Does historically free advice need to be free?
How often do we as healthcare practitioners answer medical questions for our family, friends, co-workers and/or colleagues with little thought of getting reimbursed for our time and knowledge? Probably quite frequently. How often do we do so for patients? I would assume less frequently, but probably still quite often. For example, answering patient’s questions when they sit in on their spouses medical visit, when you see them at the local store or at the kid’s games, when they call you on the phone, or when they send you an e-mail.
A recent post I read calls these types of interactions “Curbside Consults”. The article provides a rough estimate of cost per minute for the practitioner to provide these “free” consults. Now, with the particular example in this post, consult was given to a colleague – another physician – via e-mail. The author calculates that it cost him about $6.00 to offer this advice. I think the majority of practitioners would offer this same type of support to a colleague without question. However, how frequently is one willing to do so for patients? These $6.00 consults given for free to patients could pile up over a year’s time.
What really struck me in this post, however, is the last paragraph:
The sad fact … is that curbside consultations don’t fit into any reimbursement model for health care. And by the way, the “price” for a curbside consult isn’t even $6 — it’s $0.
I have a small correction to this statement: historically, “curbside consultations” have not “fit into any reimbursement model for health care”. True, if one continues to bill CPT codes for when the patient is face-to-face in the office, then they are stuck with the philosophy that there is no other reimbursement model. However, it really is time to begin thinking outside the box like so many entrepreneurial practitioners throughout the country are already doing. We have some prime examples in Steven Knope and Jay Parkinson who have cash structures that allow them to cover these types of consults regardless of whether they are in the office, at the patient’s home, in the grocery store, or answering a patient’s e-mailed question. We need to reshape our thought patterns when it comes to getting reimbursed for ALL of our valuable time and knowledge…