Don't Email Me

Rob Lamberts, MD, on The Health Care Blog, writes about doctors receiving and responding to patient email: specifically, about why he personally doesn't do it.

Basically, it's because there's no way to be reimbursed for it, so he would be working for free, or worse:

Accepting emails from patients at this point would mean more time spent doing un-reimbursed tasks. Actually, it would potentially decrease our revenue, handling problems outside of the office (for free) instead of being paid for our services. Doing so would give us three options:

1. Working extra hours to make up for lost revenue.
2. Giving free care via email and just accepting less pay, seeing less patients total.
3. Spending less time with each patient to make up for the decreased revenue.

It's hard to argue with that logic. Many of us are in favor of getting paid for doing our jobs. I myself have been known to enjoy it from time to time.

One idea suggested by Dr. Lamberts is to charge a fee for an email consult (he suggests $20, specifying that it would need to be enough to discourage frivolous inquiries, could be applied to the cost of an office visit if one were indicated, and would have to be covered by insurance).

I could see this possibly working, although you'd have to work out how the fee would be collected. An online Email Order Form where you have to give credit card or insurance info before the message is sent would work fine, I imagine.

I found the post interesting because it acknowledges the theoretical value of email for medical practice (he is busy and would be happy to take care of questions remotely and not make patients come in if they didn't have to), but still finds it financially impracticable.

I guess the lesson is that even useful technology is no use if it costs too much.

Many of us, especially those who are familiar with both exciting technologies and economic systems in which money is exchanged for goods and services, have probably run into this concept before.

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