Life Without Email? Wassup, Doc?

So a diabetic walks into an endo’s office and says, “Hey Doc, can I get your email address in case I have any follow-up questions?” And the doctor replies, “Sorry, we do medicine, not email.”

I made that up myself. No, really… I did.Old_fashioned_md_2

But don’t laugh too hard. There is actual proof now that doctors who are willing to email with their patients are a rare breed indeed. I’m very lucky to have found one — well, a few actually — here in the tech-savvy SF Bay Area who were willing to take the plunge. Why isn’t email contact with your healthcare provider more common across the country, what with it being so darn convenient, and let’s face it, pretty much the lifeblood of the business world these days? In many ways, email functions as our portal to the world, no?

What’s standing in the way is primarily fear, apparently. Fear of being overwhelmed by yet one more responsibility, of not being reimbursed for time spent answering emails, of patient privacy concerns, and of course, of legal liability if patients are unhappy with email interaction, or if anything said there should result in negative health consequences. Fair enough. Those are legitimate concerns.

But electronic communication is now a fact of life. It’s used for virtually ever other aspect of commerce in this country. “People are able to file their taxes online, buy and sell household goods, and manage their financial accounts,” says Susannah Fox of the Pew Internet & American Life Project. “The health care industry seems to be lagging behind other industries.” Ya think?

But doctors will continue to resist as long as they have no support on the concerns mentioned above. So once again, all arrows seem to point back to the need to reform our healthcare system, in this case to address and support the way people interact in this century.

Oddly enough, the pharma industry hasn’t wasted too much time finding ways to use email to reach out to doctors — bombarding them with “ePromotions,” and more recently, electronic drug alerts. Meanwhile experts have been touting the benefits of email to the physician-patient relationship since the year 2000 at least. But doctors are still holding back, for all the practical reasons mentioned (read the comments on that post).

According to this story (“It’s no LOL”): “It’s not the first time the medical field has been slow to embrace technology. When the first telephones became widely available in the late 1800s, doctors were concerned about being swamped with calls.” But the medical establishment is expected to come around on the email issue eventually. Hmm, I wonder how many more decades before they embrace Social Media?

So, how many of you actually exchange emails with your doctors? I can’t tell you how happy it makes me to receive my lab slips as an email attachment in two minutes, rather than waiting for them to arrive via Snail Mail, and then misplacing the envelope. Even my daughters’ pediatrician sends me quick replies, usually with a nice side query as to how we’re all doing. How lucky are we?

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23 Responses

  1. kkonmymind
    kkonmymind April 25, 2008 at 6:59 am | | Reply

    I can communicate with my primary care doctor through a messaging function in my electronic medical record. Through that, I can request test results, but they don’t come to me automatically.

    Unfortunately, my endo and other specialists are not on the email bandwagon yet. My retina specialist gave me his cell phone number, though, which is also good.

  2. AdrianT
    AdrianT April 25, 2008 at 7:08 am | | Reply

    Interesting enough, a few doctors have asked my wife and I to seek info on the internet instead of dispensing it to us! I can see the pressure they must be going through as small business people but in the long term it seems like a disconnect that will continue to hurt their practices. I was floored a couple of weeks ago when the doctor told me to e-mail her any questions…. and she did respond. It was refreshing to see and felt that I was really cared for.

  3. landileigh
    landileigh April 25, 2008 at 7:31 am | | Reply

    i love the Kaiser-Permanente system, all of my labs, doctor’s visits, doctor’s emails are all in one place. with so many specialists that i have (cardiologist, nephrologist, endocrinologist) all in one place, it’s a GREAT system!

  4. Denise  Bevard
    Denise Bevard April 25, 2008 at 7:56 am | | Reply

    My PCP is very high tech..all digital..and has done email for at least the last 3 years.He also gives his cell phone # to all his patients.

    My endo not so much, but does give out his cell phone#, and has always answered. I was hosptitalized once and the hosp refused to call him–my family now has his cell # also–he returns their calls as well.

  5. CALpumper
    CALpumper April 25, 2008 at 8:39 am | | Reply

    Wow, it would be great!!!

    My local Joslin Clinic is Big on the “NO EMAIL” bandwagon. The staff all say the same thing, legality.

