February 20, 2012
Patients often ask me why I don’t allow patients to email me about simple issues. Most of my patients know that I am an early adopter of technology and have had an electronic medical record for over 15 years. Email seems like a logical step, doesn’t it?
“The pitfalls of email communication with patients” by Robert Sadaty, MD published today at http://www.kevinmd.com/blog/2012/02/pitfalls-email-communication-patients.html, is an excellent article on the pitfalls of email communications. Dr. Sadaty’s experience is tame compared to mine.
Computer savvy patients have found both my personal and professional email addresses and have used them to pose “simple” medical questions in the past. My favorite is:
“Doc, its 2 am and I’m having chest pain. I’m sure it’s indigestion and will pass. You know, ever since my aunt passed, I haven’t felt well. I get short of breath easily, probably because I smoke. My back’s been aching, too. I’ve taken Tums and Zantac and think I may be a little better. My wife is at her sisters and I don’t want to disturb her. Please call me in the morning when you get this.”
So much for 140 characters. The next morning (Sunday) at 11, I read my email. He forgot to put his phone number in the email so I had to log into the office to retrieve it. There was no answer at his house. No what do I do? Send the police? You bet! He was ok and passed his informal stress test. Yes, the police knocking on your door Sunday morning is a form of a stress test.
I passed my informal stress test,as well. Yes, receiving the above email was a sort of stress test. What one individual considers common sense is not necessarily what another would deem common sense or reasonable. Emails are highly impersonal and downright dangerous.
One of my favorite Robert McCloskey quotes is “I know that you believe you understand what you think I said, but I’m not sure you realize that what you heard is not what I meant.” If human speech, complete with intonations and visual cues can be so confusing, Emails and text messages are even worse.
While other docs may adopt Email for patients, I can assure you I will not. Technology is great for many things but will never take the place of personal, live office visits. Yes, patients have also requested video Skype visits. Now, open wide and say “ah.” Can you adjust the camera? The lighting? I’ve lost my internet signal!