NCPA - National Center for Policy Analysis

Doctors and Patients Turn to Medical E-Mail

April 27, 2004

Electronic communications between doctors and patients may be the next best thing to a home visit. More and more doctors are using e-mail to work with their patients.

Some hospitals have even set up messaging systems on secure Web sites to protect patients' privacy. But many doctors feel that e-mail means working for free. Consequently, some have begun charging for e-mail consultations -- in some cases, patients pay a flat rate from $100 to several hundred dollars a year for such services. Some health insurers are experimenting with programs to pay for e-mail contacts.

  • About a quarter of practicing doctors have communicated with patients through e-mail.
  • Blue Cross of California has a pilot program that treats e-mail messages like visits to the doctor, with copayments or a modest fee of no more than $10.
  • At the Beth Israel Deaconess Medical Center in Boston, 18,000 patients routinely log on to a protected Web site called PatientSite to request prescription refills, write to their doctors or scan personal medical records.

David Ives, a general internist at Beth Israel Deaconess, receives about 30 e-mail messages a day from his patients. Although most physicians are afraid they'll be overwhelmed with e-mail requests, Ives has found it actually replaces telephone calls.

Doctors say they are most likely to read e-mail that is straightforward and concise. Long-winded messages and excessive nagging are rarely a problem, doctors say. Patients tend to write e-mail messages more carefully than they would deliver voice mail messages.

Source: Anahad O'Connor, "Take Two Aspirins, E-Mail Me Tomorrow," New York Times, April 27, 2004; Tom Delbanco and Daniel Z. Sands, Electrons in Flight -- E-Mail between Doctors and Patients, New England Journal of Medicine, April 22, 2004.


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