Does your doctor respond to requests via secure messaging?

[sengsational]

My doc could certainly bill the messaging answers as a tele-appt. It's all handled through their secure "my chart" app, so I don't see the difference compared to a phone call or in-person visit. Messaging is just so much more convenient and gives me documentation to refer back to.

Messaging is great, but the difference is that insurance companies won't let the doctors bill for answering emails. So no, the doc could not bill the messaging as a tele-appointment.

If they're not dying, I'm telling them to come in to be seen.

That's good, for all of the reasons you said.

But I am not asking the doctor to provide free unpaid care. If a messaging option is provided, it should be an allocated slot of time, just like an in-person visit.

I think you might be. The reality is that insurance and billing isn't integrated into messaging, so anything you get over MyChart is pro-bono.

My question is - why can't doctors charge for messages?

They could, but insurance wouldn't pay, and patients wouldn't want to pay. Or more likely the doctors (the companies they work for) they're bound by agreements with insurance companies and Medicare. If it ain't in the contract, you ain't gettin' paid.

What this thread has taught me is that I'm a royal pain in the rear for the doctor's office because I use MyChart messaging quite a bit. But one thing I do try to do is keep my visits to a single topic, and come back separately for anything not directly related to the single topic. And my first thought isn't "write a MyChart message", it's "I'll make an appointment"

 

[Koolau]

My PCP and specialists are good with My Chart, but I use it mostly for Rx refill requests.

My cardiologist gave me his cell number in addition to email. I’ll use the cell to text PDFs of my heart rhythm that I take at home, also asking questions about what to do. He is a gem of a doctor for providing such availability, and often calls me back—even after office hours. Got a call back a couple of weeks ago when he was 5,000 miles away. Of course, I am careful to use this access sparingly.

Reminds me that my first Cardiologist called me from his vacation in New Zealand when I was hospitalized with CAD and required stents. Pretty amazing.

 

[disneysteve]

When I have a question for my PCP, I text her. She gave me her personal cell number at our first visit.

When I have a question for my urologist, I message him in MyChart and he responds promptly.

My experience is likely skewed by me being a physician.

 

[disneysteve]

My doc could certainly bill the messaging answers as a tele-appt.

No they can’t.

 

[Koolau]

Family practice physician here. I'll warn you that my reply here may be harsh, but it is reality.

Patient messages are literally the largest source of stress in my busy life, and I would imagine 9 out of 10 PCPs would express similar frustrations with patient messages. It is universally hated. Why? Because it is nearly always a losing proposition for us.

What you think is a simple request is not a simple reply. A simple request to reduce a medication requires me to pull your chart up, go over your meds, and usually look at the last visit. Then, I need to know I have numbers I can trust. In other words, that your blood pressure and pulse were checked in my office with calibrated equipment, and I will always recheck myself. I also need to ask you questions to determine if the problem you believe is caused by your medication is actually caused by that, and not a myriad of other causes. This requires an in-person visit, both for the best care and for liability reasons. Imagine if your BP cuff is inaccurate, or you're using it incorrectly, and your BP is high, and that's why you're feeling dizzy. I reduce your medication, and then you have a stroke when your BP spikes. Bad outcome for you, and liability for me.

When you request labs 'just because' we then have to go in and order the tests and then tie them to a diagnosis. If we don't have a diagnosis (or symptom) to tie them to, we can't order them. If we tie them to an existing diagnosis and then the lab test isn't covered, we have papers to fill out, and often angry patients that have large bills.

By the way, these messages are answered in between patient visits, early in the morning before seeing my first patients, or staying late after work. We don't have scheduled patient message answering time.

I have a patient panel of about 2500 patients. These add up very quickly. Contrary to popular belief, we don't have all of our patients' medical histories memorized. Any questions that come up require us to go back in and familiarize ourselves with their charts.

This phrase here "I messaged him all the time with questions, requests to change dosage, try new meds, etc." makes me cringe. You are being selfish with your doctor's time.

Roughly 5% of my patient panel uses 90% of my mental energy. It's not the sick and complicated patients that cause me stress. It's the entitled patients who feel their time is more important than my time that cause me stress.



