I Don't Have a Patient Portal. And I Probably Never Will

Allan M. Block, MD

March 24, 2022

I don't have a patient portal. Probably never will.

This isn't an attempt at "information blocking," or intentional noncompliance, or a rebellious streak against the CURES act.

It's practical: I can't afford it.

I'm a small one-doc practice. My overhead is high, my profit margin is razor thin. In the sudden spike of COVID-19– and war-related inflation, my gas and office supply costs have gone up, but I'm in a field where I can't raise my own prices to compensate. The restaurants and grocery stores near me can, but I can't because of the way insurance works.

With that background, I don't have the money to set up a patient portal for people to be able to get their notes, test results, anything.

This isn't to say that I withhold things from patients. If they want a copy of my note, or their MRI report, or whatever, they're welcome to it. I'm happy to fax it to them, or put it in the mail, or have them come by and pick it up.

I have no desire to keep information from patients. I actually try to stay on top of it, calling them with test results within 24 hours of receiving them and arranging follow-ups quickly when needed.

That's one of the pluses of my dinky practice — I generally know my patients and can make decisions quickly on the next step once results come in. They don't get tossed in a box to be reviewed in a few days. I take pride in staying on top of things — isn't that how we all want to be treated when we're on the other side of the desk?

Politicians like to say how much America depends on small businesses and how important we are to the economy. They love to do photo ops at a newly opened ice cream place or small barbecue joint. But if you're a doctor in a small practice, you often get treated the same way the Mega-Med Group ("287 doctors! 19 specialties! 37 offices! No waiting!") is treated. They can afford to have a digital portal, so why can't you?

Just because I don't have a patient portal, though, doesn't mean I'm hiding things from patients.

Or not doing my best to care for them.

Like Avis, I may not be No. 1, but I sure try harder.

Block has a solo neurology practice in Scottsdale, Ariz.

This article originally appeared on, part of the Medscape Professional Network.


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