Nominal, transparent billing could provide balance to portal messaging system

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The use of electronic messaging has led to clinician overwork, with billing portal communications suggested as a solution to reduce burnout. However, ethical concerns, such as creating barriers to care, complicate this approach. Clinicians responding to portal messages outside working hours and increased patient messaging during the pandemic have exacerbated burnout. A pay-per-message system could alleviate burdens but may deter patients from seeking treatment. Implementing billing for messaging poses ethical challenges, as it could impact patient care, increase healthcare costs, and create disparities in care. Finding a balance between efficiency, fairness, and well-being of both patients and healthcare providers is crucial.

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