Why Can't You E-Mail Your Doctor? You'd like an Alternative to Phone Tag, but Doctors Worry about Privacy, Legal Liability and Getting Paid for Their Time

Article excerpt

Byline: Pam DeFiglio Daily Herald Staff Writer

When her toddler got sick, Holly Carlson of Buffalo Grove faced a frustrating obstacle course.

The working mom called the doctor and left a message.

When he called back, she was in her classroom teaching. It all added up to hours of delay in getting the advice she wanted or the treatment her son needed.

Several months ago, Carlson switched tactics and started e- mailing the pediatrician, Dr. David Oppenheim of Buffalo Grove.

"It's so much easier and faster," she said. "I'm a first-time mom. I have questions that aren't urgent, but I want to know the answers. He's good about getting back to me the same day, and I don't have to wait by the phone."

Dr. Oppenheim likes it, too.

"A fantastic use of e-mail is for sending health articles, or links," he said.

That helps doctors provide more health information to patients than they can in the typically short office visit. He also can more easily monitor patients with chronic conditions.

Patients consistently tell survey-takers they would like to communicate with their doctors by e-mail. After all, they use this quick-and-easy medium to contact clients, co-workers and just about everyone else.

But only about 10 percent of doctors regularly use e-mail to communicate with patients, according to Manhattan Research, a market research firm.

Most doctors resist e-mail because they fear it will eat up their time and they won't be paid for those hours. Many also worry about liability and confidentiality, especially in light of the Health Insurance Privacy and Portability Act, the stricter patient privacy law that took effect in April.

Doctors who champion e-mail say it's convenient, provides a transcript of what doctor and patient said and reduces the time spent on phone calls. These advantages far outweigh the disadvantages, they insist.

And while the use of e-mail has not yet reached the tipping point, Dr. Daniel Z. Sands of Brookline, Mass., a national advocate for e-mail, estimates 50 percent of doctors will be using it in five years.

They'll be helped by special communications networks that let doctors and patients exchange e-mails in privacy - and provide a way for doctors to charge patients or insurers for their e-mailed advice.

Off the clock

Any office worker knows e-mail can take a big chunk out of the day. That's what some doctors fear.

"Doctors hesitate to do anything they feel will add time to their day," said Sands, clinical director of electronic patient records and communication at Beth Israel Deaconess Medical Center.

Doctors should think of e-mail as a way to reduce phone calls, he said. It might even save time, since it's harder for patients to ramble in an e-mail, he believes.

Dr. Janice Krakora-Looby, a pediatrician in Grayslake, finds that's true.

"It can take less time because you avoid phone tag," she said. She spends an average of 10 minutes on each e-mail. Just as with a phone call, she asks a nurse to pull the patient's chart before she replies.

A big benefit for Lt. Jill McMullen, M.D., is the ability to answer e-mails when she has time, even if it's too early or late for a phone call.

"I get to work on my time frame - from 6 to 7 a.m., or 7 to 8 p.m., when patients aren't waiting," said McMullen, who trades e- mails with her patients at the Family Practice Clinic at Naval Hospital Great Lakes in Lake County.

Some doctors bemoan the lack of person-to-person contact that goes along with e-mail. And others say it's their patients - not them - who are unwilling to put their problems in writing.

"I'm dealing with issues like fertility, potency, cancer, very private matters. Patients won't even tell the receptionist what's wrong when they come in." said Dr. Stephen Rowe, a Wheaton urologist who'd like to use e-mail more to communicate with patients. …