The Pros and Cons of Emails Between Doctor and Patients

Some physicians hesitate to let patients reach them via email

Thoughtful male doctor sitting at desk in hospital
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Doctors and therapists all have emails, but many physicians are hesitant to allow patients to contact them via email.  

Why Some Doctors Object to Patient Emails 

Some doctors say that email would take too much time out of an already busy schedule. In contrast, other doctors who have begun to have email contact with patients find that this modality actually saves time.

Doctors are also concerned about the confidentiality of email and the fact that email creates an electronic "paper trail" that may be used against them at some point.

Hospitals and health care organizations have been split on whether emails between doctor and patient should become a part of the medical record. Some are now interpreting HIPAA regulations as requiring the inclusions of these emails into the medical record.

Why Patients Prefer Email

A Harris Interactive poll found that 90 percent of patients wanted to exchange email with their doctors, but only 15 percent of patients actually did so. A New York Times article cited physician fears about email, including the concern that "one sympathetic response (to a patient's question) could cascade into a flow of demands and questions."

Doctors who do have email contact have found that these fears aren't valid. A doctor at Beth-Israel Deaconess Medical Center in Boston reported receiving six to 10 emails a day from patients and spending two minutes responding to each. He also reported receiving eight to 10 phone calls a day and spending three to five minutes on each (often after playing phone tag).

AMA Email Guidelines

The American Medical Association developed a set of standards to guide physicians in their email communications with patients. These guidelines include the suggestion that doctors "establish a turnaround time for replying to messages from their patients;" "exercise caution when using e-mail for urgent matters;" communicate their email policies and procedures to patients (including letting patients know who else will have access to messages) and letting patients know that their messages might be included in their medical record.

Doctors are also encouraged to "acknowledge that they received patients' e-mail and ask them to acknowledge that they have read clinicians' messages" and to "print and place messages from patients, their replies and confirmation of receipt in patients' paper charts, except when they determine that the messages contain highly sensitive information."

What Patients Should Consider About Emails

Patients should consider the following points:

  • Ask your doctor or therapist his or her policy on email communication and abide by that policy.
  • If email is allowed, email only when you have a real concern and keep messages short.
  • Be aware that email is not completely confidential and that your email may be printed and placed in your chart.
  • Do not use email for urgent communications. Use the telephone. You usually have no idea how quickly your email will be read.
  • When you get a reply, acknowledge that you read it and, if appropriate, that you are acting on the suggestions. Do not try to start an ongoing email conversation unless there are legitimate unaddressed issues.
  • Don't forward jokes or witty sayings to your doctor or therapist. If you have found an article that you think particularly applies to you, consider forwarding only the URL (web address).

Email can become a convenient way to communicate brief information between visits if used with care. A telephone call usually interrupts something. A therapist or doctor can read and reply to email when he or she wants to. Limits may need to be set with certain patients, similar to limits that are frequently set on telephone calls. At some point email communication between doctors and patients will be as common as telephone contact. We have a long way to go.

Hafner, Katie. Why Doctors Don't Email. New York Times on the Web (Mobipocket version). June 7, 2002.

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