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Thinking about messaging your physician about a weird rash? You may want to hold off on it. Some hospital systems have started charging patients for digital messages to their doctors via the electronic medical record, either a flat rate (like a copay) or on sliding scale depending on the time or complexity of the physician’s response. Sometimes it’s billed through an insurer, sometimes as a direct cost to the patient. Costs have ranged between less than $10 and $100 for a message.

Now that at least 22 hospital systems have implemented the practice, a great debate has broken out in the medical profession: Is charging patients to send a note to a doctor just common sense or an unjust expense?

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In asking family, friends, and colleagues about this, my grandmother’s response was the most enlightening: “I’m surprised doctors ever stopped charging for phone calls!”

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