That’s right…it really happened.
At the conclusion of a recent doctor visit, he gave me his cell phone number saying, “Call me anytime if you need anything or have questions.”
In disbelief, I wondered if this was a generational thing – and whether physicians in their late thirties had now ‘gone digital’.
My only other data point was our family pediatrician, who is also in her late thirties. Our experience with her dates back nearly seven years when my wife and I were expecting twins. A few pediatricians we met with mentioned their willingness to correspond with patients’ families via email as a convenience to parents. The pediatrician we ultimately selected wasn’t connected with patients outside of the office at that time, but now will exchange emails.
At TripleTree we’re seeing clear signs that progressive, consumer-centric physicians and practices are making efforts to improve their customer service by encouraging digital access via email and cell phone.
Will physician connectedness and accessibility be a key driver in how consumers select their physicians in the future?
Amid the growing focus on data regarding ‘physician quality’ (still hard to find and define), and ‘price transparency’ (just starting to gain traction), is the reality that recommendations from family and friends have been and are still a highly reliable patient referral stream for physicians.
The economics of the fee-for-service payment environment in U.S. healthcare doesn’t incentivize providers to interact with patients outside of office visits. However, we see the ubiquity of technologies and care approaches like tele-health driving market changes, with some payers beginning to reimburse for telephone or web-based provider interactions.
What is the likelihood that providers will soon bill their patients for time spent on phone calls or responding to emails?
If the rise in healthcare consumerism combined with the move to fee-for-value (from fee-for-service) is real, providers will need to be more accessible to their patients in order to prevent the need for acute care and thus lower costs. Whether that accessible provider is a physician or a member of a physician-led team will likely evolve alongside models of care.
Having my doctor’s cell phone number was empowering and while I didn’t call him, I was glad to know I could.
The author is a healthcare analyst at TripleTree.
Categories: Uncategorized
We shouldn’t let others tell us what we can charge. No one else allows this. Are we wusses?
“This is incorrect.”
Mike, you are right. Many wish to blame our problems on fee for service and are dead wrong. We don’t have free market healthcare so we should recognize that all these positive innovative changes are inhibited by a bureaucracy that is out of control.
Good post. FFS lawyers LOVE phone calls and e-mail.
“The economics of the fee-for-service payment environment in U.S. healthcare doesn’t incentivize providers to interact with patients outside of office visits.”
This is incorrect. What deters physicians from interacting with patients outside of office visits is that fact that insurance companies and Medicare determine which services are reimbursable and which are not. Prior to this, physicians could either charge directly for these services or simply set his charge for office visits such that it took into account such non-contact visits. Now, the reason that many, if not most, physicians limited these interactions in the past had a great deal to do with other concerns such as record keeping and malpractice. Today, technology allows the physician to more easily record these interactions.
If only my doctor would come out of the dark ages. It seems he does not care. Does he accept whats app 🙂
I am a family physician with training and practice experience in US and India. I am currently practicing in India. I decided to take a leap of faith and started sharing my cell phone number with my patients. In my experience so far, majority of patients reciprocate by not misusing the access to my direct number. It instills lot of confidence in patients and promotes patient engagement.
I’m a medical doctor, and I practice in Asia, where the culture is different from the US. I hardly hear of anyone giving out their personal phone numbers (email is more common).
I think many of us attempt to draw a line between our work and personal lives in order to maintain a degree of sanity, even though we know medicine and healthcare is 24/7. The fear (possibly unfounded) is that giving out personal details makes this line blurer, and that we could be interrupted in the middle of well-deserved vacation or family time.
And we know that once we pick up the phone, if it’s something urgent, we can’t just say ‘Call me back next week, I’m not working today.’
@Grais
Elaborate a bit, please. Are you thinking All providers? Would their surrogates do? Nurses? Office assistants? Do you want these folks, with whom you talk, to have real tme access to your EHR? Are emails adequate substitutes? Are you thinking they might write prescriptions? Skype? If emails, are you worried about security? How about non-physician providers?..,psychotherapists? pharmacists? hospital billers? 24/7/365? Are you thinking about PCP types only? Do you want these conversations or their synopses to be put into the EHR?
$50 a month is small change compared to the insurance premium. If insurers were “encouraged” legislatively to offer policies that were more about managing risk, the premiums would be available at a savings of much more than $50 a month. When $50 to $100 a month covers preventive exams, basic labs, opens the door to phone and email visits, etc, then it becomes possible to see the value, although many won’t see it even though it is there.
While I don’t give my cell number, I do give patients immediate access without office visits (or with) as needed. I have a direct care practice and what I actually sell is access to me, not procedure or diagnosis codes. It makes a very big difference in the care I give and greatly increase satisfaction. I am much more able to withhold antibiotics when patients know they don’t need an office visit to get my ear. It’s far more efficient and I’ve seen many ways it saves money. Does it work in the FFS system? I don’t think so. It decreases income and increases work load for docs in that setting, which doesn’t go along with physicians who already feel overworked.
“$175/year admin fee.”
This strikes me as a reasonable amount to pay for (unbilled) phone and e-mail access to the doctor within reason. On the other hand, $50 a month or more would probably be too much for most of us. Concierge medicine is the equivalent of Saks Fifth Avenue and Nieman-Marcus in the retail world. They’re great stores but only a very small percentage of the population can afford to shop at them and not all of them are willing to.
One thing I wonder about in the primary care world is what percentage of patient visits can be easily handled in 10 minutes or less and what percentage need more than 15 minutes to adequately address the patient’s issues and complaints? In Japan, I’m told that the typical patient encounter lasts all of 3-5 minutes but the patient expects to leave with a prescription or a specialist referral or both. The Japanese live longer than most of the rest of us and the country spends less than 9% of GDP on healthcare as I understand it vs. more than 17% in the U.S.. It makes one wonder how important healthcare is in the first place as compared to personal behavior, genetics, and socio-economic status.
you are correct on the direct practice part. I would also love to charge the admin fee. it solves alot of issues
Imagine Doc A that has 3000 patients and sees 4600 visits a year and collects about 550K…short quick rushed appts.
VS.
Doc B that has 1500 patients sees 2400 visits a year, charges
$175/year admin fee. thus collects $550k and can double the amount of time spent with each patient.
No doubt a generational phenomenon, but also add the direct practice or membership model (and certainly the high end ‘concierge’ model) to the accessibility value prop. The solution to pollution is no doubt dilution. Digital natives get it, legacy docs simply holding on until retirement?
But context is key.
selective is the key, i have done it numerous times and it has never been abused. billing for telephone calls has always intrigued me, every time i bring it up with out group it is shot down. reason is patients are not willing to pay for a phone call, and documentation to bill for it is time consuming and inconvienent. you get called at 1000pm and either have to go to the computer then or wait till the next day to enter the data along with time stamps etc.
i think docs should be like lawyers (yikes) and bill by the hour.
I think this is the trend. I give out my number and I haven’t had any problems. But also I think it’s generational. I think the trust does helpful things.
Note that I am selective. I do not give my number to patients who I think might abuse it. I also have the right to answer or not answer my phone.