Why physicians are charging for emails

Why physicians are charging for emails unknown

Physicians are billing for emails because the deluge of patient portal communications is causing "burnout" and "moral injury" while, at the same time, clinicians are facing declining reimbursement, two physician leaders wrote in Time.

A recent Peterson-KFF study found that patients were billed an average of $39 per email, with payers picking up most of the tab but people with some out-of-pocket costs typically being charged $25. However, the physicians noted in the March 19 Time article, patient portal emails made up only 1 out of every 192 office visit claims in 2021.

"Extra uncompensated tasks increasingly weigh down physicians spiritually and emotionally," wrote Robert Glatter, MD, an emergency medicine physician with New Hyde Park, N.Y.-based Northwell Health, and Jesse Pines, MD, clinical professor of emergency medicine at Washington, D.C.-based George Washington University. "Drowning in heaps of unpaid work, the toll is physician productivity, family life, and ultimately mental health. It is sometimes referred to as 'burnout.' Others call it 'moral injury,' creating a deeper and more complex psychological crisis."

Physicians may be slow to charge for MyChart and other online communications because they don't want to turn off patients or deter them from asking health questions, don't want to deal with how and when to bill, or don't know they can, the authors wrote. But billing for the messages could catch on as physicians grapple with declining reimbursement, as Medicare payments haven't kept up with inflation and surprise billing laws put pressure on commercial payers.

"Until the time comes that artificial intelligence can reliably and accurately answer patient questions and perform other important functions and tasks, physicians or their proxies will be required to empty their inboxes beyond the hours spent involved in direct patient care," Drs. Glatter and Pine wrote.