As the value of bitcoin climbed last year, so too did its public prominence. Still, the cryptocurrency isn’t accepted in all that many brick-and-mortar shops. But a smattering of clinics across the U.S. have started taking the currency, allowing patients to pay their medical bills or their copays with bitcoin — though, in many cases, they aren’t getting any takers.
My Doctor Medical Group, a practice of seven of physicians with an office in San Francisco, has allowed patients to pay with bitcoin since 2013 — with some limits.
“We serve a lot of tech entrepreneurs who were early investors in bitcoin,” said Dr. Paul Abramson, founder of the practice. “They have a lot of it, and they want to use it. So we figured out how to do it.”
Still, Abramson says, only about 2 percent of patients pay with bitcoin, and that’s partially by design. “It’s patients we know really well,” he said.
Other, smaller clinics say, however, that though they’ve advertised accepting bitcoin for years, they’ve never had a patient ask to use it.
“I wanted to appeal to people who use it, because I was interested in bitcoin as a concept,” said Dan Vo, who manages Central Urgent Medical Care, a Los Angeles walk-in clinic that has accepted bitcoin for a few years. But, he said, the clinic hasn’t ever had a patient pay with the high-tech currency — maybe because of its high barriers to entry. “People have to go through a learning curve just to use it,” Vo said.
Across the country in New York City, Dr. Liliya Etkina runs a private dental practice that began accepting bitcoin five years ago — but also never had a patient pay with it.
“I think somebody inquired once, but no patients have used it yet,” Etkina said.
According to coinmap.org, which tracks bitcoin adoption worldwide, there are about 10,000 brick-and-mortar businesses currently taking bitcoin payments. Of those, about 200 have names that include words like “clinic,” “nursing,” “Dr.,” “surgery/surgical,” “dental,” “health,” or “medical.” That’s about 2 percent of the total.
Bitcoin exists not as actual coins but as specially encrypted computer code. Functioning outside the control of any government or banking system, bitcoins are shared through a network of users. It’s a bit like a digital version of a local currency that is valid only at participating stores. Users keep their bitcoins in an electronic “wallet” installed on a computer or smartphone. They spend it by sending a key code to a recipient’s wallet, allowing that user to receive a set amount of bitcoin units. Some vendors allow users to scan a QR code in order to transfer bitcoin.
That approach has a number of things going for it, supporters say. For one thing, it requires neither cash nor checkbook nor credit card — just a smartphone.
An unexpected injury can cost more money than many people might be carrying with them, said Vo, who sees sprains and cuts and other injuries at his urgent-care clinic.
“So, if you get stitches, plus some maintenance care, that’s going to run you about $300-$400,” he said. “Right now, that’s about .03 to .04 in bitcoins.”
And since bitcoin transactions are anonymous, patients “don’t have to have a transaction linked to them where they’re being treated for something sensitive,” Abramson said. Paying in bitcoins means that patients can discretely get cosmetic surgery, cancer treatment, or treatment for sexually transmitted infections, he added, without a paper trail.
Finally, providers can save on the fees charged for credit-card transactions.
“It costs us less than credit cards to process,” explained Abramson. “It’s like .5 to 1 percent instead of 2 to 3 percent.”
But there are other fees to consider — as well as the sometimes cumbersome nature of the technology itself.
“It can take hours to transfer bitcoin from one wallet to another,” Abramson said. “You have to pay a bigger fee for a faster transfer. And that fee can wipe out a smaller transaction. If you’re transferring, say, $20 worth of bitcoin, the cost of doing that can be $20.”
Abramson’s medical practice always exchanges bitcoin for dollars immediately: “We’re not trying to be speculators.”
For other clinics, it may be a while before they reach that point.
“I had a sign up, and I was waiting for it to catch on,” Vo said of his urgent care clinic. “But it seems like it’s still too early.”
But Abramsom thinks that health care will come around in time.
“My grandfather and great-grandfather were surgeons, and they took chickens as payment,” Abramson said. “This isn’t really much different.”