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TECH: Why physicians don’t want email from patients

Headline: Patient-Doctor E-mail Could Cut Income for Physician Practices. Kaiser Permanente Northwest’s Clinical Systems Planning and Consulting group did a study on its patient-physician email use in its NorthWest region and found that it worked as it was supposed to. Visits down 7-10%. Phone calls down 15%.

This is of course great news. Productivity goes up, patients are happier and their care is probably better. Of course in the bizzaro world of health care that we live in, this would translate into a 7–10% decline in primary care physicians’ incomes. Which is why RelayHealth et al raise suspicion of their potential customers, and why we have to get them off the fee-for-service treadmill ASAP.

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SavDaveanother former KP staffformer KP staffChris Johnson Recent comment authors
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Sav
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Sav

I’m a professor of electrical engineering and a student economics. Therefore, I’m intelligent but not that knowledgeable on health care except for the rants of my opthamalogist uncle and having spent about $150k of out-of-pocket on my family over the last 8 years. I mainly want to defend the practicioners. So from my lay, but logical and cold point of view, here are some observations: 1) People don’t want to die, and now that we have knowledge around to prolong life, we spend more and more money to stay alive whereas in the past we would just get sick and… Read more »

Dave
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Health care | VideoDebater.com

another former KP staff
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another former KP staff

I worked for KP in the mid-1990s and remember getting emails from my doctor way back then! I also remember being so impressed that the doctors took their medical notes on a PC that was in each exam room. A neurologist my PCP sent me to for migraines (in the same building, about 2 hours after my initial office visit) told me that he liked KP because he could “practice medicine, not billing.” I was also impressed by the rule that no patient should wait for a scheduled appointment for more than 20 minutes without an explanation and offer to… Read more »

former KP staff
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former KP staff

To get back to the email finding in the original post and the comment about FFS … When I left KP (I’m not a doc, I am professional staff) I was struck by how different an environment I landed in at a traditional medical center. Kaiser docs had sometimes griped about the bureaucracy, but not often and certainly not terribly venomously. They were so much more CALM than the docs in the old fashioned setting. The KP docs truly felt they could focus on patient care instead of feeding or fighting the administration (which was the hobby of the docs… Read more »

Chris Johnson
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I’ve practiced as a salaried physician for twenty-five years for three organizations. I’m not rich, but I’ve done alright. Every specialty is a bit different, of course, but I like not having my income directly tied to whether some child gets sick or injured.

Yuan Ho
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Yuan Ho

joe blow must be kidding, right?

gp120
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gp120

Pretty soon (the next 5-8 years) most of the docs who provide emergency care (gen surgeons, orthopedic surgeons, neurosurgeons, urologists) will be gone. The average age of surgical specialists is 56. This means that in five years this population will be 1/2 its present size. There are few new surgical specialists willing to take ER call. Gen Surgeons become bariatrists, or plastic surgeons. Orthopods become total joint or spine surgeons or sports medicine docs. Neurosurgeons burn out after the tenth lawsuit. Also, over 1/2 of new MD’s are women, who tend to pursue less time demanding medical careers. So, no… Read more »

Chiron
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Chiron

As for the salary vs. FFS debate, I can only speak as a person who works for a living. If I pursue an MBA I am likely to make more money. However, if I’m going to engage in more graduate education, I’m old enough, wise enough, and well-enough off, that I want it to be in something that fascinates me. For me that would be an MFA. Perhaps I’m ignorant of the reasons other people pursue advanced education but I’ve always assumed that doctors slog through the years and years of school and the hell of internship and residency because… Read more »

Chiron
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Chiron

I can answer that. Kaiser’s health care email is on a secure internal email server and network. You have to log onto their site to access the email service. Of course anything can be hacked if the programmer is determined enough, but it seems to be a sincere effort to keep patient health information private.

John Norris
Guest

Just to be clear…are we talking standard, unencrypted, email? I don’t know what Kaiser, or others, offer.
If so, that would not be a good way to communicate personal health information, and may be against HIPPA.
John

GingerB
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GingerB

I have Kaiser and I like the email feature. I have many other things to do besides sit next to my telephone waiting for a phone call from a Dr. It’s one of those things where if you have one meeting that day, that will be when they try to call you. I like being able to look at my lab results online, and print them off. I like not having to tell my problem to the receptionist while I’m sitting in the cube farm at work with everybody else listening in. I’ll also add that when I emailed about… Read more »

Peter
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Peter

“Peter needs to spend a month in my shoes trying to get reimbursement from Medicare. I don’t know where he gets his information from, but the studies I have seen looking at how good a payer Medicare all are all biased in some ways. I see thousands of patients a year and Medicare is just as bad at weaseling out of “covered” services, delaying payments and is the worst at customer service.” DrThom, I guess you assume that I agree with the way the present Medicare system operates. In Ontario Canada physician audits became a problem, or at least a… Read more »

AnonymousDr
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AnonymousDr

I’m just curious joeblow, what do you do for a living that you have all the answers for healthcare and doctor’s salaries? My guess is that we won’t be impressed. I can tell you that many current physicians may continue to work for the salaries your plan would offer because it would be the path of least resistance and care would not suffer so much in the short term, but it would discourage many people from starting medical training (Look at components of the current nursing shortage-one aspect is increasing salaries). Why would I (and I am in my last… Read more »

anonymous
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anonymous

If our patients want to contact us, they must use email, we don’t use the phone. For three days after an appointment and for special circumstances determined at the time of the visit (for which they are given a code) they may email us for free. After that, it is $25, refunded if I can’t answer their concerns satisfactorily. Questions are answered within 24 business hours. I haven’t had one complaint and though my practice is closed, I have requests daily to take patients. If they want to use my services, then they are going to have to pay. If… Read more »

DrThom
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DrThom

Interesting discussion Peter needs to spend a month in my shoes trying to get reimbursement from Medicare. I don’t know where he gets his information from, but the studies I have seen looking at how good a payer Medicare all are all biased in some ways. I see thousands of patients a year and Medicare is just as bad at weaseling out of “covered” services, delaying payments and is the worst at customer service. It is only through a sense of service imbued by my training that I take it at all. The rest of you seem to understand that… Read more »