    It’s too bad. It would make my life easier….they know with me though I would fill up their inbox in no time!

    At least when I call they call back. Better than nothing…

  6. Melissa
    Melissa April 25, 2008 at 8:59 am | | Reply

    Hmmmm, my physician’s office allows e-mailing, but it costs a co-payment, so do telephone “visits”. I figure if I have to pay a co-pay I’m going in and being seen and getting my money’s worth!

  7. Courtney
    Courtney April 25, 2008 at 9:09 am | | Reply

    I have a doctor that gave me their email address, but as they were doing so, they told me how they really weren’t allowed to do it…I can’t remember exactly why, but it was a legality issue.

  8. Marston A, SugarStats
    Marston A, SugarStats April 25, 2008 at 9:58 am | | Reply

    This is actually something we come across daily in SugarStats so it is nice to see others talking about this.

    At first it was pretty much as you described, but we felt compelled to push and recommended it to doctors and have our users encourage them as well. Over time we’ve been finding more and more doctors/endo’s (from user feedback) willing to embrace logging into SugarStats to view their patients data. Next comes the messaging and email and overall better doctor-patient communication in general.

    I think it is really a paradigm shift, similar to what they thought in the 1800′s with the telephone. Now we’re seeing they actually realize how much time they save and how much money their saving their patients by doing things virtually/on the web.

    While I think there will always those who will be “set in their ways”, I do think this is the direction we’re heading with great “online doctors” such as Jay Parkinson etc. It’ll be physicians like that which will pave the way for better patient communication, management and facilitation and really who we’ll be aiming our platform for.

  9. tmana
    tmana April 25, 2008 at 10:06 am | | Reply

    The physicians and PAs in my PCP’s office have been very slow to embrace electronic technology, period. And there are some issues with electronic record-keeping and elecctronic physician management technologies that make this a reasonable policy.

    Regarding e-mail specifically, a medical practice would need a server and a robust and reasonably intelligent suite of protective applications (antivirus/antispyware, spam filters, etc.) in order to make sure the practitioners see *only* actionable e-mails and do not *miss* any actionable e-mails, verify that the practioners have responded within a reasonable service level (customer service standard is 24 hours, although most customers expect a response in under two hours), and protect any and all proprietary applications and data from hackers, phishers, identity thieves, and other electronic criminals. The capital and operating costs of this system (which would probably also require adding in either a non-practitioner staff member or a nurse-practioner or PA with IT certifications) would be in excess of $100,000 per annum, all of which would be non-income-generating expense. Given the exceedingly (and increasingly) small margins in which medical practices are expected to operate, these costs could put a medical practice out of business.

  10. CALpumper
    CALpumper April 25, 2008 at 11:11 am | | Reply

    tmana,

    Great info! Collectively, maybe we can move this forward. Knowledge is power. If we know who is affected, how and where….progress Can happen!

  11. MeadowLark
    MeadowLark April 25, 2008 at 12:49 pm | | Reply

    My Dr is on my list at SugarStats.com When I told him about it. He was all for it. He can see what is going on anytime. Even though I currently cannot go see him due to insurance.(I cant afford the copay.) He can see what is happening with my bloodsugar numbers. He still send in scripts for me;)

  12. Jonah
    Jonah April 25, 2008 at 4:03 pm | | Reply

    My endo doesn’t do email, but he does do fax so I can get my results by fax quickly. He also calls and does patient info network, which is pretty awesome.

  13. Jonah
    Jonah April 25, 2008 at 4:04 pm | | Reply

    My endo doesn’t do email, but he does do fax so I can get my results by fax quickly. He also calls and does patient info network, which is pretty awesome.

  14. Nick
    Nick April 25, 2008 at 4:42 pm | | Reply

    My practitioner prefers not to do email (and suggests fax) because of something to do with HIPPA. Apparently email does not meet HIPPA standards or something.

  15. Lauren
    Lauren April 25, 2008 at 11:50 pm | | Reply

    HIPAA is a huge consideration. There are strict regulations about what goes out over telephone lines and protection of patient confidentiality. At my clinic we have a secure fax with a dedicated line, and very strict rules about collecting information over the phone. There are a TON of liability and privacy issues surrounding email and telephone communications with patients.

