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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

#251

Post by ktosobcy »

betaby wrote: post #151
ktosobcy wrote: post #148

Earlier quoted context omitted.

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]

Well, we also do have an overhead here and doctors usually make way more than the average person but still majority of the doctors work in public sector. It's not completely rosy though - the biggest downside is that quite often you have to wait quite long to visit a specialist, especially if it's any good (our previous government said "let them leave" so lots of medical stuff just migrated to the west...) but hopefully with the increase of spending on health (we are around 6% of gdp...) things will improve.

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

#252

Post by lotsofpulp »

pseudocomposer wrote: post #247
ineedaj0b wrote: post #244

The hospitals are poorly run. Please hate your hospitals management more. Or if you are a good manager, convince some friends to run a hospital. Imagine 10 appointments a day, 30 mins each. You have to write /everything/ down the patient tells you. You often have to go over the 30mins because some patients need it. You need to follow up to order extra tests, you need to occasionally google something. You skip lunch o…

It seems like we just need more doctors, no? The AMA is notorious for trying to limit the number of new doctors. They do that more than much of anything to do with public health.

Supposedly, AMA reversed course in 2019:

https://www.ama-assn.org/press-center/press-releases/ama-fun...

https://www.openhealthpolicy.com/p/medical-residency-slots-c...

But don't know how much is talk versus walk. It is not clear to me why only the US Federal Congress can fund residencies. Surely, with how much doctors can earn, a private underwriter would be willing to finance a residency.

https://www.washingtonian.com/2020/04/13/were-short-on-healt...

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

#253

Post by screye »

pseudocomposer wrote: post #247
ineedaj0b wrote: post #244

The hospitals are poorly run. Please hate your hospitals management more. Or if you are a good manager, convince some friends to run a hospital. Imagine 10 appointments a day, 30 mins each. You have to write /everything/ down the patient tells you. You often have to go over the 30mins because some patients need it. You need to follow up to order extra tests, you need to occasionally google something. You skip lunch o…

It seems like we just need more doctors, no? The AMA is notorious for trying to limit the number of new doctors. They do that more than much of anything to do with public health.

> trying to

That's an understatement. It is blatant and deliberate.

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

#254

Post by ejb999 »

FireBeyond wrote: post #57
smallmancontrov wrote: post #16

Earlier quoted context omitted.

> I wonder if charging for these messages will make doctors more likely to respond. I wouldn't mind a modest copay for these. How long until administration figures out that they can juice revenue by shitting up the emails to increase back-and-forth traffic?

Hah, in MyChart, my provider has started having an MA answer your emails, and then "I'll forward this to the provider". Waiting to see if I get billed for the MA's "effort".

why are you putting effort in quotes? Do you not think there is any 'effort' involved?

Why do you think someone else's 'effort' should be free?

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

#255

Post by ellisv »

oefrha wrote: post #19

> Dr. Lauren Oshman, a family physician and associate professor at the University of Michigan Medical School, says she initially experienced some patient resistance and anger about the prospect of being billed for emails. > Now, she says, patients are typically pleased that they are able to get a direct response from her through a portal message. > “They’re thrilled when they get me directly,” she says. Geez, this co…

It's ironic because I almost never want to message my doctor - there just simply isn't another option.

In the Michigan Medicine system the 3 main message options are: refill a medication, ask a medical question, and ask a billing question. If you select "ask a medical question" the next and final choice is whether you're submitting a question in English or Spanish.

Most often I want to ask a scheduler (because each office/department schedules differently) or a nurse a question, but for that you have to call. Something as simple as scheduling a flu or covid shot can't be done via messaging.

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

#256

Post by FireBeyond »

ejb999 wrote: post #254
FireBeyond wrote: post #57

Earlier quoted context omitted.

Hah, in MyChart, my provider has started having an MA answer your emails, and then "I'll forward this to the provider". Waiting to see if I get billed for the MA's "effort".

why are you putting effort in quotes? Do you not think there is any 'effort' involved? Why do you think someone else's 'effort' should be free?

This is an absolutist take.

No-one's saying it takes zero literal effort. Just "Should I be billed by the practice $25-30 for an MA to get my email and say "I have forwarded your question to the provider"?", and then a subsequent $100+ for the provider's response to my question.

Why should that not be part of the intrinsic baseline officework and not a billable service?

Especially when it's a 100% artificial roadblock inserted by the practice? After all, the communication portal in MyChart is "Message My Provider", not "Message An MA To Message My Provider".

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

#257

Post by ejb999 »

mherkender wrote: post #159
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.

Do you think if there are more doctors, they are going to be more willing to provide free services? I don't - doctors want to get paid for their services - insurance companies (in general) don't pay for doctors to respond to emails - having more doctors doesn't solve this problem.

Not saying we don't need more doctors, but seems unrelated to to the problem being discussed.

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

#258

Post by ejb999 »

tonymet wrote: post #250
__MatrixMan__ wrote: post #234

Earlier quoted context omitted.

> what would it take for the healthcare industry to restructure itself to actually function? I can't quote it precisely, but here's a gist from The Glass Bead Game: > Intelligence can find its own way, the teacher's job is to address stupidity. Overlooking the crudeness here, I think it's a good idea, and translates to medicine. Most of us are not qualified to define good care, but we know bad care when we see it. On…

We dont even recognize bad care. People are overweight and suffering from chronic disease , but since they are “alive “ and taking meds we still call that a good outcome

sadly, a lot of patients consider that good care - around me, doctors stopped weighing patients, and don't ever discuss lifestyle changes or dietary changes (patients by and large don't want to hear it) - they just give the patients the pills they want to offset the poor lifestyle choices.

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

#259

Post by Scoundreller »

chriskanan wrote: post #188

This could potentially increase the number of useful questions being asked. My spouse is a physician. Recently she had to answer a phone call from a patient in the middle of the night where they were asking a question from a party about something non-urgent for their child. In another case, she got called by a parent at 2am because their kid was having trouble sleeping but nothing else was wrong with them (welcome to…

Did those patients press “4” for “urgent problems to be responded to immediately” or something?

> If people had to pay, maybe they would _think_ before asking questions.

Be careful, a lot more people might be calling at 4am because they figure it’s okay because they’re paying for it. At least other contractors can give people a “fuck off” quote for work they don’t want to take, but might be difficult to implement that here.

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

#260

Post by ericd »

onlyrealcuzzo wrote: post #243
ericd wrote: post #64

A 15 minute email from my lawyer costs about $150, I don’t see why we should be outraged about $25? It’s much harder and more expensive to become a doctor.

> A 15 minute email from my lawyer costs about $150 Unless your lawyer is an equity partner, he's not getting much of that $150. In the US, the median doctor makes almost 75% more than the median lawyer...

Yeah, they’re a partner. I can believe your stat for specialists, but not for the general practitioners you’re most likely to be emailing.
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