Sending 3 to 4 messages a year is a lot. If all of my patients did this, I'd have 7500 to 10,000 messages per year to deal with. Figuring 48 working weeks a year, five days a week, that's 50 messages per day. If each message took me 3 minutes (don't I wish it only took me 3 minutes per message), that's 2.5 hours per day just replying to messages. That's 12.5 hours per week.


And FWIW, I am very good about responding to patient messages on time, even if it is requesting to be seen for the problem. Those patients that abuse the messaging system get a 15 second triage at best. If they're not dying, I'm telling them to come in to be seen.

I understand the issues you're pointing out here. I hope you understand that patients don't know what to do with new symptoms or health issues - we're not doctors. Typically, I want to alert my doctor if something changes and essentially ask "Is this something I need to see you about?" This seems much more efficient for me AND for the doctor. If every time I get a new pain, I have to get an appointment with the doctor (90% of the time he will only tell me - "It's normal and nothing to worry about.")

So if patient messaging isn't the answer, what is?

 

[latexman]

are you able to handle simple things with your doc via messaging

Yes, she’s real good at it. She has also given DW and I her personal cell #, but IIRC we’ve never used it.

 

[Koolau]

Family practice physician here. I'll warn you that my reply here may be harsh, but it is reality.

Patient messages are literally the largest source of stress in my busy life, and I would imagine 9 out of 10 PCPs would express similar frustrations with patient messages. It is universally hated. Why? Because it is nearly always a losing proposition for us.

What you think is a simple request is not a simple reply. A simple request to reduce a medication requires me to pull your chart up, go over your meds, and usually look at the last visit. Then, I need to know I have numbers I can trust. In other words, that your blood pressure and pulse were checked in my office with calibrated equipment, and I will always recheck myself. I also need to ask you questions to determine if the problem you believe is caused by your medication is actually caused by that, and not a myriad of other causes. This requires an in-person visit, both for the best care and for liability reasons. Imagine if your BP cuff is inaccurate, or you're using it incorrectly, and your BP is high, and that's why you're feeling dizzy. I reduce your medication, and then you have a stroke when your BP spikes. Bad outcome for you, and liability for me.

When you request labs 'just because' we then have to go in and order the tests and then tie them to a diagnosis. If we don't have a diagnosis (or symptom) to tie them to, we can't order them. If we tie them to an existing diagnosis and then the lab test isn't covered, we have papers to fill out, and often angry patients that have large bills.

By the way, these messages are answered in between patient visits, early in the morning before seeing my first patients, or staying late after work. We don't have scheduled patient message answering time.

I have a patient panel of about 2500 patients. These add up very quickly. Contrary to popular belief, we don't have all of our patients' medical histories memorized. Any questions that come up require us to go back in and familiarize ourselves with their charts.

This phrase here "I messaged him all the time with questions, requests to change dosage, try new meds, etc." makes me cringe. You are being selfish with your doctor's time.

Roughly 5% of my patient panel uses 90% of my mental energy. It's not the sick and complicated patients that cause me stress. It's the entitled patients who feel their time is more important than my time that cause me stress.



Sending 3 to 4 messages a year is a lot. If all of my patients did this, I'd have 7500 to 10,000 messages per year to deal with. Figuring 48 working weeks a year, five days a week, that's 50 messages per day. If each message took me 3 minutes (don't I wish it only took me 3 minutes per message), that's 2.5 hours per day just replying to messages. That's 12.5 hours per week.


And FWIW, I am very good about responding to patient messages on time, even if it is requesting to be seen for the problem. Those patients that abuse the messaging system get a 15 second triage at best. If they're not dying, I'm telling them to come in to be seen.

By the way, my doc (as nearly as I can tell) NEVER answers my MyChart messages BEFORE his nurse reviews it and (often) seeks clarification or more info from me before "bothering" the doctor. OFTEN just "chatting" with the nurse is all I need. The doctor may never actually be involved as nearly as I know. Depends upon the situation.

And, no, I don't believe I abuse the system as I'm reasonably "with it" about medical issues. I don't pepper the doctor with endless questions - only with issues that are very important to me at the time. Honestly, I'm not trying to "save money" by avoiding a visit. I'm trying to save my time AND the doctor's time.

