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Does Providing Email to Patients Benefit Patient-Physician Communication?

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I'm a strong advocate of patient-physician communication by email.

In the Archives of Surgery, a paper was recently published examining the effect of surgeons providing email addresses to patients prior to thyroid or parathyroid surgery. Half the patients received a sheet providing the email address and a statement saying that email was the surgeons' preferred means of communication. The other half received an information sheet without an email address or remark about a preferred means of communication. (The email addresses, however, were also available to both groups on the appointment card and website.)

Here are the results:
Overall, 26 of 100 patients (26%) initiated additional perioperative communication with the surgeon, 19 of 50 (38%) in group E [recipients of email addresses] and 7 of 50 (14%) in group S [no email addresses provided](P < .001). Of those who initiated communication, 22 of 26 (84%) did so by e-mail; 3 (12%), by fax; and 1 (4%), by telephone. For patients using e-mail, 18 of 22 (81%) were in group E and 4 of 22 (18%), in group S (P < .02). Overall, 34 e-mails were sent by 22 patients in the study group. Most e-mails sent focused on only 1 issue; however, some patients raised multiple issues, with the most being 4 issues in a single e-mail. There were no differences in any of the outcome measures in relation to patient satisfaction with communication.
The study authors remark that "Despite concerns about potential medicolegal issues and other disadvantages, providing patients undergoing elective surgery with e-mail access to their surgeon results in improved levels of communication without any demonstrated impairment of satisfaction with outcomes."

What can we learn from this study? When provided with an email address, more than twice as many patients contacted their doctors. On the face of it, this seems like a good thing -- more communication, more questions answered, better informed patients, better patient-physician relationship.

However, the study failed to show a significant difference in patient satisfaction between the two groups. Those who are skeptical about the value of email between physicians and patients might argue that this proves that email provides no demonstrable benefit. With all this additional communication by email -- none of which is reimbursed -- where's the increase in patient satisfaction? The skeptics might reasonably ask: why bother?

In balance, I think this study provides ammunition to both sides of the patient-physician email debate.

(Also posted on The Efficient MD.)

Photo Credit: Eduardo O.
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About the Author


MD, FACP, FASN

Dr. Schwimmer's blog explores the intersection of medicine, new technologies, and the Internet.

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