Something that nearly any other company would have been banished to the spambox for.
You also used to be able to reply to the message by replying to the notification email, so you could be a full conversation participant solely through email without ever opening the app.
Social media is best suited to that kind of business model - and most people won’t pay for a subscription.
So social media is broke?
I have it turned off, and the last 15 notifications are friend activity that has nothing to do with me.
Or it might have been just the doctor until someone complained and from that point on just the fact that Facebook knew about it might make them suddenly and automatically liable for further bad behaviour.
At the same time, that also makes it irrelevant to the point at hand, since it's not Facebook messenger at all, just general health posts and items offered by that medical group.
Any one that does communicate through them with their doctor, most likely doesn't know what HIPAA is or care.
To FB, it is the old "don't ask or tell" scenario.