E-mailing your doctor

The pros and cons of communicating with your doctor by e-mail are hotly debated within the healthcare community. Questions about patient security and compensation for physicians have not been resolved. But hospitals are providing some answers, albeit to a limited number of patients.

Patient Gateway is Partners HealthCare's online portal. More than 10,000 patients in the greater Boston area have signed up. All are patients of physicians affiliated with Massachusetts General Hospital and Brigham and Women's Hospital.Through it's own web site (www.patientgateway.org), members log in to a secure portal. Once logged in, patients can access a portion of their medical records, request a refill for their prescriptions, and make appointments online. Patients can also have direct e-mail contact with their physician.

According to Steven Baker, Partners' director of marketing, the results have been positive. For the patient, there is the convenience of communicating with the doctor's office outside of office hours. At the physician's end, it cuts down on phone calls that come into the office.

Beth Israel Deaconess Medical Center has a similar protected web site called PatientSite (https://patientsite.bidmc.harvard.edu). More than 18,000 patients are currently signed up. Because these secure portals are run by large healthcare organizations, hospitals are able to provide the service without charging the patient.

But for some physicians, compensation for answering e-mails from patients has become an issue. A recent article in the New England Journal of Medicine found that physicians are less enthusiastic about communicating by e-mail than their patients are. More physicians would use e-mail if they were paid for their time reading and answering messages. The American Medical Association has called upon insurers and health plans to look for ways that doctors could be compensated.

On the issue of e-mailing the doctor, patients seem to be far ahead of their physicians. Patients are even willing to pay for it, as they see the advantage of sending an e-mail over playing telephone tag with their doctor or wasting hours in a waiting room. And, as several surveys have shown, patients use their e-mail privileges wisely. They write concise, relevant messages. They also do not bombard their doctors with unnecessary e-mail.

Though still in the early stages, chances are e-mail communication between doctor and patient will someday be a healthcare fixture.