Hitting a Nerve

Allscripts’ charges for sending, refilling prescriptions


How much is $9 worth? Not much. Probably less than most people spend on coffee in a given week.

And yet, that $9 is really irritating to me.

For the last few weeks, when signing into Allscripts to send and refill prescriptions, I’ve encountered this:

I know that $9 a month doesn’t seem like much: It’s $108 a year. But still, it’s irritating.

I understand Allscripts, and every other health care company, is here to make a living. Heck, so am I. Software development isn’t cheap. Neither are the servers hosting it or the security software needed, or the buildings to house them, and a million other things. I get that. None of these things are free.

But, at the same time, it’s part of a general trend of modern health care. Our landlords and vendors can arbitrarily raise prices to keep up with their costs, but we can’t do the same to keep up with ours.

The majority of doctors aren’t in a position to raise our prices to account for these things. We’re stuck with insurance companies and government agencies that tell us to accept a given amount or eat rocks.

There are, of course, concierge practices that can raise their prices, but they’re mostly boutique-level general care with wealthy patients who can afford them. Most small specialists aren’t in that position. We can’t afford to put Keurigs in the lobby.

The few revenue streams most of us have for which we can increase prices, such as legal work and cash patients, are typically not enough of the practice where it would make a difference to overcome it. In fact, the lien company I see patients for recently told me they were lowering their reimbursements to me to compensate for their own higher expenses.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

Of course, I can always refuse to pay the $9. I could go back to my pre-2009 habits of faxing and writing scripts and say no to Allscripts. But that would also increase costs in another way: more paper, ink, staff time, etc. I suspect it would likely balance out the same either way, and, like I said, I understand where Allscripts is coming from. I run a business, too.

Some people may see the $9 a month as a minor issue and move on. But to a small practice, it’s now another $108 in revenue that I have to bring in each year to cover. And, in a field in which, unlike every other product or service people pay for, I’m not allowed to control my own prices to make up for it.

That doesn’t seem fair, does it?

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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