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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

#211

Post by derbOac »

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…

This is why I think US medicine should be deregulated, especially licensing laws.

Everything you're describing is screaming monopoly and artificial lack of competition.

If providers of class X are too busy to see you, then there's plenty of people who could, or you're just going to do it on your own. It needs to be more like that.

Obviously there are some limits, but educational pathways could be much more diverse, and there are many things that patients are capable of accessing on their own or through providers like pharmacists.

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

#212

Post by kelnos »

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…

Reading a lot of the responses here, I've realized another reason why the fight for a better health care system in the US goes so poorly. People are so used to the costs and being jerked around by the system that they've completely normalized it. "Oh, you should have known those symptoms didn't require an ER visit; it's your fault you got such a large bill." "Every hospital or doctor is going to try to push extra charges like that; you have to contest them or just not pay and hope the problem goes away; that's just how it is."

Then someone from outside the US says, "that would never happen in my country; here's how it works here..." and it's immediately assumed there's some sort of huge catch, that never, nowhere could a health care system work that well without some sort of major trade off or downside.

No! Stop this! A health care system should work for patients, not against them! Injured or suddenly-sick people are not in the best head space to make rational, informed decisions as to what level of care they need in the moment. Even if they were, nearly all lack the specific medical training that would always allow them make that decision with a comfortable level of certainty.

And even if someone should have known better, I just don't get the ire. Why should we put people into tenuous financial situations just because they made a mistake in how they sought medical care? Medical care! What the hell is wrong with people?

The US health care system is awful, despite having so many great and talented doctors, nurses, and staff! Let's get that through our heads! We pay so much more than other developed countries, for so much less care. And the reason we don't have something better is because the right public policy is labeled "socialism". This is so exhausting.

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

#213

Post by wannacboatmovie »

pants2 wrote: post #37
gnicholas wrote: post #2

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 th…

While waiting 6 weeks for an appointment with a specialist and suffering in pain, my mom diagnosed herself, created a treatment plan, ordered prescription pills from some Chinese site, and started treating her condition herself. She cancelled her appointment because she was feeling much better.

This is terrible advice.

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

#214

Post by BenFranklin100 »

kelnos wrote: post #208
alistairSH wrote: post #174

Earlier quoted context omitted.

It's not. ER - life or death (if you can drive yourself, it's probably not an emergency) Urgent Care - you have the flu, and your PCP isn't available; minor emergencies (but you can still drive yourself) PCP - flu, check-ups, whatever The balance billing and OON charges are separate issues from over-use of the ER.

Your simplistic description shows that you don't even know what you're talking about! The ER is for far more than life or death. A broken bone -- no matter how minor -- is a perfectly reasonable reason to visit the ER. Urgent care may work just as well, but there are many reasons why urgent care might not be a great option for people in their circumstances.

ER is definitely not appropriate for a small cut requiring only a band-aid.

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

#215

Post by plagiarist »

j-j-j-j wrote: post #108
danielschonfeld wrote: post #10

Earlier quoted context omitted.

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.

None of that stuff would be possible without government. It's a statism run amok. It's the same story every time. Something works relatively OK (US health care before 20 century big-gov), huge changes to incentive structure and overheads are introduced by statists ignoring higher order effects, everything goes downhill, statists blame capitalism. Let me legally not have insurance, pay anyone in cash for my health car…

We can surely fix this mess via same invisible hand that sent people down the horses aisle in the farm goods warehouses to use deworming medicine as a preventative antiviral.

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

#216

Post by wolverine876 »

aeturnum wrote: post #62
danielschonfeld wrote: post #10

Earlier quoted context omitted.

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.

I have a partner who's a nurse practitioner in primary care and I just want to emphasize how hellish it is for people on the inside as well. The economic model of running a healthcare business is entirely based on their ability to bill for provider time. Healthcare providers have very high costs to match their very high fees and also pay a bunch of people to 'help' providers see more patients. A big part of this mix…

Somehow, US healthcare is ~ 2-3x expensive as equivalents in other wealthy countries, which get better outcomes. Who is collecting this extra money? It's not the medical professionals, you say (and I believe).

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

#217

Post by BobaFloutist »

dghlsakjg wrote: post #185
BobaFloutist wrote: post #181

Earlier quoted context omitted.

>You have no idea what this person was being seen for. I feel fairly comfortable assuming that they were being seen for a minor-to-moderate burn.

That was the treatment received, but perhaps they were referred to the ER by EMS for smoke inhalation. I don't know either, but the broader point is that people are referred to the ED by medical professionals for seemingly minor issues all the time, and that the incentives are all lined up to treat stupid shit in the ER rather than have someone tell them to go somewhere that makes more sense.

>perhaps they were referred to the ER by EMS for smoke inhalation.

In that case part of the treatment they received was emergency evaluation for smoke inhalation. Just because they don't end up giving you drugs or doing surgery about it doesn't mean the assessment wasn't a valuable service.

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

#218

Post by BenFranklin100 »

dylan604 wrote: post #200
lotsofpulp wrote: post #140

Earlier quoted context omitted.

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

you're assuming that the employee had an urgent care center open available to them.

No assumption. The employee had several.

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

#219

Post by wolverine876 »

stuckindoors wrote: post #124
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…

Just go to Mexico or an online pharmacy and get your meds at cost. /s The US healthcare system is completely broken. Hospital systems and doctors offices in general lost a shit ton of money last year. There has been massive layoffs throughout this sector. There will continue to be this year. This year they all are going to try to survive by recouping their prior losses. Get ready for more fees. In addition - there is…

> Hospital systems and doctors offices in general lost a shit ton of money last year.

It costs 2-3x of healthcare in equivalent countries, with worse results. Where is that money going?

> In addition - there is consolidation in the physicians groups. Mom and pop groups are almost unfeasible at this point. Look for venture capitalists to scoop in.

Private equity already has, from what I've read.

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

#220

Post by gnicholas »

kettro wrote: post #202
QuantumGood wrote: post #183

Earlier quoted context omitted.

One Medical charges $9/month (through Amazon), all video visits are free (if you click the proper link), and I've had multiple prescriptions renewed that way. Three times waited less than a minute, longest wait was 15 minutes, and the app will call you back if you wish so you don't have to keep the app open.

My company pays for One Medical, and it’s honestly the best practice I’ve been to in the US. I can typically get an appointment the next day, there are tons of offices (in SF), and everyone is kind and efficient. They ask you to set a primary care doctor, but I have had more success with seeing a small group of their more available non-MD physicians.

What is a non-MD physician? Is that a physician assistant?
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