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Sesame, a virtual and in-person primary care provider with direct-pay pricing, has now added the ubiquitous  doctor’s note to its list of services. In the company’s press release, it clearly draws competitive battle lines in the market by calling out urgent care as an option that “is quite expensive” for patients who need to obtain doctor’s notes for work or school. Sesame offers the notes free of charge with paid consultations, which start at $30.

There are two sides to the coin: If the only thing a mildly ill or recovered patient needs is a note for school or work—either to legitimize their absence or to verify their return—then the $30-ish charge for a Sesame appointment probably makes good economic sense. Sesame may lure some note-seeking patients away from urgent care based on price alone. But before urgent care operators double down on attracting their note-seeking customer base, they would be wise to consider the fact that the doctor’s note is double-edged sword, as described by Editor in Chief Joshua Russell, MD, in Broader Issues Surround ‘Work Note Seeking’ in a recent issue of JUCM.  Dr. Russell estimates there are nearly 10 million urgent care visits each year for doctor’s notes. If the average charge for each visit is a conservative $100, then doctor’s notes for work or school represent about $950 million in revenue. At the same time, many of those 10 million visits are explicitly just to obtain the note—with no treatment necessary—and they occupy the schedules of busy clinicians whose time might be better spent treating higher-acuity patients who do need their attention.

Sesame Competes With UC on Doctor’s Notes
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