Skip to main content

Is E-mailing with Patients a Good Idea?

Physicians speak with patients every day on the phone for a variety of reasons.   Our practice now uses a portal system, giving patients access to some of their medical data and to us.  Although I was resistant to having e-mail communications with patients, I have come to appreciate the advantages.

  • It relieves our ever congested phone lines
  • It relieves patients from a state of suspended animation as they hope and pray that a living breathing human being will return to the line after being placed on hold
  • It saves our staff time who no longer have to triage calls as the patient directly reaches the doctor

While this streamlined cyber communication system is useful, it does have limitations.  It can’t solve every problem.  Indeed, some issues are not appropriate for either a phone call or an e-mail.

Calling his doctor?

Consider the following scenarios.  Which can be appropriately handled on the phone and which merit a face to face encounter with a physician?

  • I was in the emergency room yesterday and they told me to call you for pain medicine.
  • My diverticulitis is acting up and I need an antibiotic.
  • My breathing is worse.  I think it’s a side-effect of the new heart medicine I started last week.
  • What can I take for constipation?
  • My cousin had the same symptoms and it ended of being her gallbladder.  Can you give me the name of a surgeon?
  • I’m dizzy and my hemorrhoids have been bleeding for a week.  What can I take?
  • I have hepatitis C.  Is is okay if my grandchildren visit?
  • I had some chest pain yesterday when I was shoveling snow.  Should I double my Nexium?

The practice of  medicine is not fully wireless, at least not yet.  Sure, e-mail is convenient for everyone, but if used too casually it can become quicksand.  Often, the patient feels an e-mail is sufficient, but the physician may not be comfortable, depending upon the medical facts and how well the doctor knows this patient.  When you are face to face with your doctor, the medical history will be more detailed, there may be a physical examination, and there will be a dialogue and review of treatment options.  It’s a lot easier for us to assess your pain, for example, when you are in front of us.  Moreover, when you return to see us for a follow-up visit, we have a baseline to use as a comparison.

What are your thoughts on all this?   Feel free to e-mail me, but I’d prefer if you came to see me
face to face.

Comments

  1. Many of the scenarios that you presented, the answer depends upon the pre-existing relationship with the patient. Some are obviously not appropriate.

    It really doesn't matter, though. The powers to be have decided that e-mail access must be a part of meaningful use stage 3. Meaningful use is setting us up for greater heartburn and liability. For example, the dizzy hemorrhoid patient who e-mailed: the e-mail is missed or not attended to for several hours, and then they die of a massive MI because not mentioned in the e-mail, they have cardiac disease status post CABG 2 weeks ago and they were dizzy because their hemoglobin was 8.5 and they were a-fib with RVR. I am assuming that we will all have to disclaimer e-mails sent out immediately stating he time period in which to anticipate a response, ER warnings for worsening symptoms etc., etc., etc.

    ReplyDelete
  2. why the auto reply will read like the first sentence of the message when calling a hospital doctors office or such

    or better yet to send an email you'll need to be logged into the secured provider that will have you accept the terms such that this is and emergency do not send the email but log off and call 911.......

    ReplyDelete

Post a Comment

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary