Should doctors be paid to e-mail their patients?

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff to efficiently respond to patients’ cyber inquiries at scheduled times.

* Eliminate the need for the ubiquitous phone menu system, a torture chamber that tests the mettle of even the most robust and seasoned patients

* Facilitate documentation of patients’ inquiries, which is not reliably accomplished with phone calls.

* Permit staff and physicians to access patients’ e-mails from remote locations.

* Allow for e-mails to be forwarded to other staff and physicians with a keystroke.

* Available 24/7.

Sure, e-mail communications between physicians and patients makes great sense, but it costs doctors dollars. Should this be a free service? The current culture of medical practice in this country is not to charge a fee for patients’ phone calls. Like every doctor, I spend hours each week on the phone with patients. This is free medical care. Patients feel entitled to this pro bono service, as I do when I call my doctor or dentist.

But is this fair? If a patient calls me to ask a medical question, then why shouldn’t I be compensated for giving professional advice that requires medical training and experience? Is this free medical care a service that we should provide to our existing patients? What about patients whom we have never seen who call us after hours with a medical issue? Should this be a freebie also? Many phone calls morph into phone office visits, which not only are free, but also may not provide optimal care to the patient.

When I call my lawyer there’s always a ticking sound that I hear in the background. For lawyers and other professionals, phone calls are fair game. Ironically, while physicians don’t charge for phone calls, we are still legally liable for the medical advice that we offer during these gratis exchanges.

Will e-mails be the next generation of donated physician time? E-mails and phone calls to physicians should be reimbursed. Primarily, because it is fair to pay people for the work that they do. In addition, charging a fee would help reduce many of the unnecessary calls (or future e-mails) that deluge our office.

I welcome differing opinions on this issue. If I respond back, it will be free of charge.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

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