About that Email

There are two ways to look at this: Almost one-third of physicians email their patients, or, less than one-third of physicians email patients. An AP article yesterday takes the latter approach, and does a good job of summarizing the industry trend.

MedGadget reported last month that a number of health plans, including Aetna and some Blue Cross plans, are paying around $30 for email consults. Patients like it for many of the same reasons that email is used in the workplace – convenience, it’s asynchronous and there is a record to be referred to. Physicians, understandably, are concerned about being overwhelmed, with the potential for legal exposure and the lack of “hands on” interaction.

In the AP article, Dr. Daniel Z. Sands of Beth Israel Deaconess (a Harvard affiliate) points out that email has its place. If a patient email takes more than two “volleys” to adequately address, a phone call is in order. The article further suggests that “Most studies have shown patients don't abuse e-mail. They generally don't deluge doctors with rambling messages, and Internet exchanges may even help doctors' productivity and cut down on office visits.” My internist’s group recently introduced a secure telephone messaging system for lab results – my physician recorded, at his convenience, a message with the results, what they mean and what to do. I called in – at my convenience – and listened to the message. He could sit down with a stack of charts and make a series of calls – no chit chat, no missed calls, no need to repeat what he said, as the patient can simply listen to the message again. A letter was sent as well to back this up. For my physician, he could readily include comments that would not be conveyed if I simply called in and spoke with an assistant.

In some ways, we’re still learning how to work with email. It clearly has utility and is efficient, sometimes replacing phone calls, and sometimes encouraging contact. For many working people, there is a limited ability to make a private call during office hours. We do need to learn how to communicate well with the written word – dictation software can help, but we still will need to learn to be precise in our words and remember that the audio and visual cues are missing. The ability to be paid for email consults will be a boon, and as rather ironic considering that telephone consults are not generally covered by insurance plans. One of those oddities of life, I suppose.

Start exploring the available options, and start testing the use of these capabilities. Saving time has value, improving the clarity of communication has a lot of value, and being paid for at least some of it is a well-deserved bonus.