Why Doctors Don't Email Patients

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Vector version of 100pxImage via WikipediaIt's no secret that I'm a strong advocate of patient physician communication by email. (See, for example, "Does Providing Email to Patients Benefit Patient-Physician Communication," "Someone Please Create Free, HIPAA-Compliant Patient-Physician Email," and the three part "Thoughts on Patient Physician Email.")

The Associated Press published a story recently with the following title: It's no LOL: Few US doctors answer e-mails from patients.
Kreuziger’s experience is shared by most Americans: They want the convenience of e-mail for non-urgent medical issues, but fewer than a third of U.S. doctors use e-mail to communicate with patients, according to recent physician surveys.

“People are able to file their taxes online, buy and sell household goods, and manage their financial accounts,” said Susannah Fox of the Pew Internet & American Life Project. “The health care industry seems to be lagging behind other industries.”

Doctors have their reasons for not hitting the reply button more often. Some worry it will increase their workload, and most physicians don’t get reimbursed for it by insurance companies. Others fear hackers could compromise patient privacy _ even though doctors who do e-mail generally do it through password-protected Web sites.

There are also concerns that patients will send urgent messages that don’t get answered promptly. And any snafu raises the specter of legal liability.

Many patients would like to use e-mail for routine matters such as asking for a prescription refill, getting lab results or scheduling a visit. Doing so, they say, would help avoid phone tag or taking time off work to come in for a minor problem.

Still, a survey conducted early last year by Manhattan Research found that only 31 percent of doctors e-mailed their patients in the first quarter of 2007...
I'm surprised that almost a third of doctors emailed their patients, frankly. I would have suspected the number would be lower.

The article goes on to say that Cigna and Aetna have piloted programs which pay doctors for making "virtual house calls" through email. This is a step in the right direction. Dr. Robert Center points out that the lack of payment has been a major barrier to more widespread adoption of patient-physician email.
As I write repeatedly, physicians are not paid for their time, they are paid by the widget. The patient visit is our version of the widget. Anything that we do to prepare for that visit, communicate between visits, review the tests induced by that visit or discuss you problem with another physician is gratis. We cannot bill for the proper use of time to improve the patient experience.
For further reading on patient-physician email, see


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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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