Many patient encounters, like those involving medication refills for instance, can be done without an office visit. An e-mail or telephone conversation would suffice in most cases. However, with Medicare and other private insurers refusing to reimburse for such claims, it is no wonder that many doctors insist on a face to face visit that gets reimbursed.
HMO Kaiser Permanente recently published a study showing that, for its members in Hawaii, office visits dropped by about 25 percent between 2004 and 2007, after secure e-mail and “telephone visits” were instituted.
Such an effect can only take place in a salaried physician structure, which is uncommon in the United States. Many doctors belong to small practices, where they are paid fee-for-service. If the number of office visits decline, so will their revenue.
So, without a financial incentive to keep patients out of the office, I don’t expect the Kaiser findings to be replicated nationwide.