 

[skipro33]

If doctors are claiming time to be on the clock for messages, then the same should be reciprocal. How about my time waiting for a doc when I scheduled appointment and it's at least 15 minutes late? I'm not talking about later afternoon, I'm talking about early morning appointments. I try to all get appointments as early as possible. I see my oncologist at 8:30am and have never seen him in person earlier than 9am. I'll be taken in to the exam room, vitals taken, then wait. And wait. And wait!
What's that worth?
And how long is my visit window? 30 minutes, 45? Rarely is it more than 15. He looks at the labs he ordered, asks if I have any questions and tells me to schedule with the front desk for follow up in 3 months.
So I don't feel bad for messages in the interim.
He does reply to my messages though, same day, with a call back in most instances. In almost all cases, the message saves him a visit that would better serve his time with someone that needs an in person visit.
Here's an example question:
Am I considered to be still immune compromised when it comes to getting a COVID vax? Answer is Yes. Question: Should I then get a COVID booster after the vax and if so, how long after? Answer is Yes, at least 8 weeks after initial vac this season. Question: does it matter which vax? Answer is Yes, get one Moderna and one Pfizer. One is mRNA, the other is dead virus for a broader range of coverage.
I'm paraphrasing, but that's the gist of the messages and replies. Certainly not worth his time in an office visit that is better served with a patient he needs to actually lay eyes on.

My PCP is grateful for messages, even to the point she returns them, sometimes with a phone call,, even on Sunday. God bless her!

 

[harllee]

But what if the patient (like me) needs and wants an appointment and there are no appointments available for months and months? What do you do then?

 

[dirtbiker]

I appreciate hearing a doctors side of the situation and completely understand. On the other hand, why offer a messaging option if it's problematic for the doctor and useless for the patient?

I have the same complaint with businesses who post email addresses, then never answer emails.

Don't promise services that can't be provided.

The reason a messaging option is offered is because the vast majority of PCPs are employed physicians, and we don't have a choice.

That is unfortunate. But I am not asking the doctor to provide free unpaid care. If a messaging option is provided, it should be an allocated slot of time, just like an in-person visit. I would never expect my doctor to answer messages on their own time with no reimbursement.

Out of curiosity, do you have dedicated time slots for phone or video calls, and receive payment for those times? If so, why is messaging handled differently?

You are asking the doctor to provide free unpaid care. What it should be and what it actually is are two very different things.

I do not have slots for phone calls. I've never heard of any physician having slots for phone calls. It's just not a thing. We need to make phone calls between patients, before our day starts, or staying late after. That's also why it's generally a nurse calling a patient, as they do have time built into their schedules.

Video calls are treated like in-person visits, and are scheduled in any slot of the appropriate length for the problem.

3-4 was a worse case estimate. I doubt I even send one message a year, unless there's a follow-up message.

Earlier you said "I messaged him all the time with questions, requests to change dosage, try new meds, etc." These two statements are in direct contradiction to each other. You are undoubtedly not telling the truth. The only question is which statement is untrue.

I'm not trying to waste anyone's time, and I'm certainly not "entitled". Trust me, I don't want to contact a doctor in the first place. On the other hand, my time isn't any less valuable just because the doctor has other patients. I may just be a number, but I'm not seeking healthcare to benefit the doctor.

Overall, it seems best to not use the messaging option at all. We already stopped using the "e-check in" options as we found them useless. The office didn't receive notification we were there even after clicking "we're here", so we have to check-in upon arrival anyway. Another pointless option. Even the staff told us it wasn't reliable.

I don't use video or telephone calls either, so I'll just add messaging to that list and stick with in-person visits. Of course, that does mean I won't seek care for minor things that seem more trouble than they are worth (such as making an office visit just to request blood tests). Difficult healthcare translates to no healthcare.

Prudent use of the messaging system is the best approach. You have to be realistic as to what a physician can and should be able to accomplish with a message. Requesting to be seen for medication management, lab ordering, etc. is not difficult healthcare. I honestly don't know why you would expect it to be otherwise.

