Can non-physician care team members respond to patient messages?

This resource is part of the AMA's Debunking Regulatory Myths series, supporting AMA's practice transformation efforts to provide physicians and their care teams with resources to reduce guesswork and administrative burdens.

There is no federal regulation requiring that only physicians respond to patient portal messages. Depending on the nature of the request, clerical and clinical team members are often the most appropriate individuals to respond to patient messages.

The use of text-based secure messaging platforms has increased as a means of clinician-to-clinician and clinician-to-patient communication.^1,2 

Research has shown that from 2019 to 2020, clinician in-basket messages from patients increased by 57% compared to the pre-COVID-19 pandemic average.³

“The average time spent per patient portal message is 2.32 minutes. And if you’re an active, busy doctor, you might get 20 to 40 of these a day.” ⁴

- Kevin D. Hopkins, MD, vice chief, Primary Care Institute, Cleveland Clinic 

Some organizations require that only physicians respond to all patient portal messages, resulting in diversion of physician time and attention away from work for which they are uniquely trained and qualified. 

Introducing a team-based, in-basket management system to triage and address messages that do not need to be seen by a physician can expedite responses to patients, decrease physicians’ time spent in the EHR and help reduce burnout. 

• Payment for Electronic Communication H-385.919
• Guidelines for Patient-Physician Electronic Mail and Text Messaging H-478.997

• AMA STEPS Forward® Toolkit: Patient Portal Optimization. Accessed September 2024.
• AMA STEPS Forward Toolkit: A Systematic Approach to Reducing EHR Inbox Burden. Accessed September 2024.
• AMA STEPS Forward Playbook: Taming the EHR Playbook. Accessed September 2024.
• Download this myth: Responding to patient portal messages (PDF)

1. Lou SS, Lew D, Baratta LR, Eiden E, Sinsky CA, Kannampallil T. Secure Messaging and Telephone Use for Clinician-to-Clinician Communication. JAMA Network Open. 2024;7(6):e2417781. doi:10.1001/jamanetworkopen.2024.17781
2. Baratta LR, Harford D, Sinsky CA, Kannampallil T, Lou SS. Characterizing the Patterns of Electronic Health Record-Integrated Secure Messaging Use: Cross-Sectional Study. J Med Internet Res. 2023;25:e48583. doi:10.2196/48583
3. Holmgren AJ, Downing NL, Tang M, Sharp C, Longhurst C, Huckman RS. Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use. Journal of the American Medical Informatics Association. 2022;29(3):453-460. doi:10.1093/jamia/ocab268
4. Berg S. What Doctors Wish Patients Knew About Using a Patient Portal. American Medical Association. June 17, 2022. Accessed September 27, 2024. https://www.ama-assn.org/practice-management/digital/what-doctors-wish-patients-knew-about-using-patient-portal

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Disclaimer: The AMA's Debunking Regulatory Myths (DRM) series is intended to convey general information only, based on guidance issued by applicable regulatory agencies, and not to provide legal advice or opinions. The contents within DRM should not be construed as, and should not be relied upon for, legal advice in any particular circumstance or fact situation. An attorney should be contacted for advice on specific legal issues. Additionally, all applicable laws and accreditation standards should be considered when applying information to your own practice.