Healthcare IT Supply of Medical Services

Physician-Patient email communication: a review

We are now in the information age. Let’s take a look at the following numbers:

  • Internet World Stats reports that approximately 70% of Americans now have access to the Internet. (This puts it 7th in the world in terms of Internet penetration).
  • Over 85% of physicians have access to high speed internet in their offices. Sixty-three percent of physicians use email to communicate with friends/family, other doctors, or other business.
  • Among individuals with Internet access, 90% want to communicate with their physician over email. In fact, 56% of patients claim that having the ability to email their doctor would influence their choice of doctor.

One would expect that the physician-patient web messaging would be increasing at a rapid pace; however, this is not the case. In a study conducted in 2005, only 16.6% of physicians had used email to communicate with their patients. Less than 3% of physicians use email “frequently” as a means to exchange information with their patients. This is relatively shocking. Let’s now look at some pros and cons of web consulting.


  • Ends the problem of telephone tag
  • Is convenient for consumers. For instance, prescription drug refills, appointments and diagnosis of simple diseases can all occur over email.
  • Allows patients a more impersonal forum to discuss sensitive topics.
  • Email provides an easier means for documentation than the telephone.
  • Receiving information regarding a patient’s condition before a patient comes to the office, can lead to a more efficient visit.

Cons (and some fixes)

  • Doctors fear that they will be overwhelmed with emails. Most studies have shown that this is not the case. Doctors also fear that the emails will be extremely long (“please answer the following 18 questions…”). An integrated web system in which emails are limited to a certain number of characters could prevent this.
  • Responding in a timely manner is important. For instance

Sometimes [the nurses] filter questions [received by phone] appropriately but sometimes they don’t. With e-mail, when patients mail me a concern I get it.I had a patient e-mail me with questions about whether he needed a tetanus shot [after an acute event] and I got the message [several days later]”

  • English only? Limiting email to English only, may cause problems for ESL (english as a second language) patients.
  • Payment. Few doctors charge for consults via email. Having a charge per email or a monthly ‘retainer’ to be able to email the doctor would make email communication worthwhile for the physician.
  • Malpractice Liability. There have not been any suits (yet) over doctor-patient email consultations, but doctors predict this will soon occur.
  • Confidentiality. If everyone in one household has the same email, there could be problems of confidentiality.

“The biggest snafu that I committed was with a patient’s husband, who was having an affair, I breeched patient confidentiality, by sending information to one spouse who I thought was then giving it to the other spouse.”


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