Merits of patient-doctor e-mails in question

E-mail has been widely accepted as a form of communication in many industries, but some worry that the medium is not suitable for the health-care field.

A recent study by Australian doctors found that patients there were much more likely to communicate with surgeons about operations if the doctors provided e-mail addresses.

Doctors at the Children's Hospital of Philadelphia, however, had mixed views on the benefits of exchanging e-mails with patients.

CHOP doctors have largely been left to determine for themselves the role e-mail should play in patient treatment. Doctors said they generally find e-mail a useful way to communicate with patients, but have not seen strong evidence that e-mail makes patients more likely to contact their doctor.

Although the use of e-mail is a personal decision made by physicians, most doctors choose to use it for relating test results and instructions to their patients.

"I don't like to give any bad news or anything that might upset someone over e-mail, because you don't know how they're going to react," said CHOP metabolic genetics specialist Paige Kaplan.

Privacy is one concern that has led some health care providers to entirely exclude e-mail from treatment.

"It's difficult to determine that the sender and recipient are who they say they are," CHOP hematologist Charles Bailey said.

But according to Bailey, most doctors are still willing to use e-mail so long as the patient agrees to it and understands its limitations with respect to privacy.

The possibility for misunderstandings to arise between doctor and patient and the potential for unclear instructions to be used in medical malpractice lawsuits has led some physicians to further restrict the use of e-mail.

"I wouldn't use it for complex information that could easily be misunderstood," Bailey said.

But some doctors believe that written instructions - including those sent through e-mail - are easier for patients to heed than verbal ones.

"If it's written down patients know exactly how it needs to be done," Kaplan said.

Despite the limitations and potential pitfalls of e-mails, many physicians have found it an efficient tool for treating patients in today's fast-paced health care industry.

"It doesn't rely on all parties being free at the same time, as a telephone conversation does," Bailey said.

But with e-mail, more and more doctors find themselves logging in and responding from home after work.

"You can do it at night from home . you never really get away from work," Kaplan said.

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