(NewsNation) — A new study shows hospital systems are now charging patients for text messages and emails to the doctor, and it could affect whether or not they get care.

The Journal of the American Medical Association reported that charges can range from as low as $3 to as high as $100. When patients knew they could be charged for messaging their doctor, researchers found some people were less likely to seek out care.

Dr. Chad Domangue joined NewsNation to discuss the reasons doctors may charge, especially those in smaller practices.

“In my practice, I get about 200 phone calls a day, I get hundreds of emails a day, I’m a single doctor, you know, I employ 20-something staff members,” he said.

The volume of messages can make it difficult if doctors aren’t being reimbursed, he said, as well as taking time away from seeing patients.

“Right now, if I do telemedicine, I’m getting about a 30% reduction, or reimbursement, versus seeing in person,” Domangue said.

There is a difference when it comes to large hospital systems, which make money off tests and other services, like imaging, as well as patient visits.

“From a hospital standpoint, they should not be taxing a patient as much, because they have much better electronic medical record systems. They have multiple staff members,” he said.

Telemedicine expanded greatly during the pandemic, and health care systems are still adjusting to the changes. Not all systems charge for messaging, and the charges may also vary based on the type and complexity of the request.