 

[dirtbiker]

I understand the issues you're pointing out here. I hope you understand that patients don't know what to do with new symptoms or health issues - we're not doctors. Typically, I want to alert my doctor if something changes and essentially ask "Is this something I need to see you about?" This seems much more efficient for me AND for the doctor. If every time I get a new pain, I have to get an appointment with the doctor (90% of the time he will only tell me - "It's normal and nothing to worry about.")

So if patient messaging isn't the answer, what is?

I do definitely understand most here aren't doctors, and most of my patients are medical professionals. That's why I'm pointing these things out. I'm assuming this might be eye opening to some people.

It's definitely NOT more efficient for the doctor to address a new symptom over messaging, but yes, it is easier for the patient. No doubt. Keep in mind that the answer you get about a new symptom over messaging (if they don't ask you to come in) will never be as well reasoned and accurate as coming in and having a conversation and exam.

Personally, I'd like to see messages billed directly to the patient, paid before they are able to be sent. This would cut back on the silly messages, and we get a lot of them, and it would cut back on messages that should be a visit. Rather than try and squeeze a visit into a message, people would be more likely to make an appointment and receive proper care (messaging is not proper care for a new symptom). That's the answer, I believe, but it's not a reality right now. In the meantime, the answer is prudent messaging.

 

[Sarah S]

Everything dirtbiker says is so true. It is also true that medicine has changed a lot. We always worked very hard but things are different now for many reasons and providers are stretched very thin. Most work for a medical megacorp with lot of issues many of you experienced- just in a medicalized form. Plus there is the prior authorization process that barely existed when i started. Medications, imaging ,some blood tests even need paperwork. Then the insurance company tries to refuse and you get to talk to a “ peer” a doctor or nurse who works for the insurance company

Give your doctors some grace they are trying It shouldn’t be an adversarial relationship

That said, Cleveland clinic has found a way to bill messages. When they announced it I didn’t think it would last but it apparently has MyChart Messaging | Cleveland Clinic

 

[dirtbiker]

If doctors are claiming time to be on the clock for messages, then the same should be reciprocal. How about my time waiting for a doc when I scheduled appointment and it's at least 15 minutes late? I'm not talking about later afternoon, I'm talking about early morning appointments. I try to all get appointments as early as possible. I see my oncologist at 8:30am and have never seen him in person earlier than 9am. I'll be taken in to the exam room, vitals taken, then wait. And wait. And wait!
What's that worth?
And how long is my visit window? 30 minutes, 45? Rarely is it more than 15. He looks at the labs he ordered, asks if I have any questions and tells me to schedule with the front desk for follow up in 3 months.
So I don't feel bad for messages in the interim.
He does reply to my messages though, same day, with a call back in most instances. In almost all cases, the message saves him a visit that would better serve his time with someone that needs an in person visit.
Here's an example question:
Am I considered to be still immune compromised when it comes to getting a COVID vax? Answer is Yes. Question: Should I then get a COVID booster after the vax and if so, how long after? Answer is Yes, at least 8 weeks after initial vac this season. Question: does it matter which vax? Answer is Yes, get one Moderna and one Pfizer. One is mRNA, the other is dead virus for a broader range of coverage.
I'm paraphrasing, but that's the gist of the messages and replies. Certainly not worth his time in an office visit that is better served with a patient he needs to actually lay eyes on.

My PCP is grateful for messages, even to the point she returns them, sometimes with a phone call,, even on Sunday. God bless her!

I can't speak for all doctors, as some are ALWAYS late, and that is no doubt frustrating. For some, they're constantly overbooked. For others, they're just not good at managing their time. Personally, I very rarely run behind, and if I do, I promise you am more stressed about being behind than you are for waiting, as I am very type A with my time management. Sometimes I get a late patient that I have to see, a complicated patient that I can't rush out the door, a double book that I need to see urgently, etc. that gets me behind.

Your PCP is likely NOT grateful for messages if she's forced to work to reply 7 days a week. I hope you can recognize the cognitive dissonance in your last statement. Grateful for messages. Forced to reply to them even on weekends...

I agree with you that messaging about if a vaccine is required does not require an office visit, and is a quite appropriate message.

For the record, I'm not advocating not messaging your doctor. However, if you're being asked to come in when you send a message, there's a reason for it.

