Doctors who are using e-mail with their patients: A qualitative exploration

Madhavi R. Patt, Thomas K. Houston, Mollie W. Jenckes, Daniel Z. Sands, Daniel E. Ford

Research output: Contribution to journalReview article

Abstract

Background: Despite the potential for rapid, asynchronous, documentable communication, the use of e-mail for physician-patient communication has not been widely adopted. Objective: To survey physicians currently using e-mail with their patients daily to understand their experiences. Methods: In-depth phone interviews of 45 physicians currently using e-mail with patients were audio taped and transcribed verbatim. Two investigators independently qualitatively coded comments. Differences were adjudicated by group consensus. Results: Almost all of the 642 comments from these physicians who currently use e-mail with patients daily could be grouped into 1 of 4 broad domains: (1) e-mail access and content, (2) effects of e-mail on the doctor-patient relationship, (3) managing clinical issues by e-mail, and (4) integrating e-mail into office processes. The most consistent theme was that e-mail communication enhances chronic-disease management. Many physicians also reported improved continuity of care and increased flexibility in responding to nonurgent issues. Integration of e-mail into daily workflow, such as utilization of office personnel, appears to be a significant area of concern for many of the physicians. For other issues, such as content, efficiency of e-mail, and confidentiality, there were diverging experiences and opinions. Physicians appear to be selective in choosing which patients they will communicate with via e-mail, but the criteria for selection is unclear. Conclusion: These physician respondents did perceive benefits to e-mail with a select group of patients. Several areas, such as identifying clinical situations where e-mail communication is effective, incorporating e-mail into office flow, and being reimbursed for online medical care/communication, need to be addressed before this mode of communication diffuses into most practices.

Original languageEnglish (US)
Pages (from-to)9-26
Number of pages18
JournalJournal of medical Internet research
Volume5
Issue number2
StatePublished - Dec 1 2003

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Keywords

  • Communication
  • Electronic mail
  • Internet
  • Physician-patient relations

ASJC Scopus subject areas

  • Health Informatics

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