Why Not Call? (Exhaustion and Economics of Phone Calls)

A reader writes:

Why do I have to take time off of work and make an appointment for my doctor to explain test results? Wouldn't it be much easier to do over the telephone?

It would be easier to discuss this over the phone, and cheaper. Your doctor isn't paid for talking to you over the phone. Getting info over the phone is always a win for patients and a loss for doctors.

Primary Care Doctors (like Doctor D) for whom much of the job is educating you about your health are making a less and less every year (we're the green line) and we started out as the lowest paid physicians. Primary Care clinics are just barely scraping by, so when it comes to discussing your labs they can either do it over the phone for free, taking time away from seeing patients, or bring you in and get paid by your insurance to have the same discussion. The economic solution usually beats the common sense solution.

Now, I don't want this to sound like one of those Happy Hospitalist I-don't-get-reimbursed-for-all-I-do posts. Primary Care is still a good job and Doctor D doesn't have to worry about keeping food on the table.

But when Doctor D worked at Crayzee Clinic he spent many hours every day getting patients results, refills, and forms without pay. He did his best to call patients when he could, but if he knew it was going to be a long talk he usually had you come to the office. Doctor D had to keep some work during office hours—as it was he barely saw his wife or son while working primary care. Of course, some docs avoid phone calls because of greed, but most in primary care are just exhausted having to see more patients faster and faster while doing more paperwork in the evenings. An appointment to follow up tests was usually pleasant and easy, and didn't keep Doctor D in the office later at night after office hours.

But for the patient, it sucks! You have to get off work and drive to the doctor's office, just to get information you could have gotten over the phone. You can and should ask if your doc can call you the results without an appointment. Your heathcare is already too costly without extra visits. But please realize that this is harder on you doc, so don't abuse it. If you are the sort that needs to ask lots of follow up questions please schedule a visit instead of tying up your doc on the phone for 20 minutes!

Okay, after a long blog post about money and reimbursement Doctor D feels dirty and must go bathe the Happyishness off of himself.

This is one of those annoying situations that forces either you or your doc into a financially frustrating situation. The solution proposed on most doctor blogs is billing for phone calls.

What do you think? Would you be comfortable being billed for phone calls? It would save you costlier office visits. Or do you want to keep phone contact free?