Letters: Readers comment on Medical Economics stories

September 18, 2009

Charging an administrative fee is reasonable and fair, according to one reader.

Fees we'd like to see

I appreciated Dr. Leonard Hoenig's opinion regarding charging for some administrative services ["What we can learn from airlines," The Way I See It, August 7, 2009].

I have been charging for forms for a few years. My feeling is that if it requires my signature, it requires an office visit. The patient can come in for a visit and either pay me to complete the form in his presence (around $15), or he can pay his copay and help me complete the form in his presence. (My patients generally go with whatever is cheapest.) They receive a copy for their records, and I keep a copy in their chart.

One more thing I would add to Dr. Hoenig's list: a $50 fee if the patient is accompanied into the exam room by a relative or friend who asks whether I am taking new patients because their doctor "never has time to sit down and really listen" to their problems.

REBECCA P. CONWAY, MD
Huntsville, Alabama

Billable hours

Charging an administrative fee is reasonable and fair. I find myself working an extra hour per day to catch up with non-clinical paperwork for patients. I will not follow the route of airlines, however; I will mimic what our friendly lawyers do: $100 per form or $250 per hour, rounded to the nearest minute for all phone calls.

STEVE LE, MD
Kingwood, Texas

The harder the form . . .

I'm an internist in the Bronx, and I charge for each form I fill out, according to complexity. The big question is what the Obama plan will bring for us.

HECTOR RODRIGUEZ, MD
New York, New York

Government job

Who's the brilliant mind that finally figured out electronic health records cost a lot of money ["EHR 'deinstallation' trend hits Phoenix," InfoTech Bulletin, July 30, 2009]?

If I have $100,000 lying around, I sure wouldn't throw it away on a system that isn't portable, universal, or standardized. I would buy a Ferrari-much more enjoyable and easier to learn to use.

This is one of those things government was formed to actually provide: If they want everyone to have EHRs, they need to pay someone to write the software and make it available nationwide for free. If they want access to my charts, they need to pay for it, not me.

SCOTT TOUGER, MD
Birmingham, Alabama