Are you a premium practice?
I recently participated in a discussion, sponsored by a veterinary pharmaceutical company, that focused on a consumer behavior called "trading up." The idea, as it's articulated by the authors of Trading Up: Why Consumers Want New Luxury Goods... and How Companies Create Them (Portfolio Hardcover, 2004), goes like this, "Consumers are now willing to pay a significant premium for goods and services that are emotionally important to them and that deliver the perceived values of quality, performance, and engagement. But in other categories that aren't emotionally important, they become bargain hunters."
In other words, most of us generally work hard and endure a lot of daily stress. So we reward ourselves with premium products from Starbucks, Ben & Jerry's, Samuel Adams, Victoria's Secret, BMW, and more.