I recently received this query from a client and would be very interested to hear what others have found to work in this particular situation. My associate recently said she feels she is losing money if she refers to the therapist. I don’t know how therapist fees are managed in other practices to give incentive to refer? Currently for the hygienist, patients pay fees directly to the practice that are not included in the totals earned by the associates for “pay as you go” patients. For Denplan patients I deduct the normal private fee that would be earned by the hygienist from the Denplan schedule. I then credit back 15% of the total of all the related hygienist earnings to the associate, to reward them for the work in arranging the referral. At present my part-time therapist is carrying out about 90% hygiene, so the therapy is a small amount. I am keen to increase the proportion of therapy over time, and increase her hours. Please can you let me know your thoughts on how to deal with payments for patients seen by the therapist on behalf of the associate for therapy? At the moment I would disagree with my associates, because at this point in time I am not making any deduction for the therapy services. So if for instance they see an NHS child and refer fillings out to the therapist, they would get the entire NHS band 2 fee allotted to them, without any deduction being currently made for therapy services.