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Some doctor’s offices are charging patients for administrative tasks: Here's why

Some doctors struggling to balance completing administrative tasks with patient care are charging for certain things like responding to lengthy patient emails.

Physicians are facing increasing demands for administrative tasks that are taking more time away from patient care. They say it's also hurting their bottom line.

Some are now charging for services like answering patient emails asking for medical advice or filling out extra paperwork to compensate for their time and recoup costs lost from in-person visits, medical experts tell FOX Business.

Typically, doctors charge what's known as a concierge fee for the privilege of accessing medical care in this way, Robert Pearl, a Stanford University professor and former CEO of Permanente Medical Group, told FOX Business.

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It's a practice that's "becoming very frequent" as patients avoid office appointments for fear of high out-of-pocket costs, Pearl said. In 2024, researchers at PwC estimate that health care costs will rise 7%, which is higher than the projected medical cost trends in the past two years.

"You find yourself saying, 'Oh my gosh, if I see the doctor, I got to pay $300, $400, $500. I can't afford that. Let me send an email,'" Pearl said.

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Typically, doctors end up sending back detailed emails with medical advice. In many cases, there are even several back-and-forth messages between the patient and the physician.

"Ultimately, the economics are driving a change that's basically sapping more and more of the doctor's time," he said.

However, the National Patient Advocate Foundation (NPAF) is concerned that doing so will make it that much harder for certain patients to get care.

NPAF spokesperson Caitlin Donovan noted concerns that when offices begin charging patients even small amounts of money "they are less likely to follow through on their appointments and get the treatments they need."

"There's going to ultimately be people who say, 'I'm not going to reach out to my doctor because I don't want to get charged for this,'" she added. 

These administrative tasks are adding to the burnout that's hit the health care industry since the COVID-19 pandemic began in early 2020. 

New York City-based emergency room physician Dr. Robert Glatter told FOX Business 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."

According to the American Medical Association (AMA), data shows that nearly 63% of physicians reported signs of burnout like emotional exhaustion and depersonalization at least once per week.

The AMA noted that "administrative burdens" are one of many factors contributing to the issue.

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In October, AMA President Jesse Ehrenfeld said that on average, physicians spend about two hours on paperwork for every hour they spend with patients.

"They don't have enough time to do the job they're required to do," Pearl continued. "And this is an opportunity to say, 'OK, well, if I have to fill out all these forms, I better charge for them, because if I don't charge for them, I have even less time with my family or to do the activities that I needed in my particular life.'"

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While Donovan agrees 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 that one of the issues with this practice is that doctors and administrators often claim that they only charge for diagnostic services. She said patients have been billed for preventative services that should not incur charges.

"We want there to be trust between the patient and the provider going both ways because that means that there's going to be better outcomes," she added.

Glatter noted that the decision to charge "should be carefully considered" in the context of how they provide care "since virtual care is now a major aspect of the evolving landscape and paradigm of patient care models."

Both Pearl and Glatter said the solution to this growing problem could be artificial intelligence.

On the other hand, Donovan said that a doctor can reply to a patient and tell them to come into the office.

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