NCPA - National Center for Policy Analysis


October 4, 2006

Many physicians don't like to use e-mail for patient consultations because there's no way for them to be paid for their time and because they fear adding a big slug of e-mail correspondence to the end of their day, reports the Denver Rocky Mountain News.

  • Physician are taught that in order to get a proper gauge of the problem, they have to take a history, which can't be done over e-mail; they also feel that the time it takes to do this doesn't get reimbursed enough.
  • Electronic patient consultations pose technical challenges because medical privacy rules require that medical communications go through encrypted e-mail or a secure Web portal.
  • Technologies that offer secure Web portal access add expenses for physicians, further discouraging their use.

According to a recent report released by the Center for Studying Health System Change:

  • Only about one-fourth of physicians use e-mail or other electronic means for patient consultations.
  • Health care experts attribute the trend in part to a lack of reimbursements from health plans for electronic patient consultations.

Some health plans have begun reimbursing doctors who interact with patients on specially created Web sites, but the numbers are still negligible and, for the most part, doctors are not paid unless they see patients face to face.

Health plans maintain that, although they are not averse to paying doctors for electronic consultations, they would like a more structured setting, such as a secured Web site that screens patients for symptoms and differentiates clinical consulting from administrative questions, such as whether lab tests are in.

Source: Rachel Brand, "Some doctors delivering care via e-mail;

But most physicians don't because of pay, privacy issues," Rocky Mountain News, October 2, 2006; and Daniel Yi,"You've got mail? Not from the doctor; Just a quarter of physicians use e-mail to interact with patients, though some say it can save time and money," Los Angeles Times, October 2, 2006.


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