Does my medical practice need a patient portal?

For sharing records, results and secure messages, yes, and most patients now expect it. The portal that comes with your electronic health record covers that, and federal rules already push you to give patients electronic access to their information. But do not confuse having a portal with growing your practice. A portal is a locked room patients need a password to enter, and most already have several they rarely open. It is good for existing patients managing their care. It does almost nothing to win a new patient who is deciding whether to book with you.

What is the difference between a patient portal and online booking?

A patient portal is a private, password protected account where an existing patient views records, messages the office and pays a bill. Online booking is a public button on your website or Google listing that lets anyone grab an appointment in a minute with no account required. They solve different problems. The portal serves people who already chose you. Online booking helps strangers become patients. New patients almost never want to create a portal account just to schedule a first visit, so hiding booking behind a login is one of the most common ways practices lose them.

Do patients actually use patient portals?

Use is rising but uneven. In 2024, 77 percent of individuals were offered online access to their records and nearly two thirds accessed them at least once in the year, according to federal ONC data. But only about a third log in six or more times a year, and 59 percent juggle two or more separate portals. Only 7 percent use anything to combine them. So patients tolerate portals for records and results, but many avoid the logins, which is exactly why the everyday things like booking, reminders and questions work better outside the portal.

Should patients have to log in to book an appointment?

No. Forcing a login before someone can book adds a wall between a ready patient and your schedule, and a share of people give up at that step. Let new patients book in a minute with no account, then invite them into the portal after they are on the calendar, once there is a reason to log in. Booking should feel like buying a movie ticket, not opening a bank account.

Is a patient portal required by law?

Federal rules under the 21st Century Cures Act require that you give patients timely electronic access to their health information and do not block it. In practice most practices meet that through the portal built into their electronic health record. What the law does not require is that patients use a portal to schedule, communicate or interact with your marketing. So keep the portal for records and compliance, and keep booking and everyday contact open and login free.

Does Your Practice Need a Patient Portal?

Two patients looking at a health app on a phone, the kind of everyday screen where booking and reminders happen outside a patient portal — Your patients live on their phone, not inside a login. The everyday moments that book and keep patients happen where they already are. Photo via Pexels.

A dermatology office called us last year, proud of a big decision. They had just paid for a shiny new patient portal. Records, messaging, bill pay, the works. Three months in, they were frustrated. Barely anyone used it, the front desk was still buried in phone calls, and new patient numbers had not moved an inch. What went wrong? Nothing, really. The portal was fine. They had simply bought a tool for a problem they did not have, and skipped the one they did.

This is the trap hiding inside the question. Should your medical practice offer a patient portal? Yes, in a narrow sense, and it will not do what most owners hope. Let us separate what a portal is actually good at from what actually grows a practice, because they are not the same thing.

First, what a patient portal really is

A patient portal is a private, password protected account tied to your electronic health record. Inside it, a patient who already chose you can look at lab results, read visit notes, send a secure message to the office, request a refill and pay a bill. That is genuinely useful, and it is increasingly expected. Federal rules under the 21st Century Cures Act already push you to give patients electronic access to their own records, and the portal that ships with your record system is the usual way practices meet that.

So on the records and compliance side, this is close to settled. If your electronic health record includes a portal, turn it on and use it. The real debate is not whether to have one. It is what you expect it to do.

Patients do use portals, and they are also drowning in them

Here is the part that surprises owners. Portal use is actually up, and patients are honestly sick of them at the same time. Both things are true.

According to federal ONC data from 2024, 77 percent of individuals were offered online access to their medical records, up from 73 percent two years earlier, and nearly two thirds got in at least once during the year. Good news on the surface. Then look closer. Only about a third of people log in six or more times a year. And a striking 59 percent now juggle two or more separate portals from different doctors, labs and insurers, while only 7 percent use anything to pull them together.

59% Most patients now manage two or more separate portals, each with its own login, and only 7 percent use any tool to combine them. Source: ONC, Individuals' Access and Use of Patient Portals, 2024.

Sit with that number. Your new portal is not landing on a clean desk. It is the sixth app fighting for a password your patient already forgot. Researchers who study this call it portal fatigue, and it is exactly why so many people open one to check a result, then never log in again. When your everyday practice runs through a portal, you are asking busy people to clear a hurdle every single time they want to reach you. A lot of them just will not.

