There are plenty of reasons why this isn’t happening:

Doctors have their reasons for not hitting the reply button more often. Some worry it will increase their workload, and most physicians don’t get reimbursed for it by insurance companies. Others fear hackers could compromise patient privacy “” even though doctors who do e-mail generally do it through password-protected Web sites.

There are also concerns that patients will send urgent messages that don’t get answered promptly. And any snafu raises the specter of legal liability.

Robert Centor comments:

If you email your lawyer, you may well receive a bill for the time necessary to handle that email. You will also receive a very long paragraph designed to protect that correspondence from liability.

As I write repeatedly, physicians are not paid for their time, they are paid by the widget. The patient visit is our version of the widget. Anything that we do to prepare for that visit, communicate between visits, review the tests induced by that visit or discuss you problem with another physician is gratis. We cannot bill for the proper use of time to improve the patient experience.