In a response to an ACP Internist article about patient web portals, we recently asked InternistWeekly subscribers whether they communicate with patients online. The results showed that our readers (or at least those who responded to the survey) are ahead of the curve with patient email: 38% said they communicate with patients online, and another 19% are interested in the idea. The remaining 43% said "No, and I'd like to keep it that way."
As a follow-up, the survey asked why the respondents do or don't use online communication. Not surprisingly, the answers revealed time, technology and money to be the biggest hurdles to implementation. Many readers saw no reason to mess with the status quo and add potential complications with HIPPA, encrypted email or malpractice risk. "The phone works fine and actually talking to a patient is far preferable to email," a commenter said. Or as one succinct doc put it, "Think it would double my workload."
Another saw a wide range of risks inherent in emailing: "Increases risk of misunderstanding and potentially increases liability. Increases tendency to carry out 'telephone' medicine with the lack of hands on, visual, and intuitive clues to the real underlying problem. It is time-consuming in aggregate and adds to an already overloaded schedule. There is no evidence that engaging in this type of communication will improve medical care or decision making, reduce liability, reduce workloads or increase income."
The physicians who do use email would likely disagree with that reader. Several mentioned that they limit their online communication to brief messages, like sending test results or setting up appointments. Listed benefits were the ease of communication, avoidance of phone tag, and savings on postage. And then there was the most unusual reason for using email: "It also intimidates enough people to not pursue silly things." Perhaps a selling point that EMR vendors will want to add to their pitches.
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