19/05/2025
You're absolutely right—many seemingly simple questions from patients are, in fact, low-key consultations that take up time, clinical reasoning, and emotional labor. It's a modern dilemma in healthcare, especially with the rise of messaging apps and telehealth. The desire for efficient communication often clashes with the need to protect your time and maintain professional boundaries.
Here are a few guiding thoughts:
1. **Acknowledge the Value of Your Time**: Just because something is done via message or outside the clinic doesn’t mean it’s free of value. Clinical expertise, even in short exchanges, is still expertise.
2. **Set Clear Boundaries Upfront**: Establish a policy (perhaps in your welcome packet or through your secretary) that outlines:
* Response time frames (e.g., within 24–48 hours).
* What constitutes a billable consult (e.g., any medical advice, prescription changes, or review of labs outside a formal visit).
* Channels for urgent vs. routine concerns.
3. **Introduce Paid Messaging**: You might explore structured options like:
* Subscription-based follow-ups.
* Charging for "e-consults" if the message thread goes beyond basic admin.
4. **Automate Where You Can**: Use message templates or even AI-based auto-responses to filter inquiries. For example: “Thank you for your message. If your concern requires medical advice or treatment adjustments, we may need to schedule a formal consultation.”
5. **You Can Be Kind *and* Professional**: Firm boundaries don’t mean being cold. Patients often respect structure—they just need to know what it is.
You’re not alone in feeling this tension. Many clinicians are redefining how they engage in the digital age.
"Doctors Are Not Free Helplines."
We give free consultations.
We write free prescriptions.
We interpret lab reports at 11 p.m.
We answer medical questions on birthdays, weddings, and funerals.
Why?
Because we care.
Because we took an oath.
Because we were taught that healing is noble.
But what do we get in return?
“Why are you talking about money?”
“This is a noble profession.”
“You should serve humanity, not charge for it.”
All this, while other professionals say this with ease:
Lawyers charge consultation fees — even for phone calls.
Chartered Accountants charge for a signature.
Architects charge for blueprints.
Therapists charge per session — no discounts.
IT consultants won’t fix your software for free.
Tutors don’t teach for free because you're “like family.”
But us?
We're expected to diagnose over WhatsApp.
To give life-altering advice in 2 minutes over a call.
And never mention fees because it's “just a service.”
But what we give is not information it is insight.
It’s not Google it’s wisdom shaped by years of study, sleepless nights, and sacrifice.
This needs to change.
Because if the value of medical care continues to be measured in rupees and not respect,we might just hang our white coats and let the world face what it chose:
A system where care is expected, but not valued.
from Dr Pooja Iyer.
