New York Times Looks at Patient-Physician Communication Via E-Mail
The New York Times on Tuesday examined physicians' increasing use of e-mail to receive and answer patients' questions and the billing practices some doctors and insurers are using for such consultations. Surveys indicate that about 25% of physicians have communicated with patients via e-mail, the Times reports. Doctors say that answering minor questions and concerns by e-mail instead of by telephone is more efficient and allows patients to be more comfortable asking sensitive questions. "People are often more comfortable talking to a computer than they are to a doctor," Dr. Tom Delbanco, a professor of medicine at Harvard Medical School and lead author of an article on the subject in the current issue of the New England Journal of Medicine. Delbanco said, "There's evidence that people tend to be more open in front of a computer, especially with tricky stuff like alcohol or sexual behaviors." Some hospitals, such as Boston's Beth Israel Deaconess Medical Center, have set up messaging systems for patients on secure Web sites. About 18,000 patients regularly log on to Beth Israel's PatientSite to request prescription refills, ask doctors questions or access personal medical records. According to the Times, "many" doctors are concerned that answering patients' questions over e-mail means "working for free," and some doctors are now charging for their online services. Under a pilot program currently underway, Blue Cross of California charges members a copayment of no more than $10 for e-mail exchanges with their doctors, according to company spokesperson Michael Chee. Dr. Daniel Sands, assistant professor of medicine at Harvard Medical School who also practices at Beth Israel, said some doctors are charging patients a flat annual rate ranging from $100 to several hundred dollars. Sands, who coauthored the NEJM article, said e-mailing patients should be a billable service because "it's reasonable to assume that if lawyer and accountants charge for time, then physicians should, too" (O'Connor, New York Times, 4/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.