Well, this depends on a variety of things. It depends on the physician's specialty and the kind of patient care he is doing. It depends on the market, geography, demographics, as well as the kinds of payers in the area. It depends on the business model of the physician. If a physician is in a fee for service model accepting insurance, there is no reimbursement for phone calls, emails, Instant messages, facebook interactions, twitter recommendations, blogging, responding to blog comments, etc. Physicians in fee for service medicine often contract with hospital entities offering " call centers" to handle phone triage from patients at night. Doctors pay for this out of pocket. This is common in large metro areas. Very large entities just create their own call centers (like Kaiser) Some markets physicians utilize their own staff, either RN's or Midlevel providers to handle evening calls. Physicians that are in cash businesses that are out of the realm of third party payers often deal directly with their patients in the evenings, notably lasix surgeons, plastic surgeons, and direct practice physicians as seen at www.personalmedicine.com There is a new kind of physician that is starting to crop up that utilizes modern communications and social media in a variety of platforms to broadcast information to patients on a large scale. We use blogging platforms, social media platforms as slideshare, twitter, linked in, facebook, to " interface" and create community with our patient families. Note that these interactions are outside of and distinct from the medical record and do not give specific advice to a specific patient about a specific complaint. But I would also consider our Patient health record ( that our patient families access through our websites securely) to be another " touchpoint" or " interface" that improves the physician patient relationship. Other notable experts in this arena are Allan Greene a Silicon Valley Pediatrician, Epatient Dave, a Boston patient advocate and perhaps the first " epatient" and Trish Torrey,another advocate of patients and friend of the patient health record.