Current:Home > Stocks'Hi, Doc!' DM'ing the doctor could cost you (or your insurance plan) -TradeWisdom
'Hi, Doc!' DM'ing the doctor could cost you (or your insurance plan)
View
Date:2025-04-11 19:16:05
If you wanted to talk with your doctor before the pandemic, you generally had to schedule an in-person appointment. But the sudden, rapid expansion of telehealth means patients generally can now text or email their health care providers.
"When you wanted to get a Zoom visit or an audio visit, you needed to sign up for the patient portal, and I think a lot of people became aware that they could message for the first time" during the pandemic, says A Jay Holmgren, a researcher in health care information technology at the University of California San Francisco.
Patients love that direct contact with their doctors — so much so their messages are overwhelming doctors' inboxes. Now, some patients are getting billed by hospitals or health systems for some responses to their message queries.
Holmgren tracked how doctors spent more time during the pandemic managing electronic health records. Even after lockdowns ended, doctors were fielding over 50% more patient messages than before, he notes in a research letter published in the JAMA. That compounded stress for doctors already dealing with a pandemic, then responding to emails after hours, essentially working for free.
"Physicians who receive a ton of portal messages tend to report being burned out, tend to report being more cynical about their job, tend to report that they are thinking about leaving clinical practice," Holmgren says.
Many hospitals and health systems, from Johns Hopkins to Houston Methodist and Cleveland Clinic to Veterans Affairs, now charge patients who receive clinical advice through messages. Such charges are generally covered by Medicare and Medicaid, as well as most private insurance, though patients may bear co-pays, ranging from $5 to $75, depending on the type of plan.
Holmgren says the goal of charging for these messages was both to reimburse doctors, and discourage patients from excessive emailing. In actuality, however, he says the new charges have not solved either of those problems. His research shows doctors only bill for a tiny fraction of messages — about 3%. And the move to charge for them did not cut down on email volume. The fees led to slight declines of about 2% in the number of messages.
"Uptake has not been super high amongst our clinician workforce," Holmgren says, in part because billing for messages itself is complex and time consuming. Plus, doctors don't want to alienate patients by charging them for communicating.
In short, there's still no business model to support the realities of how patients and providers now talk to each other.
But Caitlin Donovan, senior director of the nonprofit National Patient Advocate Foundation, says finding one is essential. She represents patients who are chronically ill, or live in rural areas.
"Over the last few years we've realized that telecommunications is a health issue," Donovan says, adding that the ability to email doctors was transformative for many patients: "Sometimes patients don't have the energy to make that phone call, let alone come into the office." Plus there are people who live hours away from their doctors.
Donovan hopes the ability to email doctors can remain in place, without adding major costs to patients: "We're balancing both this need to rapidly expand access and to really entice providers to make it part of their practice, with trying to make sure that it is accessible and affordable for patients."
Eve Rittenberg, a primary care doctor and assistant professor at Harvard Medical School, also wants a system that supports the relationship between doctors and patients. "For me it's an incredible privilege that my patients share their fears and their worries and their questions with me and I can talk with them directly," she says.
But it also has to be sustainable, Rittenberg argues, and what's needed are better systems to sift through the constant influx of messages, filter out administrative tasks, and allow her to focus on responding only to clinical matters.
Part of the challenge is the compensation model itself, the most common of which is what's called fee-for-service. Health care companies bill for each and every service doctors and nurses perform. Rittenberg says she wants to see payment systems instead compensate doctors for providing overall care, regardless of whether that's in an office or over email.
She says that would give doctors and patients the flexibility to decide what works best for them. "Finding ways to make clear communications sustainable is really, really important," she says.
veryGood! (16)
Related
- Why members of two of EPA's influential science advisory committees were let go
- Long walk to school: 30 years into freedom, many kids in South Africa still walk miles to class
- Greece’s opposition Syriza party splits as several prominent members defect
- Taylor Swift Runs and Kisses Travis Kelce After Buenos Aires Eras Tour Concert
- Have Dry, Sensitive Skin? You Need To Add These Gentle Skincare Products to Your Routine
- Deshaun Watson engineers long-awaited signature performance in Browns' comeback vs. Ravens
- Jaguars embarrassed and humbled in a 34-3 loss to 49ers that ended a 5-game winning streak
- Without Jim Harbaugh, No. 2 Michigan grinds past No. 9 Penn State with 32 straight runs in 24-15 win
- Federal Spending Freeze Could Have Widespread Impact on Environment, Emergency Management
- A veteran donated land to build a military cemetery – and his brother became the first veteran to be buried there
Ranking
- Why members of two of EPA's influential science advisory committees were let go
- Tiny Pretty Things' Barton Cowperthwaite Is Battling Cancer
- Michigan vs. Penn State score: Wolverines dominate Nittany Lions without Jim Harbaugh
- NC State stuns No. 2 UConn, beating Huskies in women's basketball for first time since 1998
- Sam Taylor
- Mega Millions jackpot grows to $223 million. See winning numbers for Nov. 10.
- After massive fire closes Los Angeles interstate, motorists urged to take public transport
- In adopting blue-collar mentality, Lions might finally bring playoff success to Detroit
Recommendation
See you latte: Starbucks plans to cut 30% of its menu
NFL playoff picture: Which teams are looking good after Week 10?
The West is running out of water. A heavy snow could help, but will it come this winter?
Barbie Secrets Revealed: All the Fantastic Behind-the-Scenes Bombshells
Man can't find second winning lottery ticket, sues over $394 million jackpot, lawsuit says
Michael Thomas injury update: Saints WR ruled out after suffering knee injury vs. Vikings
A flight expert's hot take on holiday travel: 'Just don't do it'
Taylor Swift and Travis Kelce Draw Cheers During Dinner Date in Buenos Aires