You wrap up your last appointment of the day, open your messages, and find five patients asking if you have just a minute. If you’ve never set boundaries with patients between appointments, your clinical expertise becomes available around the clock, and nobody’s paying for it.

It didn’t happen on purpose. It happened one compassionate answer at a time, until the texts, emails, and chat portal messages started piling up faster than you could answer them.

Your patients are completely unaware of what’s happening. Meanwhile, those few minutes here and there can add up to as much as three full work weeks a year, not to mention the loss of focus that occurs every time a message pulls you away from what you were doing.

The answer isn’t prohibiting your patients from asking questions. It’s knowing exactly where the line belongs, and holding it kindly, without any guilt.

If checking your work inbox for patient questions has become something you dread, watch the full episode below and find out where to draw the line.

Why Do My Patients Message Me So Much Between Appointments?

 

Your patients message you between appointments because, somewhere along the way, they were told to reach out with their questions. Whether you’re a chiropractor, an acupuncturist, or a clinical nutritionist, you didn’t open a practice planning to offer free, unlimited help whenever a patient wants it. Setting boundaries with patients between appointments was never articulated, so the access naturally grows on its own.

It rarely starts as a firm policy. It starts with a warm “Let me know if you need anything, I’m happy to help,” and in the moment, you meant every word.

Then a patient takes you up on it. There’s no such thing as a quick question, and one request to look at a supplement turns into a request to evaluate their labs. Pretty soon you have patients texting between appointments, emailing, and sending portal messages on a regular basis.

Patients who constantly message you between appointments are simply following the rules you unintentionally set, not trying to take advantage of you.

They have a question, you’re their go-to person, and no one ever explained the difference between a question you answer for free and one that needs your time. But the good news is that the rules you created – by default in this case – are rules you get to change.

 

How Much Time Does It Actually Take To Answer Patient Questions Between Appointments?

 

Patient questions between appointments can cost you as much as 120 hours a year, which is three full 40-hour work weeks. It doesn’t seem like it takes that much time because some of the answers only take a few minutes. But when the response required is longer, that’s where the time really adds up.

Here’s how the math works. Let’s say you have 15 patients a week that send you a question requiring you to review their chart, look at their last protocol, and then provide a response. Each of these takes about 10 minutes. That’s 150 minutes, or two and a half hours, every single week.

Spread out over 48 working weeks during the year, two and a half hours a week adds up to 120 hours. Even if every answer took only five minutes, you’d still be giving away about 60 hours a year.

Spending five to ten minutes per answer can add up to as much as three full work weeks of your time every year.

And the hours you spend are only part of the cost. Every message opens another loop in your brain, and the research shows that the more open loops, the less efficient we become. We simply aren’t great at multitasking. So you start firing off answers just to close the loops, losing track of what you were doing in the first place.

By the end of the day your brain hurts, you feel like you got nothing done, and there are still six patient questions that need to be answered. Some days, ignoring it altogether starts to look pretty tempting.

So put on your CEO hat and look at this situation as the owner of the business, not the practitioner doing the work. What is all this availability costing the business in revenue, in productivity, and in overall wellbeing? You’re running a business, not a charity, which makes this a great time to reevaluate how these questions are managed effectively.

 

Should I Charge Patients for Questions Between Appointments?

 

Yes, charge for questions that take clinical thinking or research, and simply answer the ones that don’t. Taking care of people is what you love to do but that doesn’t mean you need to give your time and clinical knowledge away for free. Every answer you provide came from years of training and more hours of study than you could ever count.

When the patient question comes in, you are using the same information, the same brain, and the same clinical judgment you bring to an appointment. The only thing that changed is where the question was asked.

Your clinical judgment is worth the same amount whether you provide it during an appointment or in a text message.

A great starting place to establish new boundaries is five minutes. If you can answer a question in under five minutes, go ahead and answer it. However, if the answer requires pulling up their notes, reviewing the protocol, or researching a supplement, it becomes paid time.

That paid time can be a quick 10-minute appointment to answer the question or a flat fee for your time. Either way, the patient gets a complete, thoughtful answer instead of a rushed one, and you get paid for the clinical judgment behind it.

And don’t be surprised if the random questions start to drop away. Once there is a potential fee associated with more in-depth questions, patients have to decide if the question is important enough to pay for or maybe not as urgent as they thought.

 

Should I Answer Patients’ Supplement Questions by Text?

 

Answer a supplement question by text only when it’s quick and you don’t need to open the patient’s notes to get it right. Anything that requires evaluating their protocol or looking back at the patient’s history should be in an appointment, because that’s where you can see the whole picture.

