Emailing Your Doctor or Therapist

Email is everywhere. If you are reading this, you undoubtedly have an email address. Your doctor and therapist are also very likely to have an email address. Could you email your doctor or therapist if you wanted to?

Most doctors and therapists are not particularly interested in email contact with their patients. In many cases the reason given is that email contact would take too much time out of an already busy schedule. In contrast, some 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.

Katie Hafner addressed some of these issues several years ago in a copyrighted New York Times article. Hafner quotes a Harris Interactive poll from April, 2002 which found that 90 percent of patients wanted to exchange email with their doctors. She noted that only 15% of patients actually did so. Physician fears discussed in her article include 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 feared problems have not developed. Hafner quoted Dr. Richard Parker who practices at Beth-Israel Deaconess Medical Center in Boston in her article. Dr. Parker reported receiving 6-10 emails a day from patients, and spending two minutes responding to each. He also reported receiving 8-10 phone calls a day, and spending three to five minutes on each (often after playing phone tag).

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 e-mail 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."

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.

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

Last edited 11/5/05