Viewpoint: What doctors can learn from airlines

August 7, 2009

In light of the current economic recession, patients must realize that many doctors will begin to charge for goods and services that up until now have been free and taken for granted.

It is likely that we may soon see similar economic measures occurring within the medical profession. Already, some physicians in South Florida are asking patients to pay a voluntary "administrative fee" of $120 each year. This fee covers services such as completion of medical forms for employers and insurance companies, providing jury excusal letters and medication refills, returning phone calls at all hours, and getting authorizations.

Some of our Canadian colleagues have adopted this policy. A relative of mine who lives in Toronto pays his doctor $100 per year as an administrative fee to cover the time the practice spends completing medical forms and prescriptions. Many American physicians may be forced to charge these types of additional fees for the same reason that many airlines are doing so: declining revenues coupled with the rising costs of running a business. Due to this financial squeeze, physicians, like airlines, must seek other sources of revenue.

Although this list was compiled with tongue firmly in cheek, I believe that the underlying problem is serious: Doctors need to get paid fairly for all of their efforts and time. In light of the current economic recession, patients must realize that many doctors will begin to charge for goods and services that up until now have been free and taken for granted.

I have begun to charge a small fee of $15 to $25 to complete certain forms for patients. Not surprisingly, none of my patients are happy with this policy. Perhaps it is time for organized medicine and medical societies to come out with guidelines that will help physicians decide what to charge for administrative services.

Many readers may feel uncomfortable about charging for administrative medical services that they traditionally provided to patients for free. I respect this view, and I hope that their patients will continue to appreciate all of the time and effort they devote to keeping them in good health. Wouldn't it be nice if we could get paid more fairly for that too?

Leonard J. Hoenig, MD, is an internist in Pembroke Pines, Florida. Send your feedback to meletters@advanstar.com
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