The mistake: hiding the front door behind a login

Now to the expensive error we see all the time. A practice gets excited about the portal and starts routing everything through it. Want to book? Log in. Have a quick question? Log in. Fill out your forms? Log in. It feels organized. It is actually a wall.

Think about the person you most want to reach: someone who found you an hour ago and is deciding whether to book. They do not have an account. They will not make one to schedule a first visit with a doctor they have not met. The moment your booking button asks a stranger to create a login, a chunk of them leave and book with the next office instead. We wrote a whole piece on why patients abandon your online booking form, and forcing an account before they can pick a time is near the top of the list.

The simple rule that fixes most of this

A portal is for people who already chose you. Your public website and booking are for people deciding whether to. Never make a new patient log in to do something they should be able to do in a minute as a stranger, like book, ask a question, or fill out an intake form. Let them in the easy way first, then invite them into the portal once they are on the calendar and there is a real reason to log in.

What actually wins and keeps patients

If a portal is not your growth engine, what is? The open, login free things patients already reach for. None of these require anyone to remember a password.

Online booking with no account required

The single highest value upgrade for most practices is letting anyone grab an appointment from your website or Google listing in under a minute, no login. Patients increasingly prefer to book this way, and many will only do it if it is truly frictionless. We broke this down in online booking for medical practices and in whether patients prefer to book online or call. Bonus: you can even let them book straight from your Google Business Profile, before they ever hit your site.

Text messages, not portal inboxes

When you need to reach a patient, meet them where they already are. People read texts within minutes and open portal messages, well, rarely. Reminders, confirmations, a quick follow up after a visit, a note that results are ready. A text lands. A portal notification that sends them off to hunt for a password does not. We covered the case for this in whether practices should text patients.

Online intake they can do from the couch

Forms are worth digitizing, but send a simple link they can fill out at home the night before, no account needed. That calms the patient, protects your schedule and saves the front desk from a stack of clipboards. More on that in using online intake forms.

A front desk that actually answers

None of the tech matters if the phone rings out. Studies of medical practices find a large share of calls go unanswered during business hours, and most people who hit a voicemail simply call the next office. A portal will never fix that, because the patients you are losing are not logged in, they are on hold. If your calls slip through, our AI receptionist answers every one, day or night, and books the appointment on the spot.

Our honest opinion

Here is where we plant a flag. The industry loves to sell practices a portal and call it patient engagement. We think that is backwards. A portal is a filing cabinet with a lock on it. It is useful, and it is not marketing. Real engagement is measured by how easy you are to reach and to book, not by how much you can cram behind a login.

So our advice is simple. Turn on the portal that comes with your record system, use it for records, results and secure messages, and stop there. Do not spend a fortune on a fancier one hoping it brings new patients. Put that money and that energy into the open front door instead: a fast website, login free booking, texting, easy intake and a phone that always gets answered. That is where new patients are won and current ones are kept. The portal is a nice back room. The front door is your business.

A quick gut check we give owners: pull out your phone and try to book yourself as a brand new patient. Count the taps. If you hit a login screen before you ever reach a time slot, you just found a leak, and it is costing you more patients than any missing portal feature ever could.

How EtherealMinds thinks about this

When we build a patient acquisition system for a practice, the portal is not the centerpiece, the open front door is. We build a website that converts with booking a stranger can complete in under a minute, wire up texting so reminders and questions actually reach people, add login free intake, and back it all with reception that never drops a call. The portal keeps doing its small job in the background. Everything that touches a new patient stays open, fast and password free. That mix is what fills a schedule, and a portal on its own never will.

So, does your medical practice need a patient portal? Offer the one built into your records for what it is good at, and do not ask it to grow your practice. Growth comes from being the easiest office in town to find, reach and book. Get that right and the portal becomes a small helpful detail, instead of an expensive thing you keep wondering why nobody uses.

Make your practice the easiest one to book

Book a free strategy call. We will look at your website and booking as a brand new patient would, find every login and dead end costing you appointments, and build the open, login free path that actually fills your schedule. No jargon, no pressure.

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Does Your Medical Practice Need a Patient Portal?