 

[ShadowBloom]

Your PCP is likely NOT grateful for messages if she's forced to work to reply 7 days a week. I hope you can recognize the cognitive dissonance in your last statement. Grateful for messages. Forced to reply to them even on weekends...

Are doctors truly forced to reply 7 days a week? Every messaging system I've seen says not to send urgent questions and to allow 2 business days. I was shocked when my doctor replied to a message within a few hours the day after Christmas, when I know he wasn't in the office.

He had told me to message regarding any changes or lack of changes in my condition but I didn't need or expect an instant response. I appreciated the reply but would feel terrible if the fast response on a day off was because of this kind of pressure.

 

[TripleLindy]

I do definitely understand most here aren't doctors, and most of my patients are medical professionals. That's why I'm pointing these things out. I'm assuming this might be eye opening to some people.

It's definitely NOT more efficient for the doctor to address a new symptom over messaging, but yes, it is easier for the patient. No doubt. Keep in mind that the answer you get about a new symptom over messaging (if they don't ask you to come in) will never be as well reasoned and accurate as coming in and having a conversation and exam.

Personally, I'd like to see messages billed directly to the patient, paid before they are able to be sent. This would cut back on the silly messages, and we get a lot of them, and it would cut back on messages that should be a visit. Rather than try and squeeze a visit into a message, people would be more likely to make an appointment and receive proper care (messaging is not proper care for a new symptom). That's the answer, I believe, but it's not a reality right now. In the meantime, the answer is prudent messaging.

While I can understand that messaging can be abused, especially when there’s a large disconnect with expectations, I think some clarity around the issue is a better solution than trying to inflict financial pain. I’ve spoken with my PCP about it and he’s fine with questions such as “do I need to come in to see you or can you issue a referral”. I certainly don’t abuse the system.

Turning physician practices into banks with unnecessary fees would be a terrible direction to go, especially when patients are spending more than $40k annually before they have any coverage (premium + deductible). I completely understand that this isn’t the physician’s issue, but you can’t separate it from the overall care process.

You are asking the doctor to provide free unpaid care. What it should be and what it actually is are two very different things.

If this is the consensus of the medical community, then a reset is probably needed on your part. Expecting to be paid for every minute is unrealistic. Virtually all professionals spend time on work outside of the normal 8-5, 5 day work week.

 

[dirtbiker]

Are doctors truly forced to reply 7 days a week? Every messaging system I've seen says not to send urgent questions and to allow 2 business days. I was shocked when my doctor replied to a message within a few hours the day after Christmas, when I know he wasn't in the office.

He had told me to message regarding any changes or lack of changes in my condition but I didn't need or expect an instant response. I appreciated the reply but would feel terrible if the fast response on a day off was because of this kind of pressure.

No... Though sometimes I'm expecting something so I will log in and message, but this is uncommon.

If you're receiving messages on weekends consistently, that's a nearly sure sign your physician is overworked, or bad at time management, or both. Everyone needs time off, even doctors. Though, there are a few that love working, and don't mind working 7 days a week.

 

[skipro33]

Your PCP is likely NOT grateful for messages if she's forced to work to reply 7 days a week. I hope you can recognize the cognitive dissonance in your last statement. Grateful for messages. Forced to reply to them even on weekends...

I asked her point blank at my last visit if she minded that I messaged her and I told her that obviously my message wasn't important enough to have disturbed her Sunday morning. She assured me it was not a problem at all and to never consider a question to be a burden on her, that she was happy to be there for me.
For reference, the message was about my wife's diagnosis with Mono. Mono is caused by EBV and that I have a higher risk of complications from EBV, the virus that causes Mono, because my immune system has been compromised, with my chemo for non-Hodgkin's lymphoma, even after recovery. EBV is linked to certain types of lymphoma. I plan to take extra precautions to avoid exposure to my wife's saliva. I don’t know how long she may be contagious for me, so maybe you could advise me about that?
I’m curious if I should be tested to determine my immunity status with an EBV titer to confirm if I have been previously exposed to the virus and have antibodies. I don’t recall ever having Mono in my past. I’m very concerned that if I become infected, it could be severe and lead to complications.

