The operational business model of most doctor’s practice offices is horrendous. Appointments are never on time and hurried. Standard protocols are employed and no one is thinking outside the box.
I am sorry that the insurance companies have to some extent shaped this system and applaud your efforts to change it.

The fact remains that the use of Email would cut down on phone calls and workflow interuptions.

In closing, in ancient China, Doctor’s were only paid if their patients felt better!!!

I am not asking for a 1 hour consultation when I email.

Maybe my E-mail could be to order lab work or ask to change medication or share the latest research I have been looking at regarding my disease. But NO I have to call staff that never pick up plus have trouble speaking english as a language.

This communication stone wall I am facing is an outrage and only serves to limit quality healthcare.

Dr House…. Even Foreman on your TV show would agree with me.

The Doctors’ unwillingness to use email is symtomatic of their crass and uncaring attitude. I can’t reach my doctor on Wednesdays and anytime after 3:30.

Plus I can’t shoot her an E-mail.

And they took an OATH?????

Despicable!!!!!!!

They have isolated themselves.

Nancy R. Terry

Author Information

Advances in communications technology have altered the way that people interact with one another, both globally and within the same household. It has also affected the way that physicians communicate with their patients. Recent postings on Medscape’s Physician Connect (MPC), a physician-only discussion board, address the issues involved in email communications between physicians and their patients.

“How many times have you played phone tag with patients?” asks a doctor in family medicine. “Email gets the patient’s concern and your reply across without having to rely on timing.”

“I use it to communicate with family members of my patients in the ICU,” offers a New York neurologist. “Dealing with patients by email can save headache if you have a difficult personality,” says another MPC member.

Gerald W. Staton, Jr., MD, Professor of Medicine at Emory University School of Medicine, said in an interview with Medscape, “I communicate all the time by email with patients who want to communicate that way. They don’t have any trouble getting my email address from the Emory Web site, and if they initiate the email, I respond.” Dr. Staton admits that his institution has a problematic phone system, which makes emailing the easier form of communication. “I have had one or two patients who abused email communication, but most have been very appropriate. So, bottom line, I like communicating by email with patients.”

Some MPC members see few advantages to emailing patients: “Communicating by email with patients sounds attractive, but is easily prone to abuse.”

“Keeping up with your emails in a timely way is not any less demanding than keeping up with phone messages, which you will continue to get also,” says one harried MPC community member. A New York department head at a major teaching institution agrees. “I get about 200 emails per day, and I’m not looking for more.” However, he adds, “When patients live in other countries, it is often the only practical way to communicate.”

Apart from the necessity of responding to an increased volume of emails, the harried MPC poster considers emailing patients to be a medicolegal minefield. “These emails are discoverable, even when they haven’t been formerly incorporated into the medical record. They are also never truly confidential, because copies of them exist on every server that handles them.” The New York department head points out that his institution discourages emails concerning patient care because emails are not confidential (for example, a patient’s employer can access the physician’s email) and, therefore, not HIPPA compliant.

One method to eliminate the problem of confidentiality, says one MPC physician, may be to use email services such as http://www.housedoc.us, which are encrypted and HIPPA compliant.

A critical care physician is concerned about the potential of emails to be used by litigious patients. “Every email you send is saved for posterity and can be manipulated for future lawsuits.” Another member has even stronger reservations about emailing patients. “I am computer savvy, yet I do not use emails to communicate with patients — no, no, no. Until people stop suing, no medical email communications for me!”

For some, the specter of malpractice lawsuits seems no more a threat with email than with other forms of communication. “It’s actually no different than any communication,” says an MPC physician. “We are now legally required to maintain a written record for each interaction, whether in or out of the office. Otherwise, you can’t prove what was said if challenged.”

Dr. Staton is not particularly concerned about email communications being used in malpractice lawsuits. “I just refuse to worry about the lawsuit issues. My word is my word, whether I speak it or write it; I figure I should stick by what I say.”

To reduce the potential for patient abuse of email, one MPC contributor advises, “Make it clear that the medium is not for emergency use and you will charge for the service (no insurance). They’ll think twice about using it.”

Do you personally agree or disagree with consumer-direct health care reform?

Would consumer-direct insurance allow the people to buy insurance from other insurances?

80% of health costs contribute to preventable diseases, why doesn’t the government focus on preventing diseases instead of cures? (In your opinion)

Should health care be a basic right?

Is health care something the U.S. should be focused on?

Why do most doctors change their work field? Does med school factor into the shortage of doctors we have?

Inversely, the MDs against the use of email with patients do not seem to have understood that, in the world we are all developing together, medical knowledge is a network (one of the principle of participatory medicine).

Soon we will start real large scale implementations of PHR. When this happens only the doctors who have developed or transformed their practice to actively use email communication (or other forms of secure electronic communications) with their patients will be competitive!

I’m interested in medical journal articles (which I suspect will be the most influential among health professionals) as well as popular press accounts (like this AP story, which reach the rest of us). You can email me at sfox(at)pewinternet(dot)org.

1) It is more efficient. Both patients and I have complicated schedules and it is frustrating to play phone-tag.

2) It is a competitive market place and I feel that by providing better service (communication), I can compete better.

It certainly isn’t for everyone. But I feel it is the direction we are heading. Particularly with the convergence of the phone/text/email/PDA/beeper.

I harbor the suspicion that many doctors don’t want to use email because they type slowly! But I agree with the article – it’s only a matter of time ’till email is the norm.