E-Mail Your Doctor

By Christine Gorman

Playing telephone tag with your doctor is one of the most common--and frustrating--rituals of modern medicine. You phone...can't get past the receptionist...leave a message. Your doctor calls back while you're in a meeting...leaves a message. The amount of time wasted on both sides turns everybody sour. But a growing number of physicians are prescribing a dose of e-mail as the antidote.

There are still a few bugs to work out, of course, which is why e-mail has not replaced the pager in most doctors' offices. But enough physicians have added regular stints at the PC to their office routine that at least one professional group has drawn up guidelines. And the American College of Physicians is undertaking a survey this summer to determine just how widespread doctor-patient e-mail has become.

Not surprisingly, some of medicine's most enthusiastic e-mailers work at universities and teaching hospitals, where both doctors and patients have easy access to communications software and the technical support that allows it to run smoothly. But some managed-care organizations are promoting it as well. "I believe we're looking at something that will become a standard of service in the healthcare industry," says Dr. Joseph Scherger, chair of the Department of Family Medicine at the University of California, Irvine College of Medicine, who estimates that e-mail has cut his telephone use by two-thirds. "It's really opened up communication with my patients."

To encourage that sort of relationship, patients should follow a few important rules. First, remember that e-mail is not a perfectly private medium. If you're writing from the office, even if you use a password, your employer has the legal right to read your messages. Encryption works only if you and your doctor choose the same program, which can be tough to coordinate. So I recommend that you confine your e-mail messages to routine inquiries: appointment scheduling, follow-up questions after a checkup, requests for a prescription refill or a referral. Stanford University Medical Clinic forbids discussion of a patient's HIV status, mental illness or worker's compensation claims via e-mail--and for good reason.

By law, any e-mail you send your doctor must be filed in your medical record. Since a lot of e-mail addresses consist of nicknames, be sure your message includes your real name and, if you know it, your patient identification number (or your child's or other family member's ID number, if appropriate). Keep your messages brief, and focus each e-mail on a single issue. If you want a prescription refill, be sure to include the pharmacy's name and telephone number.

Don't expect an instant response. Most doctors try to reply within 48 hours. If it's an emergency, use the phone. And think before you send. One reason why a lot of doctors have not installed e-mail on their office computers is that they fear being overwhelmed with messages. (Which they will be, unless they set ground rules, and their patients cooperate.) So if you're lucky enough to have direct access to your physician via computer, don't abuse the privilege--or we could all wind up playing telephone tag forever.

See time.com/personal for more on medical e-mail. Send a brief e-mail about this article to Christine at [email protected]