    I will be a doctor in a few years. I’m obviously nowhere near physician-hood yet, but as of now, I disagree with communicating with patients over email. I’m already quite leery of telephone consults. Medicine is not something that can be done at a distance, at least my in experience. (Emailing lab slips and results is different, though; I don’t see why a nurse can’t do that on behalf of a doctor, to make our lives easier.)

  16. laurie edwards
    laurie edwards April 26, 2008 at 7:02 am | | Reply

    I have a fantastic doctor who is even more fantastic in communicating with me over e-mail. Our correspondence does not replace the need for sputum tests and cultures, pulmonary function tests, etc, but is great for quick questions about changing dosages, monitoring symptoms, and the like. For someone with chronic problems like mine, it makes sense.

    Plus, when I get released from the hospital, he often shoots me an e-mail just to see how I am doing. Does he have to do that? No, of course not. But he has no idea how much I appreciate it. Reminds me that he thinks of me as a person, not just one of his many, many patients.

  17. Carol
    Carol April 26, 2008 at 12:29 pm | | Reply

    My PCP communicates with me by email but I know he is selective about the patients he does this with. I know he won’t do email with people who want to use it instead of coming in for a visit, or who would inundate him with it.

    He sends me test results via email and it’s not unusual for us to trade a few follow up chatty emails. He has a wicked sense of humor and isn’t above making me laugh.

    Just last week I got an email from him that was sent very early in the morning saying he wanted to call and check up on me but that he was going to wait because “I know how much you loooooooove being called at 7am!”.

    And, he is much more likely to just pick up the phone to check in if he hasn’t heard from me for a few months.

    What I love is that I’m so fortunate to have such a great relationship with my wonderful doctor.

  18. Jo
    Jo April 27, 2008 at 7:58 am | | Reply

    Every email communication between patient and doctor would have to be electronically filed to that patients’ records. The need of a person to sit all day long and forward, save, etc to email may not be cost effective to a small doctors’ office.

    In my industry, we have to save every email that we get from the client, and to etc. One day a week I do nothing but file these emails to the clients record. And I mean one whole 8 hour day.

  19. MaryM
    MaryM April 27, 2008 at 4:41 pm | | Reply

    I think that’s reasonable to charge a co-pay for email. The DR. that answers it has to look you up in his/her records so they can remember who you are.

    If you talk with your lawyer he/she will send you a bill.

    The plus of paying for a service is then the service is available. If you are just sponging off the office then they’ll be less reliable in answering you.

    If you wouldn’t pay $10 to have a question answered is it really worth asking?

  20. Faith
    Faith April 27, 2008 at 7:37 pm | | Reply

    My endo has email set up through a system the hospital has set up. I just wish all my drs would decide to use it. Any concern, big or small I can email her about and get a response within a few hours. It goes through the hospitals website and I have to have a special sign in and log in picture and pw just for the email stuff.
    I can also see when my appts coming up are there and results of any recent labs.

  21. Kendra
    Kendra April 28, 2008 at 7:15 am | | Reply

    I didn’t realize how lucky I was! I can email my blood sugar logs to the PA at my endo’s office, and I will receive a phone call reply that same day with adjustments. They prefer sending documents like logs over email vs fax; fax is too slow and wastes paper.

  22. Julie
    Julie May 6, 2008 at 12:45 pm | | Reply

    I’ve been seeing my endo for 10 years and don’t ever even get phone calls with her, much less emails. I would LOVE to have my test results emailed or electronically accessible but instead I have to wait a week for her to leave a message on some kind of phone message system and then I call it with a code to get the results. It seems like the entire system is set up to keep patients from bugging their Dr. with questions….but don’t we actually need to communicate with them? It might make it easier for them to leave messages for “numbers” instead of patients and to only talk to the nurse about patient issues…but it’s a lot harder for us and there have been several instances of miscommunication due to the passing of information through several people. This issue has bothered me for a long time and I can’t wait to move, so that I can try out a new endo.

  23. Kris Gainsforth
    Kris Gainsforth June 18, 2008 at 3:21 pm | | Reply

    I wouldn’t want to use regular e-mail to transfer data. It’s unencrypted and easy to read, just like mailing your numbers on a postcard.

    If there was a secure web-based log, with mobile options, I’d be all for it, but raw e-mail is too unsecure for most medical purposes.

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