Pricing in Medicine as a Process of Social Coordination: an Economic Sociology Analysis in the Case of Moscow Commercial Dentistry

Abstract

Elena Berdysheva — Junior Research Fellow, Laboratory for Studies in Economic Sociology, National Research University “Higher School of Economics”. Address: 20, Myasnitskaya St., Moscow, 101000, Russian Federation. E-mail: eberdysheva@hse.ru

The study presented in this article deals with the mechanisms and practices of pricing in Moscow commercial dentistry. Following Max Weber’s classic statements and results of contemporary sociological investigations in consumer markets, we claim that pricing is not only economical, but also a social process.

The aim of our research was to analyze, describe and explain the social mechanisms which contribute to the formation of legitimate commercial prices for medical services.

We base our arguments on the empirical materials of price monitoring through the web sites of 184 Moscow dental clinics, supplemented with the data of 25 in-depth interviews with doctors and managers working in Moscow commercial dentistry. Qualitative data allow us to depict pricing in Moscow commercial dentistry as a series of steps:

1. Monitoring current market prices;

2. Adjusting to neighbor clinics’ prices according to the organizational form (‘professional’ or ‘chain’) and desired status of the clinic (‘economic’, ‘medium’ or ‘VIP’);

3. Choosing between two possible forms of pricelist (‘marketing’ or ‘nosological’);

4. Developing discount programs for patients and employees.

However, the steps above do not exhaust the process of pricing in a dental clinic. It requires daily attention and tuning.

Our quantitative analysis points out that the character of clinics and services can hardly explain the disconcerting variations of prices in Moscow commercial dentistry. The only significant factors that matter are the professionalism of doctors and the market status of the clinic. The results of the quantitative analysis confirm that instead of calculating their prices, dental clinics make efforts to coordinate own pricing behavior with prevailing market prices and with the prices typical of the market niche they belong to. They also seek to support the legitimacy of the prices in daily relations with their patients and employees. In sum, all of this evidence supports the idea that prices in commercial medicine originate from complex social coordination among different actors in the medical market field.