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Online and On Call: Part Two

© Michael Wysocki

Doctors’ Concerns About Email

Despite email’s propagation throughout society, most physicians have not been willing to accept it as a method of communication with their patients.

A recent survey of physicians conducted by Healtheon indicated that only 3% of physicians routinely use email with their patients. Although a larger percentage has used email with their patients at some point, and the overall use has risen since Healtheon's prior survey, the number of regular physician users of electronic communication is still quite low.

Why is this?

There are many reasons for this, and understanding them will sensitize you to physicians’ concerns and make the discussion with your own physician easier. Although it is not fair to generalize these issues to all physicians, many do share at least one of these concerns.

Reimbursement for time
High on the list of physician concerns are issues related to time and reimbursement for it. Physicians, unlike attorneys, accountants, consultants, and other professionals, are not able to bill for time they spend communicating with their clients.

Physicians are wary of anything that might cause them to spend even more time on the job with no apparent reward. They are especially concerned about the potential for patients to abuse the privilege and send frequent or rambling messages.

Ironically, the physicians who have these time concerns are generally those who have not yet used email in their practices. Generally, the use of email replaces the telephone calls that were previously required to manage these patient inquiries. With email it is actually more difficult to have long, tangential discussions, than on the telephone.

Also, email can be answered when it is convenient, which can often be early in the morning or late at night when it would be impolite to call patients back.

Finally, patients are generally respectful of their physicians’ time and do not bombard them with email messages.

Lack of patient use
Because a majority of physicians are not asking patients about email, the assumption that patients do not or cannot have access to email is just that - an assumption. The explosion in access to the Web has not missed special populations.

Statistics show access to the Web is increasing among all socioeconomic strata. Data also show prominent use of the Web among elderly patients. The perceived lack of patient use really amounts to doctors not discussing the email option with their patients.

Medicolegal implications
The next issue of concern to physicians is the legal ramifications of using email. They do not understand this new technology and are concerned they will get themselves into trouble.

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