February 28, 2008

Doctor-patient Email

There is already an established literature on doctor-patient email, but there is always room for one more journal article, right? Especially one which reveals (to me, for the first time) that the very first phone call was actually a call for emergency medical assistance. Alexander Graham Bell had just spilled battery acid on himself, hence his hurried, “Mr. Watson, come here, I want you.”

The very first email was not so urgent, which is probably as it should be since it’s much less immediate than a phone.

This Archives of Surgery article’s contribution (abstract) is to confirm that “in the setting of a prospective randomized controlled clinical trial, patients encouraged to use email access have significantly increased the level of preoperation interaction, without any reduction in measured satisfaction outcomes” (but no increase either, I might add). In all, 26 of 100 patients initiated communication with their surgeon. Those who were given the surgeon’s email address were more likely to initiate contact compared to those who were given a standard contact information sheet.

Most of the emails focused on “general” questions (their example: “…if it’s possible to surgically cut out assorted lumps and bumps from the thyroid gland, is it in fact possible to reduce the size of the gland itself?”) but 4 messages contained requests for reassurance and 2 contained “social” questions (their example: “I would like to request if I can be scheduled for operation a little later in the day. As I have 2 young kids who go to school and child care, it will be difficult to organize care for them before 7am.”) The authors point out that many people “open up” when using email and may feel more free to raise issues that are difficult to raise in a face-to-face meeting.

That reminded me of an earlier article published in the Journal of Clinical Oncology (and beautifully summarized by Denise Grady in the New York Times) which found that empathy is a key component of care in cancer treatment. If doctors are not effectively communicating empathy in face-to-face meetings, can email (as well as coaching) help improve care?

Comments are welcome at e-patients.net.