From American Medical News: Doctor redefines visits with phone, e-mail ... American Medical News
It's an interesting story about a physician who has set up a practice based largely on cash payments (he accepts no insurance) for visits, phone calls, and e-mail communication.
Dr. Dappen charges $20 for a five-minute block spent on the phone and $25 if that time is spent in the office. However, he reduces his fees -- $15 for a five-minute phone visit, $22 in person -- if the patient sets up a prepaid account that allows Dr. Dappen to withdraw funds as services are provided. He said he doesn't charge for time spent doing the "back-end work," like faxing information or ordering a test after the conversation is completed.
It's an interesting concept. I would agree that the current method of reimbursment isn't working very well. Capitation didn't work so well either. Most days, I would say that I spend 60 - 70 minutes talking with patients by e-mail or on the phone. E-mail certainly speeds this up a bit, and it does provide a useful method of communicating quickly. The fees for office visits seem inflated -- until one considers the "free" care that goes on between office visits. Perhaps it all comes out in the wash. Hmmm.
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