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The hidden consequences of portal message fees

Eddie Fatakhov, MD, MBA
Physician
March 3, 2023
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As the health care industry continues to evolve, many practices and hospitals have turned to electronic portals to communicate between patients and their providers. However, some practices have begun charging patients a fee for responding to messages sent through these portals. While this may seem like a viable solution for increasing revenue, it could ultimately have negative implications for the care of patients.

One major issue with charging patients for portal message responses is that it could discourage patients from reaching out to their providers with important health concerns. If patients are hesitant to pay for a response, they may avoid asking questions or bringing up concerns that could be vital to their health and well-being. This could lead to delayed or inadequate care and worse health outcomes for patients.

Furthermore, charging patients for portal message responses could disproportionately impact low-income and vulnerable populations. These patients may not have the financial means to pay for a response and may therefore be less likely to communicate with their providers. This could lead to disparities in health care access and outcomes.

Another problem that could occur is that if patients are charged for getting responses, they may feel more inclined to misuse the portals—for example, sending irrelevant and unnecessary messages, leading to overwhelming the providers and disrupting their workflows.

In addition, charging patients for portal message responses could negatively impact the patient-provider relationship. Patients may feel they are being treated as customers rather than as individuals receiving health care. This could lead to a breakdown in trust and communication between patients and their providers, ultimately undermining the quality of care.

While charging patients for portal message responses may seem like a solution for increasing revenue, it could ultimately have negative implications for the care of patients. It could discourage patients from reaching out with important health concerns, disproportionately impact low-income and vulnerable populations, and misuse portals. It could also have a negative impact on the patient-provider relationship. Health care providers must consider these potential consequences and weigh the cost-benefit of charging patients for portal message responses before implementing such a policy.

Eddie Fatakhov is an internal medicine physician.

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The hidden consequences of portal message fees
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