Let’s play a little game of “What if?” Tune into your creative side for a few minutes—imagine, just for a second, if we billed like lawyers. I know, I know… I’m not saying we should, but imagine. Please let that sink in for a moment.
How often have we been casually approached at a party, a family gathering, or even in line at the grocery store with, “Hey, Doc, I have this rash—what do you think?” I know I have been there countless times—people asking me for medical advice that I couldn’t bill for—free, unsolicited advice.
Now, picture this scenario:
You smile politely and respond: “Of course! I’ll need a $5,000 retainer upfront, a copy of your ID, and if you could sign this contract establishing our professional relationship, I’ll get right on that.”
(Oh, and I’ll be billing you for that one-minute consultation. The invoice will arrive shortly.)
Doesn’t that sound tempting? For some reason, lawyers have managed to set boundaries we could only dream of. They’ve got hourly billing down to a fine art, even if they’re thinking about your case on their commute home. Meanwhile, we answer texts, field phone calls, and run mental diagnostic checklists while getting ready for bed. Oh, don’t get me started about the paperwork! As a physician, I am inundated with forms to fill out. Often, it starts with patients telling me, “Oh, we just need your signature!”—yes, my signature, after three pages of questions that I need to answer with detail.
Now, imagine if we actually did charge for every interaction, thought, or moment we spent working through a case—whether we’re physically with the patient or mentally preoccupied with their care after hours. What would that look like?
A few things would probably happen:
The initial phone call
“Hello, doctor’s office? I’d like to speak with the doctor.”
“Certainly! The doctor will be happy to answer your questions after the $300 consultation fee is processed. Would you like to pay via credit or direct transfer?”
I’m thinking after doing this a few times, our patients would take copious notes during their visit with us and ask clarifying questions.
The casual, “‘quick question”‘ text
“Hey, Doc! Just a quick question—should I be worried about these headaches?”
“Absolutely! After the $150 text response fee, I’d gladly chat further.”
I suspect those direct messages through our electronic medical records will dwindle to nothing in a few months.
Follow-up emails
Emailing with a question? No worries, I’ll get back to you as soon as the retainer is in place!
Let’s be honest: Patients would think twice before calling with a billing structure like this. I’d probably be less likely to call my physician casually. Heck, I might not even call the receptionist if an hourly rate was attached! (And don’t even get me started on being billed for leaving a voicemail.)
The shift in the patient-physician dynamic
Would this change our relationship with patients? Probably. Our access and connection with them would likely feel different—more transactional, less personal. But it also begs the question: How do we value our time?
As physicians, we spend an enormous amount of time on patient care that extends far beyond the actual office visit. We’re constantly thinking about cases, planning treatments, consulting colleagues, and reviewing labs—even during off-hours. Yet, we often don’t factor that into the “value” of the work we do.
If we adopted a lawyer-style billing system, suddenly, every minute would have a monetary value attached. While I’m not advocating for this shift, there’s something powerful about acknowledging the hidden hours we invest in patient care.
What would happen if we valued our time like lawyers do?
Suppose we genuinely valued every minute of our time the way lawyers do. In that case, we’d probably set stricter boundaries, take fewer phone calls at 9 PM, and limit “quick questions” to scheduled appointments. We’d also be more mindful of where we invest our energy.
More importantly, though, we’d likely feel less burnout. Why? Because when your time is explicitly valued, you feel more in control. It’s easier to say no to that 15-minute “quick consultation” that turns into an hour when you know that hour is costing you—financially and emotionally.
A reality check
Health care is different. We provide care, connection, and comfort in a way that goes beyond what lawyers do. The patient-physician relationship is built on trust and accessibility, and we don’t want to lose that. But maybe we could take a note from our legal colleagues and start valuing our time—really valuing it. It’s not just our legal colleagues; I’m noticing this shift in other professionals, like accountants.
Maybe that means setting firmer boundaries, acknowledging that our mental bandwidth has limits, and recognizing that every “quick question” isn’t so quick after all.
At the end of the day, we probably won’t be sending out invoices for texts or charging a retainer to enter our offices. But if we started valuing our time with the same mindset as a lawyer, we might start valuing ourselves—and our well-being—a little more, too.
Tomi Mitchell is a board-certified family physician and certified health and wellness coach with extensive experience in clinical practice and holistic well-being. She is also an acclaimed international keynote speaker and a passionate advocate for mental health and physician well-being. She leverages over a decade of private practice experience to drive meaningful change.
Dr. Mitchell is the founder of Holistic Wellness Strategies, where she empowers individuals through comprehensive, evidence-based approaches to well-being. Her career is dedicated to transforming lives by addressing personal challenges and enhancing relationships with practical, holistic strategies.
Connect with her on Facebook, Instagram, and LinkedIn, and book a discovery call to explore how she can support your wellness journey. For those interested in purchasing her book, please click here for the payment link. Check out her YouTube channel for more insights and valuable content on mental health and well-being.
