This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf.  Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all my professional positions, including as press secretary in Washington, D.C. for a Democrat Congressman from Oregon (Les AuCoin), as an Oregon state government manager in Salem and Portland, as press secretary for Oregon’s last Republican governor (Vic Atiyeh), and as a private sector lobbyist.  This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.  I could have called this blog “Middle Ground,” for that is what I long for in both politics and golf.  The middle ground is often where the best public policy decisions lie.  And it is where you want to be on a golf course.

The question in this blog headline arose for me in two ways:

• First, as a dedicated e-mail user, I have wondered about this as doctors responded to me on-line.
• Second, the Washington Post carried a story recently that appeared under this headline:  Your Doctor Replied to Your Email.  That’ll Cost $25.

Reporter Sumathi Reddy started her story this way:

“The next time you send your doctor an email, don’t be surprised if they charge you a fee to answer.

“More healthcare groups are charging fees to answer patients’ electronic messages, often the ones you exchange via their portal.  Doctors say it’s only fair if they’re spending time on the messages and note that an email discussion can often save you the time of having to come in. 

Some patients, Reddy reports, have been taken aback by the charges.  They are surprised at the notifications on portals about the change, and irritated at the idea of a new fee.

But, for me, charging for this kind of work only makes sense.

I have been among those who are pleased with being able to get a direct response my doctor in an e-mail, or even a response on a patient portal. 

Better, I thought, that going through the pain and agony of trying to book an appointment, then waiting for a response. 

As I reviewed this issue this morning, I learned that federal guidelines exist which are typically followed by private insurers and which say that patients can only get charged for messages that require at least five minutes of a doctor’s time over the course of seven days.

Billable messages also have to involve some sort of medical decision-making rather than just dealing with an administrative matter, like scheduling an appointment, according to those guidelines.  And emails that stem from a follow-up to a visit, such as explaining lab results, aren’t typically billed.

To all of this, I say “good.”  And, I say that it has been helpful to interact with my physicians without alwa