Chat with a doctor for free by Email: Reduced Physician Income ?

74% of patients said they would like to chat with a doctor for free by email but only 4% had such access. 


Why Do Patients Favor Email Consults with Physicians ?

1. Saves Time (10 minutes to compose and send an email  and chat with a doctor for free versus an hour or more to drive, wait for the MD, visit the MD and drive back).

2. Saves Gas Money.
3. Saves Physician visit money.

Why Insurance Companies and Employers Would Favor Them ?

Reduced patient visits would mean less money spent from the Insurance treasure troves and eventually lesser premiums to pay for the employer.

And this reason is exactly many physicians are vary of using email communication - due to a possibility of reduced income. This especially concerns the primary care physicians are already.



Will Adopting Email Patient Consults Really Drop Physician Earnings ?

Yes - they will for physicians who depend on patient visits and utilization for their incomes. A Kaiser study showed a 10 to 11% drop in patient visits when email communication with physicians was allowed. And for primary care physicians with plummeting reimbursements from the insurance dogs...oops I meant gods, that decrease could be significant. The salaried physicians paid on a per-patient basis will obviously not be affected.

While many still doctors are still wary to adopt emails, the usage is increasing and a good number of physicians believe offering email consults is advantageous as a great marketing tool since most Americans with Internet literacy desire the facility.

Here are Some  Benefits That Physicians Could see :

1. Save time over reduced phone calls. The Kaiser study mentioned above showed a 14% decrease in phone calls.
2. You would agree that as physicians, you do a better job thinking and planning management in solitude than having an anxious patient in front of you
3. Gives more space for patients who really need to see the doctor
4. Reduced "No-Show" Revenue Losses
5. Potentially reduce malpractice threat with email consults that are better documented communications than face-to-face visits

Dr. Jasmine says it best: "I will do the e-mail with [patients] because I can control how much time I spend on it, and I can control when"

To get around the small loss of revenue, here are some techniques that could be used:

1. Charging patients an annual free upfront for a "Direct Physician Email / E-consultation" Service, like the GreenField clinic at Portland, OR does.

Here's what the site says:

"Email communication with your physician, with or without a related face-to-face encounter. This is a great way to communicate when time is less of an issue, and when you prefer written answers to your questions. It is also very useful when you want to share information with family or friends. This is limited to 15 email consultations per year, which are defined as in-depth email conversations with your physician, not to be confused with email to schedule appointments, or email conversations with your health coordinator."

2. Charge patients pay per email online. The fee charged is similar to the Co-Pay the insurance company would charge if the patient visited the patient.

3. Negotiating with the insurance companies for reimbursing email communications. While currently, a small number of insurance companies compensate for email consults, if the big employers voice a strong demand, am sure they will bend.

Physicians should research some economics of their practice and price them at an optimum level so that it saves the patients some money and offers compensation reasonably aligned with the other benefits I mentioned above.

Should Physicians Charge for Email Consultations ?

a. Why Not - its the same professional medical service they are providing as they would on a visit and are in fact doing a favor to the patients by saving them the hassle of showing up in person at a fixed time.

b. Secondly, charging limits email usage to important and meaningful professional consultations rather than clutter your inbox with casual chit-chat or hypochondriac 'patient spam' ;-)


Hmmm....I would say MDs should aggressively push email usage ! We are living in the Experience Economy where its not JUST the product or service but the whole experience which a customer values very highly. As this article says: "Why would someone buy a cup of coffee and be willing to pay over 300% the price of a coffee at a convenient store, or 800% more than a coffee brewed at home ?" - speaking of Starbucks (Its not about coffee, its about the experience) . I feel that When I walk into a plush techie Apple Store to check out iPods or when I use one. Similarly there are tons of creative possibilities that can be built around e-consults and more, that can give a physician's practice a great brand image and other benefits and that patients and even not-patient healthy people will highly value....and pay for.