I sent her a message this morning:
Hi Dr Cheng,
As you know, I’m a 69-year-old advanced skier. This season I've developed chest pain, but only after strenuous runs, it resolves with a short rest before continuing the ski run. I had a normal EKG pre-op, in your office in advance for hernia surgery, but I’m concerned about exertional ischemia. I never have this pain when doing any other exertion and I am quite active in other activities, just this season with skiing hard. I wasn't sure if it might be the altitude, the cold air, my history with chemo treatments, or something serious.
The symptom concerns me and I want to ask you if you think it should be further investigated with a Stress Echocardiogram.
Thanks!

When I hear back from her, I'll ask her again if she would prefer I not message and make an appointment instead. I have a PPO for insurance and probably don't require a referral from my PCP to make an appointment for the tests or to see a cardiologist, but I respect her opinion and she's told me in the past it's not a problem when I ask.

P.S.
I realize this is a lot of personal information, but I figure so is my financial health and I discuss that openly here as well, so why not?
Cheers!

 

[dirtbiker]

While I can understand that messaging can be abused, especially when there’s a large disconnect with expectations, I think some clarity around the issue is a better solution than trying to inflict financial pain. I’ve spoken with my PCP about it and he’s fine with questions such as “do I need to come in to see you or can you issue a referral”. I certainly don’t abuse the system.

Turning physician practices into banks with unnecessary fees would be a terrible direction to go, especially when patients are spending more than $40k annually before they have any coverage (premium + deductible). I completely understand that this isn’t the physician’s issue, but you can’t separate it from the overall care process.

If this is the consensus of the medical community, then a reset is probably needed on your part. Expecting to be paid for every minute is unrealistic. Virtually all professionals spend time on work outside of the normal 8-5, 5 day work week.

I'm not suggesting inflicting financial pain. I'm suggesting putting a reasonable barrier in place to reduce unnecessary messaging burden, which leads to burnout and poor patient care. Maybe there's a better way than charging for messages. Have any suggestions?

Also, suggesting a charge for messages is not turning a physician practice into a bank. We already collect copays, and there are many charges. You do realize we charge for our services, right?

We already spend a significant amount of time working beyond our normal business hours. Besides our scheduled patient hours and overbooks, we have paperwork, forms to fill out, results to review and respond to, patient calls, patient messages, CME, and other administrative tasks.

 

[mountainsoft]

You are asking the doctor to provide free unpaid care. What it should be and what it actually is are two very different things.

I appreciate the information, as I am not a doctor and can only view things from the patients perspective. If a messaging option is provided, I assume the doctor or nurse is being paid for their time. From what you have described that is not the case, and I will be more selective with my use of messaging.

Earlier you said "I messaged him all the time with questions, requests to change dosage, try new meds, etc." These two statements are in direct contradiction to each other. You are undoubtedly not telling the truth. The only question is which statement is untrue.

I am not being untrue. Different doctors, different situations. I had my previous doc for over 10 years. By "all the time" I meant I had messaged him numerous times over those 10 years and always received a response. I certainly never abused the messaging system or wasted his time.

I've been with my current doc about three years. I've probably only messaged her 4-5 times since I've been with her. I can't recall a single response other than "make an appointment".

Prudent use of the messaging system is the best approach. You have to be realistic as to what a physician can and should be able to accomplish with a message. Requesting to be seen for medication management, lab ordering, etc. is not difficult healthcare. I honestly don't know why you would expect it to be otherwise.

Yes, it's easy to make an appointment, but it usually takes days or weeks to get in. Unless the situation feels significant enough, I'm not likely to wait out that process. I'm certainly not going to make an appointment just to ask a question.

 

[dirtbiker]

I asked her point blank at my last visit if she minded that I messaged her and I told her that obviously my message wasn't important enough to have disturbed her Sunday morning. She assured me it was not a problem at all and to never consider a question to be a burden on her, that she was happy to be there for me.
For reference, the message was about my wife's diagnosis with Mono. Mono is caused by EBV and that I have a higher risk of complications from EBV, the virus that causes Mono, because my immune system has been compromised, with my chemo for non-Hodgkin's lymphoma, even after recovery. EBV is linked to certain types of lymphoma. I plan to take extra precautions to avoid exposure to my wife's saliva. I don’t know how long she may be contagious for me, so maybe you could advise me about that?
I’m curious if I should be tested to determine my immunity status with an EBV titer to confirm if I have been previously exposed to the virus and have antibodies. I don’t recall ever having Mono in my past. I’m very concerned that if I become infected, it could be severe and lead to complications.

