Doctors have begun charging patients hundreds of dollars to write sick notes and approve medication refills, industry experts said.
Administrative tasks that were once free are being monetized across the country due to increasing demands on doctors’ time and to discourage patients from submitting non-urgent requests.
Services range from a few dollars for replying to messages to more than $100 for prescription refills.
“Basically, doctors are saying, ‘The things I used to do for free, I can’t afford to do now,'” said Robert Pearl, a professor at Stanford University and former CEO of The Permanente Medical Group.
Processing fees can range from a few dollars to a few hundred dollars.
The above data comes from an Athenahealth survey conducted late last year among physicians.
‘Actually, it’s much more than just the money. It’s really my time.’
‘I know a lot of people who haven’t had [a fee] “Now I’m thinking about giving it to them because they’re overwhelmed,” Dr. Pearl said. axios.
Responding to a large number of patient emails and document requests can add hours of unpaid work to doctors’ workdays.
Kacie Lewis, 29, manages her health problems online. Since late 2021, she had been billed $32 for each of three email threads, requesting treatments for psoriasis, eczema and a yeast infection from Novant Health providers in Charlotte, North Carolina, she told the New York Times.
A growing number of healthcare organizations, including some of the largest hospital systems in the United States, such as the Cleveland Clinic, have begun charging more for things like electronic messaging.
Starting November 2022, Cleveland Clinic bills for virtual messaging.
Most private insurance will cover fee messages, he said, but if it’s not a covered benefit or patients have a deductible, they could owe between $33 and $50, depending on the system.
Most Medicare patients will not be charged, although some will be charged $3 to $8, and those with secondary insurance will owe $0.
Since the Covid pandemic, doctors — who earn an average of $350,000 a year — say they are more burned out than ever, and the emphasis on virtual care has seen more patients adapt to interacting with their doctors online.
More than 90 percent of doctors in the United States report that they regularly feel burned out, while 60 percent say they have considered leaving the profession entirely, a survey of 1,000 doctors by the healthcare company found this week. Athenahealth.
Many doctors said excess paperwork and patient demands were causing them to burn out, and that they needed to work an extra 15 hours a week on average just to keep up with their workload.
The growing number of high-deductible health plans, which require patients to shoulder a greater share of the cost of their care, means patients are trying to find ways to avoid doctor visits and may instead message them said Dr. Pearl.
Patients don’t always know what they should talk to their doctor about and what isn’t urgent, said A. Jay Holmgren, an assistant professor at the Center for Clinical Informatics and Improvement Research at the University of California, San Francisco.
During the pandemic, patient emails spiked because people couldn’t visit their doctor in person, leading to more providers charging for responses.
The hope is that withdrawal and refill fees will discourage people from making non-urgent requests while allowing doctors to focus on more timely requests.
Employers may also be partly to blame. A growing number of employers are asking employees for sick notes to take sick days, said Michael Botta, co-founder of Sesame, a primary care startup where patients pay directly instead of using insurance.
In 2023, Sesame charged a $29 service for doctor notes, which included a virtual appointment that would culminate with the doctor’s letter if necessary.
Doctors can recoup these fees if their financial prospects improve or if artificial intelligence takes on more administrative tasks, said Jon Freedman, digital strategist at healthcare consulting firm Chartis.
It comes as experts warn of a “massive” crisis affecting the country’s health service, with very few functions covered.
According to estimates, there were around 193,000 vacant positions for nurses in the US during 2023, and around 60,000 vacant positions for doctors.
Many hospital systems have also been rocked by staff strikes in recent months, amid disputes over pay and working conditions.