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More doctors are charging fees to respond to patient messages

wsj.com

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

#161

Post by bdzr »

danielschonfeld wrote: post #10
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…

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.

It's really not, it's a frankenstein of a system with capitalist and socialist traits. If it were capitalism run amok, a consumer would be able to figure out the price of something as though it were a cup of coffee. Pricing is completely opaque and provides nearly zero demand for providers to compete.

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

#162

Post by rqtwteye »

mjamesaustin wrote: post #32
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!!

My recent ER visit charged $5000 to walk in the door, without even accounting for any actual care.

Wow!

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

#163

Post by ClarityJones »

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…

Prescriptions should not be required.

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

#164

Post by rqtwteye »

lotsofpulp wrote: post #140
BenFranklin100 wrote: post #138

Earlier quoted context omitted.

Fighting the ER. The employee screwed up and did not go to the urgent care per policy for minor cuts. Still, it’s bad optics to fight an employee.

It’s bad optics to employ someone who doesn’t know what emergency means.

The system should not be that complex and full of traps. I rarely go to a doctor and when I have to go every few years I have no idea how things work and what to avoid.

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

#165

Post by Johnny555 »

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.

I love it -- I have an annual blood test to check on a condition, after the blood test results come in, it's followed up with a doctor appointment to discuss. It's so convenient to be able to Zoom in for a 5 minute visit instead of driving 30 minutes away to the doctor's office and waiting 30 minutes to see him for that 5 minute visit.

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

#166

Post by thaddeusmt »

My spouse is a physician, and "patient messages" (aka "non-face-to-face" encounters) usually aren't reimbursed by insurance. Having a friendly online conversation with a patient doesn't generate the "RVUs" they need (contractually!), so time spent messaging is time taken out of their personal day on top of their regular workload.

Responding to messages can also just be very difficult and time consuming. Maybe you ask concise, clear, pertinent messages to your doctor (or think you do!), but most do not. It's similar to problems HN readers might be more familiar with: user-created support tickets, and comment moderation. Medical office staff help with this triage and moderation, but it has become a big problem to manage with how easy it now is for bored/sick/scared patients to send messages.

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

#168

Post by arealaccount »

gotbeans wrote: post #149
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!!

26k for an mri /w contrast last week because insurance decided it's not necessary despite the doctor asking for it. Now the doctor has to put an appeal to explain medical necessity, I'm at his mercy.

Is insurance the villain on this one of the hospital charging insurance 26k for an MRI?

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

#169

Post by Buttons840 »

BenFranklin100 wrote: post #98

People talk a lot about prescription drugs, but the real driver of costs are the hospitals, both public and private. Drugs account for 10-15% of total healthcare spending; it’s the hospital reimbursement & compensation framework along with private insurance that is driving the bulk of costs. It’s evolved into a patchwork, opaque, dysfunctional system where the end consumer has little view into the inner workings and…

Last I checked about 15 to 20 percent of all US workers were in the health industry. It's basically a patriotic duty to pay your medical bill, because you have to pay all the insurance industry workers, and all the hospital administrators and CEOs, and all these people, and there might even be a few bucks left over for the doctor in the end. I don't see how healthcare can ever cost less until we simplify these systems and eliminate a lot of jobs (which wont be politically popular).

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

#170

Post by ultra_nick »

thaddeusmt wrote: post #166

My spouse is a physician, and "patient messages" (aka "non-face-to-face" encounters) usually aren't reimbursed by insurance. Having a friendly online conversation with a patient doesn't generate the "RVUs" they need (contractually!), so time spent messaging is time taken out of their personal day on top of their regular workload. Responding to messages can also just be very difficult and time consuming. Maybe you ask…

Same, my wife works a 10 hour day, comes home, gets yelled at by neurotic patients for an hour, then does paperwork for another hour.

We're not even making money yet due to student loans. Sucks.

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