I sent her a message this morning:
Hi Dr Cheng,
As you know, I’m a 69-year-old advanced skier. This season I've developed chest pain, but only after strenuous runs, it resolves with a short rest before continuing the ski run. I had a normal EKG pre-op, in your office in advance for hernia surgery, but I’m concerned about exertional ischemia. I never have this pain when doing any other exertion and I am quite active in other activities, just this season with skiing hard. I wasn't sure if it might be the altitude, the cold air, my history with chemo treatments, or something serious.
The symptom concerns me and I want to ask you if you think it should be further investigated with a Stress Echocardiogram.
Thanks!

When I hear back from her, I'll ask her again if she would prefer I not message and make an appointment instead. I have a PPO for insurance and probably don't require a referral from my PCP to make an appointment for the tests or to see a cardiologist, but I respect her opinion and she's told me in the past it's not a problem when I ask.

P.S.
I realize this is a lot of personal information, but I figure so is my financial health and I discuss that openly here as well, so why not?
Cheers!

FWIW, new chest pain is definitely not an appropriate MyChart message symptom.

God, I can't wait to retire...

 

[latexman]

But what if the patient (like me) needs and wants an appointment and there are no appointments available for months and months? What do you do then?

Similar with our Dr. We just schedule with other Drs or PAs in the same practice. If our Dr needs to get involved, she does behind the scenes/at the water cooler.

 

[mountainsoft]

I've satisfied my own curiosity for many years by simply getting my own labs done.
requestatest.com and walkinlab.com are reliable, reasonably priced, and professional. There are others, but I haven't used them. You simply go to a local blood extraction center (Quest or Labcorp, usually) and get it done at your convenience.

Thanks for the info. I didn't know these types of services were even available. I might give them a try.

 

[Amethyst]

I gave up on messaging, because responses (if any) bore little or no relation to the questions I had asked and thus were useless. This was true for four different physician's offices. In each case, the message had been filtered through the doctor's assistant (not a nurse). I assume the doctor dictated a brief response to the assistant, who filtered it back to me.

 

[RetiredHappy]

When my PCP set up his own concierge practice in 2018, he called us to join him, i.e. continue to be his patients, and explained that he could never provide proper care to the 2,500 patients that he had before. He said that he was going to keep his patients to no more than 300 in his concierge practice. He said we would be able to text him, email him and be seen same day and certainly no more than 48 hours. He has lived up to his promise.

If you want a responsive doctor who would text and email back to you in a timely manner and your doctor is not doing that, then you need to look into paying for concierge membership. For us, it is worth every penny of it. While my PCP is actually quite mediocre with his diagnosis, his networking with specialists is what makes him valuable.

 

[skipro33]

FWIW, new chest pain is definitely not an appropriate MyChart message symptom.

God, I can't wait to retire...

So what then? I call to make an appointment that I'm seen in 4 weeks? Is THAT appropriate for my symptom? Hardly. The point is that the doctor be able to judge how urgent of an issue this is. She knows my history and can tell me to go straight to an ER, not pass go and she'll call for me ahead so they expect me, or she can tell me this is concerning and to schedule an appointment at my earliest convenience.

I'm not a doctor, how would I know if something is serious or not? I'm at 10,000+ feet, exerting myself in sub freezing, near zero air temperature and for all I know, I'm giving my lungs the equivalent of an ice cream headache. I don't feel bad, my chest has a pain. My pulse is fine, I'm able to make conversation, so it's not that I'm exhausted, weak, tired. I ask her, do I need to have this further examined or not.

If my doctor ever told me what you just did, she can't wait to retire, based on a question I asked, I'd be shopping for someone who wants to be a doctor. You want to be retired, can't wait even. Physician heal thyself.

In the meantime, I'm out the door. 6" of fresh snow fell overnight and I want first tracks. Come on ticker, hang in there for one more day on the slopes baby!
Cheers!