More doctors are charging fees to respond to patient messages

Getting a doctor to respond through our digital messaging platform is practically impossible. Unless you're extremely persistent and specifically ask for the doctor's input (and send 3-4 messages back and forth with the nurse, whose responses are less relevant than a google search), it's impossible.

I wonder if charging for these messages will make doctors more likely to respond. I wouldn't mind a modest copay for these. But if I pay $30 for an appointment, a quick message should be under $15. There would also have to be some sort of SLA, or the ability for a patient to specify that a question/email has expired and no longer requires an answer.

I've had situations where I waited for a doctor's callback so long that I ended up calling a friend who was a physician assistant, watching a youtube video about how to fix the problem, and taking care of it myself. The only way that process could be any worse is if I got a reply after I had fixed it — and a bill for the message.

Here's American health care:

• I needed refills for two prescriptions that I've been taking for years. This time, for opaque reasons, I needed to talk to a doctor first.

• Fine, but I couldn't accommodate an in-person check-in. I chose a "video visit" that, due to logistics, I had to do while away from home. Because they were a half-hour late, I was effectively forced to do this from the couch of a Costco floor display so I could still pick up my kid on time.

• The appointment was 8m, at an out-of-pocket cost of $160+. I was not warned that I'd be forced to pay $20/minute for the privilege of being blessed with refills.

Land of the fee, baby.

I met with a new accountant yesterday. He told me that if I email him and ask if I can expense a lunch and it's a 1 minute answer, he's not gonna charge me. But if it's gonna take him a good amount of time to respond, then he will. And I think that this is completely fair.

I'd expect the same from a doctor. If I am asking a very occasional and non-urgent question with a quick answer (e.g., can I take my medicine and drink alcohol safely) then yeah, I'll be annoyed if I get a $25 fee. But typing out responses to question might take my doctor 30 minutes, so it's fair if they charge me, so long as I get a good answer in a reasonable timeframe.

Obviously there's exceptions. If it's a brain surgeon who just made $25,000 on a single procedure and I have a 15 minute followup question, it seems a little nervy to bill me $25 more, but not if I'm emailing my kid's pediatrician a picture of a rash.

In some countries in Europe, if you have private insurance they'll pull off the "call charge" trick as often as they can. Need to make or reschedule an appointment? Make a call. Did some blood test and need the results? Call to get them. They call you to tell you they can't make the appointment and need to reschedule? You still get charged. If it's not a call it's a fake shot. Fake disinfection charge. And so on. The principle is "anything that can be charged, will be charged". The level of insurance fraud with this is ridiculous.

American healthcare is the epitome of capitalism run amok.

It’s terrible and the only thing worse than the exorbitant fees is the complete and utter lack of consideration to the patient’s time.