Medical experts report that doctors are now charging for certain services, such as answering patient emails, asking for medical advice or filling out extra paperwork, to compensate for their time and make up for costs lost from in-person visits.
Robert Pearl, a Stanford University professor and former CEO of The Permanente Medical Group, explained that doctors usually charge a "concierge fee" for the privilege of accessing medical care in this way. He added that this practice is becoming more common as patients lean toward avoiding office appointments due to concerns over high out-of-pocket costs
Researchers at professional services firm PwC estimate that healthcare costs will increase by seven percent this year, much higher than the medical cost trends of the past two years.
According to benefits consultants from Mercer, Aon and Willis Towers Watson, employers’ healthcare costs could increase by a range of 5.4 percent to 8.5 percent in 2024 due to factors like medical inflation and the wider availability of high-priced gene therapies.
A survey by Mercer, a unit of Marsh McLennan, found that more than two-thirds of employers don't plan to shift any cost increases to their staff or will pass on less than the expected cost increase in 2024.
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According to Pearl, more patients would rather send an email to their physicians instead. Generally, doctors end up replying with detailed emails with their medical advice. Most of the time, there are even several back-and-forth messages between the patient and the physician.
Pearl warned that, ultimately, the economics are triggering a drastic change that's taking up more and more of a physician's time.
However, the National Patient Advocate Foundation has expressed concern that doing so will make it harder for certain patients to get proper care.
Organization spokesperson Caitlin Donovan said that when offices start charging patients even small amounts of money, more patients could be "less likely to follow through on their appointments and get the treatments they need." (Related: Southern California doctor accused of STEALING $150M from federal COVID-19 program for uninsured patients.)
She added that there could be more people thinking that it would be better not to get in touch with their physicians, especially if they are worried about being charged for it.
Data: 63% of physicians experiencing signs of burnout at least once a week
Experts also said these administrative tasks are adding to the burnout that's affected the healthcare industry since the Wuhan coronavirus (COVID-19) pandemic.
Dr. Robert Glatter, a New York City-based emergency room physician, explained that burnout is "one of the main reasons behind the impetus to charge patients an administrative fee to complete such tasks that go beyond direct patient care."
The American Medical Association (AMA) has also reported that according to data, at least 63 percent of physicians have reported experiencing signs of burnout, such as emotional exhaustion and depersonalization, at least once a week.
The AMA also said that "administrative burdens" are one of several factors contributing to the issue.
In October, AMA President Jesse Ehrenfeld said that, on average, doctors spend at least two hours on paperwork for every hour that they spend with their patients.
Pearl claimed that doctors don't always have enough time to "do the job they're required to do," which some of them take as an opportunity to charge their patients for. He added that some doctors might rationalize the decision to charge for admin tasks because they have even less time to spend with their families or to do other activities in their free time outside the clinic.
And even though Donovan agrees that doctors should be paid for the services they provide, "at a certain point, when absolutely every single thing is getting nitpicked … we don't want the practice of medicine to turn into flying on a low-budget airline."
Donovan said one of the issues with charging for administrative tasks is that doctors and administrators often claim that they only charge for diagnostic services. She added that many patients have also been unfairly billed for preventative services that should not incur charges.
Donovan advised that there should be trust between the patient and the provider "going both ways" because this helps ensure that there will be better outcomes for both parties.
Glatter explained that the decision to charge must first be carefully considered, particularly in the context of how doctors provide care because virtual care is now a major aspect of the quickly changing "landscape and paradigm of patient care models."
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