Edit: In no way am I saying "American healthcare is just fine!" only that I actually have had a really good experience using messaging to communicate with my care teams.
That said--hospital management, driven by the insurance world, tries to wring as much uncompensated labor out of the medical workforce as possible. Doctors (including my MD colleagues) do not get together to limit the number of doctors available. That's baseless conspiratorial thinking that doesn't withstand a moment's scrutiny when you understand the incentives at work in American healthcare.
There are limited slots each year at the accredited schools you must attend in order to acquire your role.
Nobody's accusing you of doing it - but the number of doctors is limited
Ultimately, the number of training slots in the current system is limited by MHA and MBA administrators who see training and instruction as subservient to profits, not the doctors who make up the departments and training faculty. Or, more broadly, they are limited by the healthcare operations not being legislated in a saner way. I was just clarifying.
How long until administration figures out that they can juice revenue by shitting up the emails to increase back-and-forth traffic?
Why do you think someone else's 'effort' should be free?
No-one's saying it takes zero literal effort. Just "Should I be billed by the practice $25-30 for an MA to get my email and say "I have forwarded your question to the provider"?", and then a subsequent $100+ for the provider's response to my question.
Why should that not be part of the intrinsic baseline officework and not a billable service?
Especially when it's a 100% artificial roadblock inserted by the practice? After all, the communication portal in MyChart is "Message My Provider", not "Message An MA To Message My Provider".
That is semantics, could be changed to "Message the office" but that isn't going to be the most clear title for the majority of people to understand what it is doing. It's the same as calling the office, 99.9% of offices (basically all outside of concierge/direct care) are going to be triaged by an MA/nurse first.
As far as the payment requirements I've heard of, I have never seen anyone bill just for the MA reply.
My comment on this was in response to a comment positing the potential for exactly this:
> How long until administration figures out that they can juice revenue by shitting up the emails to increase back-and-forth traffic?
And then, the reply I got was basically "Well, why shouldn't they be able to do that?"
Sometimes I have questions that don’t need the provider’s time, but there is no way to get ahold of anyone else in the office (the practice is part of a large hospital system and calls are answered by a call center that knows nothing)
Why would it do that? If they get money for messages sent (rather than messages sent by doctors) then some flunky can send a message and you can still be billed. Given how this sounds like a profit center, and doctors are cost centers (imagine if they needed to send more messages... now they have to pay more doctors!), I figure physicians will be kept far away from any such system.
If we plot out perverse incentives as a space, I believe that our fate will be to trek through every possible point in that landscape such that we eventually see every single one. This means you will eventually get universal healthcare, most likely as the very last of those perverse incentives.
I think it’s much more likely that doctors will end up sending AI-autocompleted messages that take very little time to complete but seem like took much longer.
The standard will evolve to something like clinic staff sending the messages which will be overseen/supervised by a medical doctor (who won't be involved in composing the messages or spend any time looking at them before or after they are sent). We'll see trials where the doctor who was supposed to be keeping an eye on the messages wasn't, and some flunky kills a patient by suggesting that drinking used engine oil will cure the sniffles. Keep in mind that the messages can be sent from anywhere too, technically no need to keep that onshore. May eventually get legislation that would guarantee that, but only after a wild west period that lasts a few years.
Physicians won't see a dime of that money unless it's through RVUs and even then it's marginal at best. The real money is in procedures.
I wonder if charging for these messages will make doctors more likely to respond. I wouldn't mind a modest copay for these. But if I pay $30 for an appointment, a quick message should be under $15. There would also have to be some sort of SLA, or the ability for a patient to specify that a question/email has expired and no longer requires an answer.
I've had situations where I waited for a doctor's callback so long that I ended up calling a friend who was a physician assistant, watching a youtube video about how to fix the problem, and taking care of it myself. The only way that process could be any worse is if I got a reply after I had fixed it — and a bill for the message.