Wow, I didn't think my first little post would lead to such an interesting discussion. A lot of it is what people are used to. For instance, it seems like anytime our office starts talking on this subject, the analogy of the lawyer comes up. "Your attorney wouldn't do that for free. And he/she wouldn't" It's amazing the amount of things we are asked to do for free by patients. And, it's amazing what some organizations will pay when they are asked. I despise Penquis Cap in our area (they do a great service) but like about five other organizations, they have this knee jerk reaction that every year they need a complete medical record of the patient. So, we started charging $18.00 and damned, if they didn't pay. But, I digress here.
I think it will be very hard to get a patient to pay for a phone consultation whether on call or otherwise. And, since call goes along with being a physician, calling in Vigamox is convenient for the patient, but it is also convenient for me at times. Sure, I increase my medicolegal risk as I didn't rule out uveitis (even if I could have), but I doubt I can then ask the patient, "now that I did you that favor, can you pay me whatever?" Of course, a lawyer would charge, but they don't go through insurance, and we are USED to their charging. That is the huge issue.
But, I think email does have a place. I already use it quite extensively at no charge, and I should be able to charge for it. Like most of you, it is only with a few select people. To be honest, I would rather email them than call them back.
On the other hand, I can't imagine just having a free pipeline via email to my doctor anytime I wished.
But, I agree with Wayne. First, some patients don't want to call either. And, some don't think it is worth having to come in.
The parent that used to call and for me to call back later (at no charge) now may choose to email me, since she will get the answer sooner sometimes and because people just don't want to call and wait around for a return call.
So, she emails about a rash, goes through some of the questions, explains that her two year old now has about 15 red bumps on his trunk and neck. It looks like Chickenpox, but shouldn't there be more and a fever? You determine that he had the Varivax and so you surmise (as you would on the phone) that this is the chickenpox kids now get that have been vaccinated. You advise Benadryl AND you ask her to follow up with you tomorrow if not better. (I think there are some laws or rules maybe that if they see you within a certain amount of time you can't charge for both.
I don't think you should charge the same as an actual visit as you didn't see the patient and you probably didn't take as much time AND there is very little overhead. As far as liability goes, I don't see the difference between an email and a phone call. Actually, the email provides evidence for US that we told them to go to the ED if the fever increased or the patient got this or that. As opposed to the phone call where you may or may not write down what you told them, but they can still deny you did.
Personally, I don't really worry too much about medicolegal issues. (Please don't yell at me).
I do feel a little funny, answering the next email for $22.00.