When you prepare for an appointment, you have the notes, the protocol, and their history open. You know what you recommended last time, what’s changed since then, and what you planned to do next. That’s when you can answer a supplement question in context.

A text message is different. You’re answering from memory, while in the middle of doing something else, without the full history in front of you, and hoping you can remember the supplements you gave them. This is not the ideal way to provide patient care.

What your patients need is for you to be effective, not indispensable.

Being constantly available and solving the problem are two very different things. Your patients came to you to get better, not to have you on call around the clock.

Good boundaries protect the quality of your care as much as they protect your time. They make sure your best clinical thinking shows up when the answer matters most.

 

How Do I Set Boundaries with Patients Who Text Between Appointments?

 

Start by acknowledging that giving them unlimited access to you is a boundary that was never articulated in the beginning and then decide where your line belongs.

Second, ask yourself the much harder question. Are you responding to every message because your patients actually need that kind of access, or because you want to be seen as helpful and supportive? If it’s a little of both, that’s okay. You’re in good company.

Other professions manage client questions in a much more abrupt way. You can’t speak directly to your attorney or medical doctor every day when you have a quick question. You’ll either get charged for the time or asked to come in for an appointment. No one blinks an eye about this. And you’re allowed to do it the same way if that feels right.

You should never eliminate all access. Your patients need to be able to reach you. Instead, think about where your time and mental energy goes when you’re answering a question. Would the patient be better served if you could speak with them for 10 minutes to get additional insight about what might be going on before providing an answer? Or are you content just giving your time away for free?

Clear boundaries around patient access protect your time, the quality of their care, and the health of your business all at once.

Patients can respect a boundary and still feel well cared for. Your expertise deserves that boundary, and so do you.

 

Call to Action

 

Watch the full episode to find out where to draw the line on patient questions, and how to hold it.

If you’re wondering what all that availability is costing your practice, take the free Practice Vitals Checkup and find out where your business needs attention first.

About

 

Ronda Nelson, PhD, MH, is the founder of Clinical Business Academy and Clinical Academy, and host of The Clinical Entrepreneur Show. Drawing from more than 20 years of experience as a practitioner, educator, and business owner, and having trained more than 4,000 wellness practitioners, she helps them identify the operational, financial, and leadership problems that keep their practices from growing. Her work focuses on patient retention, follow-up, communication, systems, profitability, and the business structure required to build a practice that supports both excellent patient care and long-term sustainability.

 

Related Content

• Clinical Business Academy – get control of your business, your revenue, and your time.

• The Clinical Entrepreneur Show – my YouTube channel, with business and clinical episodes for wellness practitioners.

 

Frequently Asked Questions About Boundaries with Patients Between Appointments

 

Should I answer patient texts after hours?

 

Answer after-hours texts only when the question takes less than five minutes and doesn’t require pulling up the patient’s notes. Anything that needs clinical thinking should require a short appointment or charging a flat fee for your time. Answering outside of business hours teaches patients that your expertise is available around the clock, for free.

 

Is it okay to charge patients for questions between appointments?

 

Yes, it’s okay to charge for questions that require your clinical judgment, research, or a review of the patient’s protocol. That knowledge has the same value outside an appointment as it does inside one. A short appointment or a flat fee for your time ensures the answer is thorough and keeps your practice sustainable.

 

How much time do patient messages between appointments take?

 

Patient messages between appointments can take as much as 120 hours a year. Fifteen questions a week at 10 minutes each is two and a half hours weekly, which adds up to 120 hours over 48 working weeks. That’s three full 40-hour work weeks, before you count the loss of productivity and focus from the interruptions.

 

What do I say when a patient’s question needs more than a quick answer?

 

Invite the patient to book a quick appointment so you can give the question your full attention. Something as simple as “Let’s schedule a quick 10-minute appointment and get this sorted out” works great. You aren’t refusing to help. You’re making sure the answer comes with the notes, protocol, and history in front of you.

 

Call to Action

 

Every quick question feels small on its own, and that’s exactly why the time you’re giving away is such an easy weak spot to miss. The Practice Vitals Checkup is a free 10-question business assessment that shows you where to focus first, so you can stop guessing.

Take the Practice Vitals Checkup

 

Disclaimer/Disclosure

 

This content is for educational purposes only and is intended for wellness practitioners working within the functional medicine and integrative health space. This episode reflects Ronda Nelson’s personal experience and professional perspective as a practitioner, business owner, and mentor. It is not medical, mental health, legal, or financial advice. Practitioners are responsible for applying this information within their legal and professional scope. Ronda Nelson is the founder and owner of Clinical Business Academy, which is mentioned in this episode. No sponsorship or outside compensation was received for this mention.