Last Writes: Thinking About E-mailing Your Patients? Have You Lost It?

April 2, 2008
MDNG Psychiatry, April 2008, Volume 9, Issue 4

I believe the positives of e-mail far outweigh the negatives, for too many reasons to list.

I received a phone call this morning from a physician I’ve been corresponding with over e-mail, trying to set up an in-person interview for an upcoming cover story. “I just thought this would be easier than volleying back and forth over e-mail,” he explained. Indeed it was. In two minutes, we had coordinated a date, time, and place for the interview. The same territory could have easily been covered over six e-mails, which would have taken twice as long to type out and longer than that to fi nd time to answer in between reading and sending other e-mails.

This is not the prelude to an indictment of e-mail as a tool for communicating, working, and staying in touch. Let’s face it, most of us are lost if our e-mail goes down for even a few hours. I believe the positives of e-mail far outweigh the negatives, for too many reasons to list. But as the debate heats up about physician—patient e-mail, I can sympathize with the reservations physicians feel when thinking about e-mailing with patients as part of their practice. We know the key barriers to wholesale communication by e-mail with patients, and we at MDNG outlined those issues in the article, “Show me the money!” in our January issue. As important as the compensation issue is, I’d argue that the time commitment e-mail entails is equally crucial. I receive about 100 e-mails on an average day, although occasionally the number is much higher. Perhaps half of all e-mails I receive are social queries from friends, irrepressible spam, unsolicited press releases (most of which are wildly off -topic for MDNG), or administrative notices (“The server will be back up shortly…”). That leaves about 50 e-mails on a typical day that relate directly to my work and that have to be read, dealt with, fi led away, incorporated, acted upon, delegated, or at least thought about before deletion. Try as I might to ignore that little yellow notifi cation envelope in the bottom right-hand corner of my monitor, I can rarely resist opening e-mails immediately.

On the rare occasions I have successfully ignored that envelope, it has always been a crucial, time-sensitive e-mail—Murphy’s Law. Th ere are days as a medical editor when I feel like a thousand people are trying to get in touch with me, whether seeking coverage for their latest product, looking for an editorial calendar, following up on the press release, or wondering why their April issue hasn’t arrived yet. How many times do you feel like that? I can only imagine how many e-mails you receive per day just in the day-to-day running of your practice. I know what when I talk to our readers, many have thought about declaring e-mail bankruptcy, a concept explored in detail in the Washington Post and several other media outlets. Now think about starting to e-mail with your patients. Th ink about that particularly needy patient who is likely to fire off two or three follow-up questions for every question you answer. How would you keep up with that? Would you want to?

Giving up on e-mail is not the answer. It’s no surprise that two of the three main sources in the Post article about “declaring e-mail bankruptcy” were back in the game in no time. There’s an odd feeling of disconnect when we sever that line, even temporarily, for a golf outing, a vacation, or some quality time with the family. We all have that friend who can’t get through a single dinner without firing off at least one text message or e-mail. Or maybe we are that friend. There’s a reason the nickname for a common mobile device is “CrackBerry.” While grabbing a quick lunch at a recent medical technology meeting, I looked on with wry amusement as four fellow attendees at a nearby table sat in silence, furiously typing at their miniature keyboards. It would have been little surprise to learn that they were e-mailing each other.

Now consider this: Th e Post article cited a study from research firm DYS Analytics (now called Permessa) showing that the volume of e-mail traffi c in the United States doubled in the past two years. Anyone think we’ve reached the peak of that trend? Neither do I.

I have thought of a solution to this problem that will allow all of you to get control of your inboxes and start e-mailing with your patients (with fair compensation, no less!). I’d tell you about it right now, but that little yellow envelope just popped up. I should open it now. Could be important.