My spouse is a physician, and "patient messages" (aka "non-face-to-face" encounters) usually aren't reimbursed by insurance. Having a friendly online conversation with a patient doesn't generate the "RVUs" they need (contractually!), so time spent messaging is time taken out of their personal day on top of their regular workload.
Responding to messages can also just be very difficult and time consuming. Maybe you ask concise, clear, pertinent messages to your doctor (or think you do!), but most do not. It's similar to problems HN readers might be more familiar with: user-created support tickets, and comment moderation. Medical office staff help with this triage and moderation, but it has become a big problem to manage with how easy it now is for bored/sick/scared patients to send messages.
Glad to see this mentioned (twice even!). Ambrosia Software! This was the first game I was really exposed to "mods" and user created content with, too. Takes me back!
Responding to messages can also just be very difficult and time consuming. Maybe you ask concise, clear, pertinent messages to your doctor (or think you do!), but most do not. It's similar to problems HN readers might be more familiar with: user-created support tickets, and comment moderation. Medical office staff help with this triage and moderation, but it has become a big problem to manage with how easy it now is for bored/sick/scared patients to send messages.