the same figures but 70 effective consultations instead of 100, the floor jumps to COP $285,000. Filling your schedule lowers your minimum price; running it half empty raises it. That is why demand and price are one problem, not two.

How do I know if I am charging too little?

Your schedule tells you before your accounting does. Three signs, in order of severity:

• Your next available appointment is more than three weeks out. This is the clearest sign of all. You have more demand than supply and you are resolving it by making patients wait rather than by adjusting price. Every week of waiting is money left on the table, plus patients who leave for whoever can see them sooner.
• Nobody asks about the price. When price sits clearly below perceived value, it stops being a topic. It feels comfortable, but it is information: there is room.
• Your fee has been the same for more than two years. With Colombia’s accumulated inflation, a price frozen for two years is a silent discount nobody decided to give.

And the opposite sign, the one that stings: gaps in the schedule and a high price. That is almost never a pricing problem. It is a demand problem, and cutting the fee rarely fixes it, because a patient who does not know you will not find you cheaper either.

What about the follow-up visit?

It is the decision that moves the most money and gets the least thought.

In the August measurement we found that follow-ups usually cost 30% to 50% less than the first visit, and that some specialists include one in the price of the first consultation. Both decisions are defensible, but they mean different things.

Including the follow-up raises your entry price and lowers your effective capacity, because every new patient takes two slots instead of one. Charging it separately leaves you a more competitive entry price, but forces the conversation about the second payment to be clear from the start, or the patient feels ambushed.

What does not work is leaving it undecided. If your team cannot answer “does that include the follow-up?” in a single sentence, you are already losing patients on the phone.

And the online consultation?

Another finding from the measurement worth keeping in mind: an online consultation costs practically the same as an in-person one. Across the 390 virtual consultations we measured, the median was also COP $250,000.

Intuition says it should be cheaper because it saves office space and travel. The market says otherwise, and it makes sense: the patient is not paying for the physical room, they are paying for your time and your judgement. If you are charging half price for virtual visits “because it is easier”, you are giving away half of that consultation without the market asking you to.

How do you raise prices without losing your schedule?

A price is sustained by demand, not by arguments. These four things are what I have seen work with doctors who raised their fee and kept their patients:

• Raise in steps, not in a leap. Adjustments of 10% to 15% six months apart get absorbed; a 40% jump from one month to the next gets noticed and talked about.
• Raise for new patients first. Keep the previous fee for your regulars for a while, and tell them explicitly. It is cheap and it buys loyalty.
• Change something they can notice. More consultation time, a channel for questions after the visit, results explained in writing. Patients accept paying more when they perceive they are getting more, even if what they get is mostly attention.
• Have the demand before you need it. Raising your price with a full schedule is a decision. Raising it with a half empty one is a bet.

That last point is what connects all of this to the work I make a living from. A medical marketing strategy does not exist so that you charge more: it exists so that you have the demand that lets you decide your price instead of accepting it. A specialist with built reputation and patients who arrive on their own has a very different pricing problem from one who depends on whoever walks past the door.

Why do I write this from economics rather than marketing?

Because I trained for that before I trained for the other. I hold an MSc in Health Assessment and Market Access from Universidad Carlos III de Madrid, which is pharmacoeconomics and health economics, and an MSc in Industrial Economics and Markets from the same university. I worked on medicine pricing in Europe before I turned to bringing patients into practices in Colombia.

That changes the conversation. A price is not a comparison figure: it is the point where your cost structure, your capacity and the demand you built all meet. Most agencies offering medical marketing learned the sector on the job and treat price as a communication variable. It is an economic variable that also happens to be communicated.

Frequently asked questions

How much should a specialist charge in Colombia in 2026? It depends on your cost structure and your capacity, not on the average. As a reference, the median measured in August 2026 across 771 specialists in Bogotá and Medellín was COP $250,000, with the middle half between COP $210,000 and COP $300,000. You calculate your floor by dividing your fixed costs plus the income you need by your effective consultations per month.

Is it better to charge low at first to fill the schedule? It is a legitimate strategy only if it has an expiry date and you communicate it. The risk is building a patient base that chose you on price, because that base leaves when you raise it. It is usually better to hold your price and be more aggressive on acquisition.

How much should my follow-up visit cost? The market sits between 30% and 50% below the first consultation. What matters is not the percentage but that it is decided and that your team can answer it without hesitating.

Should I publish my fee online? A good share of the profiles we reviewed publish a price. Publishing filters out people who were never going to book and saves you calls, but it also exposes you to direct comparison. If your differentiator is price, do not publish it. If your differentiator is something else, publishing usually plays in your favour.

How often should I adjust my fee? At least once a year, even if only for inflation. A price frozen for two years is a discount nobody decided to give.