E-medicine

So doctors are now getting paid for e-mail correspondence with patients. I can't put into words how much more convenient and efficient e-mail is than the phone for following up with patients.

Typically, patients call, get a nurse, who takes a message, I call back, they aren't there, etc. Per HIPAA we aren't supposed to leave test results as a message, which I often violate.

With email, I answer promptly with no need for nurse involvement and no need for wasted time. Plus, some of my patients are up to a couple hours drive away, so often I can take care of minor problems without them having to come in.

So what is my hospital's policy toward e-mail? Patients must sign a 3 page release form before we can give out our email address. Why? Lawyers. It is a new technology so everyone is scared. What if the parents get the wrong message; what if the email isn't "secure"

Of course, the same problems and worse occur with phone calls. As the NYTimes article points out:

The records could even be useful in fending off medical malpractice
lawsuits, according to Eric Zimmerman, a senior vice president of RelayHealth,
based in Emeryville, Calif., because allegations based on undocumented telephone
calls are often hard to rebut. "Good communications with patients is
protective," said Frank A. Sloan, an economist at Duke University who has
studied malpractice suits. "This kind of interaction is helpful."

I've resorted to just telling my patients "here is my card. The format for email at this hospital is firstname.lastname at xyz.edu in case you ever want to contact me.

God I hate bureaucracy.