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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

#271
post #5

Earlier quoted context omitted.

I've never had a problem across several doctors on getting a direct reply to my message. For me, there is an SLA. They explicitly state I'll receive a reply within 24 hours. That has been true across multiple health systems I've used. Edit: In no way am I saying "American healthcare is just fine!" only that I actually have had a really good experience using messaging to communicate with my care teams.

Are you, by chance, using concierge doctors?

Negative.

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

#272

My partner has had issues that could be fixed with a few messages and the doctor just refused to respond and said they have to wait until the next appointment. It begins to feel like malpractice when they're refusing to fix simple issues because of billing limitations. I think the core issue here is that we're trying to make healthcare profitable when it probably shouldn't be. Stuff like healthcare, housing, and educ…

The fact that so many messages in this thread are variations on "well this should be covered by insurance" to other stuff like "I understand they need to charge" makes me think we will never see a proper system of any kind in this country because everyone is just too heavily propagandized into thinking healthcare just must be expensive and that any attempt to have the Government in any way pay for it will quite literally destroy the United States, which is of course failing to take into account that insured Amercans spend vast, vast amounts more than anyone else on the planet while receiving... middle-to-low quality care. And that's just what the people spend, the insurance companies when they can be arsed to actually pay what they've agreed to are also paying through the nose for every last service and minute of a doctor's time.

The only people actually winning in our health insurance system are the shareholders and the executives. Everyone else is being left worse off than they'd otherwise be.

TL;DR: The arguments against socialized healthcare make sense if you believe healthcare actually costs what American providers charge. It doesn't. They just know you have to, you know, not die and that they can charge whatever they want for that service. That's why it's fundamentally unethical for medicine to be a for-profit industry.

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

#273
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.

i agree this is a big problem. but as long as you have 10+ admins for every doctor , costs will be through the roof.

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

#275

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…

I agree that charging a fee can be fine. For me it's often a win-win. I spend less time having to go there, and the doctor can spend less time than an in-person visit and even do it on some down-time. But it's still a service, so paying about same as a regular doctor visit (about ~$20 or so here in Norway) is fine. My biggest gripe here is that if the doctor answers me outside office hours, an additional "emergency /…

So the doctors only respond late in the evening for all that free extra cash?

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

#276

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.

The problem is doctors are expensive so the management is economizing their time.

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

#277

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…

I agree that charging a fee can be fine. For me it's often a win-win. I spend less time having to go there, and the doctor can spend less time than an in-person visit and even do it on some down-time. But it's still a service, so paying about same as a regular doctor visit (about ~$20 or so here in Norway) is fine. My biggest gripe here is that if the doctor answers me outside office hours, an additional "emergency /…

> about same as a regular doctor visit (about ~$20 or so here in Norway)

In the US, a regular doctor's visit can cost hundreds of dollars.

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

#278
post #253

Earlier quoted context omitted.

> trying to That's an understatement. It is blatant and deliberate.

Is it greed? Is it all doctos tacitly agreeing to this so they can get bigger paychecks?

Yes. They sign up for big salary at hospital where their schedule is managed for them.

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

#279
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…

Could be they are same people who are thrilled while paying 30% tip on a mediocre meal at restaurants.

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

#280
post #253

Earlier quoted context omitted.

> trying to That's an understatement. It is blatant and deliberate.

Is it greed? Is it all doctos tacitly agreeing to this so they can get bigger paychecks?

The individual doctors don't have much choice when they're heavily indebted by the time they become doctors.

We (the AMA?) regulate where a doctor gets their education in order to become a doctor. This gives schools a lot of power. It also gives hospitals a lot of power when those doctors work insane shifts during their rotations.

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