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More doctors are charging fees to respond to patient messages

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Re: More doctors are charging fees to respond to patient messages

#151

Post by betaby »

ktosobcy wrote: post #148
CharlesW wrote: post #4

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 displ…

Uhm... in Poland there are usually "refill forms" at your chosen / doctors office, you fill it out, drop at the reception and then you get prescription code via sms with which you can claim it at any pharmacy (that has the drug)

[flagged]

Re: More doctors are charging fees to respond to patient messages

#152

Post by dghlsakjg »

BobaFloutist wrote: post #106
codegeek wrote: post #20

Earlier quoted context omitted.

Talk to me when you get a $4000 bill for 2 hours in ER where the actual doc saw you for 5 mins and then the nurses did band-aid and over the counter burn ointment. This with Insurance (biggest mafia). AMerican Healthcare system baby!!

I mean I'm not sure that you shouldn't be charged ER prices for taking an over-the-counter-treatable injury to the ER. You probably shouldn't be charged 4000 for going to the ER, but just because you didn't actually need to go to the ER doesn't mean you didn't consume ER resources (the 24/7 staffing, the intake logistics, the trauma expertise, etc). Probably the biggest surprise there is that a doctor saw you at all…

You have no idea what this person was being seen for.

It is fairly common for someone to be advised to seek emergency treatment out of precaution to ensure that a minor symptom is not indicative of a severe problem.

For example dizziness can be a completely nothing-burger inner ear problem treated with a bunch of motions from youtube, or it can be a stroke. The ER exists to make that distinction.

Part of all those logistics and resources should be used to shunt people to the correct treatment center, but liability suits and extreme profitability mean that the incentive is to treat them in the ER.

Put into other terms, if you were hospital admin incentivized on billing, and could bill someone $5k instead of $160 for a non-urgent issue, wouldn't you? The fixed costs are the same, the ER is running 24/7 with a trauma team, might as well make it profitable.

Re: More doctors are charging fees to respond to patient messages

#153

Post by gnicholas »

Someone1234 wrote: post #147
sithadmin wrote: post #92

Earlier quoted context omitted.

Most of those platforms seem to require the patient to pay for a virtual visit for every refill, or require some kind of a monthly fee.

That is accurate. But those virtual visits are 50% cheaper than full telemedicine visits and 70% cheaper than in-person renews. It should be noted their virtual visits are mostly performative. You're filling in a survey beforehand and the doctor is just there to read the survey and push a big green button.

How long do the refills last? I would think that even with the cheaper cost of medicine, and the discounted telemedicine visit, it would still be more expensive than seeing a doctor annually and getting refills for all prescriptions for the rest of the year without needing additional appointments. But perhaps I'm underestimating how cheap these platforms are (both the meds and the docs)?

Re: More doctors are charging fees to respond to patient messages

#154

Post by amelius »

edm0nd wrote: post #102
codegeek wrote: post #20

Earlier quoted context omitted.

Talk to me when you get a $4000 bill for 2 hours in ER where the actual doc saw you for 5 mins and then the nurses did band-aid and over the counter burn ointment. This with Insurance (biggest mafia). AMerican Healthcare system baby!!

Counter point, why did you even bother going to the ER if that is all that was required? That solution doesn't really scream "emergency" and seems like a waste of their time and resources...

Maybe they couldn't really give the treatment that was required.

Or maybe the patient didn't know what was required.

Re: More doctors are charging fees to respond to patient messages

#155

Post by freeAgent »

BobaFloutist wrote: post #119
freeAgent wrote: post #55

Earlier quoted context omitted.

Yeah, and typically when you do the same with a doctor the fee you pay has been negotiated with your insurance provider. This is no worse than anything else billing-related in healthcare.

>This is no worse than anything else billing-related in healthcare. I don't think I've ever seen a lower bar.

I agree. Im just saying that this is not uniquely bad or unfair in context.

Re: More doctors are charging fees to respond to patient messages

#156

Post by dml2135 »

throwaway2016a wrote: post #36

I think the ridiculous thing here is not the doctor charging but that all insurance doesn't cover it. I bet there are a ton of consultants and lawyers (and maybe some accountants) on HN and most of them will charge you for time spent replying to emails. Edit: inserted the word "all" before insurance to clarify my intent.

I would think that there are very few scenarios where an email isn't cheaper than the alternative.

I would guess that fully covering patient emails would save insurance companies money in the long run, but why do that when you can boost short-term profits?

Re: More doctors are charging fees to respond to patient messages

#157

Post by patwolf »

gnicholas wrote: post #14
CharlesW wrote: post #4

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 displ…

My doctor's office pushes really hard for me to set up a physical if I haven't been in recently and need prescription refills. This includes for allergy and asthma medication, which I have used as-needed since I was a child. This started happening around a decade ago; before that, it was never a problem to have the pharmacy call the doctor's office for the refills, and that was that.

I had a prescription that I used to get updated at my annual physical. I would schedule my next physical when I'd leave the office, but then they started telling me that they couldn't schedule anything more than 6 months out. I waited, and when I tried to finally schedule the physical they couldn't see me for 9 months. So now I order the medicine from India.

Re: More doctors are charging fees to respond to patient messages

#158

Post by dghlsakjg »

JTbane wrote: post #111
CharlesW wrote: post #4

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 displ…

Call me old-fashioned but I really hate the idea of telemedicine.

Totally context dependent.

Call me new-fashioned, but I don't want to spend a few hours of a workday several times per year to see a doctor for less than 5 minutes for prescription refill for a drug that I have been taking for years.

Why in the world would either of us need to see each-other in person when he can ask me the same 3 questions he always does over the phone?

Re: More doctors are charging fees to respond to patient messages

#159

Post by mherkender »

tonymet wrote: post #9

I worked for a mature healthcare company and much of our marketing centered around healthcare provider surveys of doctors and nurses. The results were unsettling. Extremely high rates of burnout, typically due to administrative overhead. Horrifying medical error rates. Doctors should be compensated for the amount of time to send an email. Every other industry is capable of restructuring support to satisfy demand. It'…

Maybe it wouldn't fix everything but I'd like to see a great increase on the cap of the number of medical residencies supported by the government. The AMA and doctors in general shouldn't be artificially limiting the number of doctors.

I'd like to see the other usual suspects addressed too but it seems like the doctor shortage is a big part of the problem.

Re: More doctors are charging fees to respond to patient messages

#160

Post by Someone1234 »

gnicholas wrote: post #153
Someone1234 wrote: post #147

Earlier quoted context omitted.

That is accurate. But those virtual visits are 50% cheaper than full telemedicine visits and 70% cheaper than in-person renews. It should be noted their virtual visits are mostly performative. You're filling in a survey beforehand and the doctor is just there to read the survey and push a big green button.

How long do the refills last? I would think that even with the cheaper cost of medicine, and the discounted telemedicine visit, it would still be more expensive than seeing a doctor annually and getting refills for all prescriptions for the rest of the year without needing additional appointments. But perhaps I'm underestimating how cheap these platforms are (both the meds and the docs)?

They aren't that cheap. But when your doctors appointment is $120+/each, they don't need to be that cheap, just cheaper. They're like 20% cheaper all-in compared to the traditional way, and you don't need to leave the house.

Plus many of these places specialize in stigmatized products like anti-bolding, ED meds, anti-depressants, etc.

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