Health Care Coalition Issues Guidelines on E-Mail Consultations for Physicians

The eRisk Working Group for Healthcare, a coalition of medical malpractice insurers, the American Medical Association and 40 other physician groups have issued new guidelines that ask physicians to conduct e-mail consultations only with patients they have treated in the past, the Wall Street Journal reports. The consultations "should occur only within the context of a previously established doctor-patient relationship that includes a face-to-face encounter when clinically appropriate," the guidelines said. Although the guidelines have no "formal regulatory clout," they "reflect a growing consensus" about the safest way to practice medicine online, the Journal reports. "I believe doctors are getting an increasingly consistent message, that physicians ought to have an established relationship before providing online medical services" to patients, James Thompson, executive vice president of the Federation of State Medical Boards, which helped develop the guidelines, said.

According to a Harris Interactive survey released in April, about 77% of adults who use the Internet want to e-mail their physicians with questions. However, many physicians "have been reluctant to use e-mail" over concerns about liability, time and reimbursement, the Journal reports. The new guidelines could benefit companies such as Medem, a for-profit company operated by the AMA and physician groups that provides a service to allow physicians to charge patients for online consultations, but could "pose further hurdles" for services that offer online visits between patients and physicians who have not met, the Journal reports (Carrns, Wall Street Journal, 12/4).