It never occurred to me to charge patients who need my help. If I had a sliding scale fee, I would have to collect financial information and go through a whole process that would just add to my work. And the truth is that most of the people who come to me can't afford to pay me; most of them are in crisis.
But there's a consequence of working for free. The patient doesn't invest in you, and throws you over the side of the boat on a whim.
I had one client for whom I did a tremendous amount of research, found a litigation attorney when the other side wouldn't budge -- and the client then accused me of not doing anything for him after he decided he didn't want to litigate!
I had a client for whom I wrote a first level appeal, and while I was working on the second level appeal, she went shopping for another attorney -- whom she paid -- and never even told me, so all that work was for nothing.
And most recently, there's the client who doesn't believe I'm really working for free. She has a very messy and complex health insurance coverage issue that I've been working hard on. If we lose, she's on the hook for literally hundreds of thousands of dollars. She's convinced that the only reason I'm helping her is because I am being paid by the doctor's office to make sure they get their money from her insurance company. Never in my life have I done a collection matter for a doctor, and I never would.
My sense is that, while there are some people who are incredibly grateful for what I do, there also are people who take it for granted because it's free. Somehow, the fact that it's free makes it less valuable to them. And while some people make a charitable donation after I conclude my work with them, others just walk away. Recently, I won an insurance appeal for a surgery that costs about $50,000. The patient got a letter saying we won and scheduled the surgery and everything -- he just didn't bother telling me that we won, nor did he thank me. A charitable contribution was the furthest thing from his mind.
I guess when you work for free, you have to really mean it -- no strings attached -- and not expect anything in return, whether it be a thank-you or a donation or just a sense of appreciation. If you expect even a thank-you, it's not really free, is it?
On the other hand, a thank-you would be nice. Jennifer
P.S. -- And then I read the comment to my previous post. And now I remember why I do this.