Can you just write me a quick letter?
A patient emails asking for a sick note for the days they missed work last week. Another needs a fitness-to-fly letter before a trip in ten days. A parent wants a letter for school about their child's absence. Someone else needs a letter confirming a condition for a gym membership or a travel insurer.
Each email is a short conversation. Reception reply to ask for dates, the airline's wording, the school's name. They check whether a fee applies, send a payment link, wait for it, then put a note in the doctor's task list. Some requests need the patient to be seen first, which the doctor decides, so there is another round of emails to book that.
By Thursday there are thirty of these, all in different states, in one shared inbox.
Why letters take far more time than they should
The requests arrive unstructured. Patients do not know what details the doctor needs, so the first reply is always a question. Fees are handled separately from the request, so payment and work drift apart. Doctors receive requests as free text in a task list with no indication of the deadline, such as a flight date.
There is no status for the patient, so they ask again, often through a different route. A single fitness-to-fly letter can generate a handful of emails and a phone call before it is sent.
What the drip of letter requests costs
| Hidden cost | Where it lands |
|---|---|
| Back and forth for details | Reception inbox time |
| Unpaid letters written | Lost fees for chargeable work |
| Deadline missed | Patient misses a flight or deadline, complains |
| Doctor interruptions | Requests arriving mid-surgery by message |
| Duplicate requests | Same letter asked for by phone and email |
How we build a letter request route
- A request form on your website or patient portal, with one path per letter type you offer. Each path asks for what that letter needs, such as travel dates or the organisation it is addressed to.
- Your fee for that letter type is taken at the point of request through Stripe or your card provider, or marked for invoicing where you prefer.
- Phone and email requests are entered by reception into the same form, so every request looks the same.
- Each request goes to a doctor's queue, ordered by the date it is needed by, with the patient's details linked to their record.
- The doctor can mark a request as needing an appointment first, which sends the patient a booking link, or as done, which sends the letter securely.
- Patients see status updates by text or email: received, with the doctor, sent.
Whether a letter can be written, and what it says, is always the doctor's decision. The form never promises the patient a particular outcome, and the wording makes that clear before they pay.
After the change
The shared inbox stops being the letter system. Requests arrive complete and paid for, or clearly marked for invoicing. Doctors work through a queue in date order between appointments. Patients stop chasing because they can see where their request is. Refund rules for letters the doctor declines are applied the same way every time.
Reception still take phone requests from patients who prefer to call, but the call is short because the form tells them exactly what to ask. And because every request is logged, the practice can see which letter types are most common and decide whether any of them deserve a clearer page on the website explaining what the clinic does and does not provide.
Are letter requests eating your week?
- Most letter requests start with you asking the patient for more details
- Fees for letters are collected separately, or sometimes not at all
- Doctors get requests with no deadline shown
- Patients ring to check whether their letter is done
- Nobody can list the letters currently outstanding