Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Does electronic communication actually improve care?

Natalie Azar, MD
Tech
September 18, 2013
93 Shares
Share
Tweet
Share

The subject heading of a recent email correspondence read “beware, graphic picture ahead!” Obviously this piqued my curiosity, so, with one eye closed, I scrolled down on my iPhone to a picture of my patient’s tongue, which, truth be told, had a certain “you haven’t seen anything yet quality.”

The tongue in question? Maybe some white spots, certainly nothing gruesome, and most assuredly nothing I hadn’t seen before in my 12+ years in clinical practice. My advice to the patient, after confirming through a few back and forth emails that this was not an immediate threat to her, was that she see her dentist and/or primary care doctor for evaluation. If she wasn’t able to book either of them, then, yes, I would be happy to take a look myself.

What was remarkable about this exchange was not that a patient was asking for guidance, or for that matter, a diagnosis, about a symptom that drew her concern. Rather, it was that this correspondence did not involve an actual doctor-patient conversation, in the traditional sense of the word. Currently, a little under one third of physicians say the communicate with patients by email, according to Manhattan Research. That said, the practice is far from routine. On the patient side, data from the National Health Interview Survey found that just over five percent of Americans say they email with their doctor.

A number of explanations have been offered for physicians’ reluctance to use email rather than a traditional face-to-face visit. Frequently cited is the concern about increasing workload without a commensurate increase in compensation. Yet as my lawyer husband reminds me, “not every minute can be monetized in medicine.”

In other words, doctors are not lawyers worried about billable hours. Nevertheless, with reimbursements from Medicare and insurance companies down, and pressure to create revenue for our hospitals and practices ever on the rise, it is becoming increasingly difficult for physicians of this generation to engage in “pro bono” work, to borrow a term from our lawyer brothers and sisters.

Not unexpectedly, a major concern (and one which most physicians freely acknowledge) is patient privacy, data security, and liability. The EMR, which has already been adopted more universally as federal requirements have mandated, is likely going to be the IT wave of the future for even the most reluctant among us. Indeed, in July 2010, the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology announced final rules to implement the provisions of the America Recovery and Reinvestment Act of 2009.

My belief is that while EMR reimbursements are not currently linked directly to electronic communication with patients, there will likely be some financial incentive to use the electronic messaging tools available in the EMR, and this may encourage more use, thereby solving the “billable hours” barrier to entry I mentioned earlier.

Additionally, some private health plans such as Aetna and CIGNA have explored reimbursement for providers for virtual or “e-visits.” Another option which may be even more popular with physicians, is a “one size fits all” annual fee that they charge a patient for access to email correspondence with their doctors.

But here is the real question: Is the care of our patients being compromised by the use of electronic communication? Or are we improving communication and thereby enhancing efficiency, and then ultimately, patient care? I am fairly certain it will take a generation or two to know for sure. In the meantime, I propose that we all keep an open mind, adapt to the changing world we live in, and — as we do in the office — tailor our approach to each case as it comes.

Natalie Azar is a rheumatologist who blogs at The Doctor Blog.

Prev

A case of paralysis, cured in the emergency department

September 18, 2013 Kevin 2
…
Next

How physicians can fight obstructivism over Obamacare

September 18, 2013 Kevin 24
…

Tagged as: Health IT, Primary Care

Post navigation

< Previous Post
A case of paralysis, cured in the emergency department
Next Post >
How physicians can fight obstructivism over Obamacare

More by Natalie Azar, MD

  • Motivate patients to exercise more and eat less

    Natalie Azar, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Can doctors ever work together with insurance companies?

    Natalie Azar, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Patients who come with a family member doctor

    Natalie Azar, MD

More in Tech

  • Is AI the solution for the shortage of nephrologists? ChatGPT weighs in.

    Amol Shrikhande, MD
  • How AI is enhancing patient care and improving radiologists’ lives

    Brett Mollard, MD
  • ChatGPT masters USMLE: a real win for AI, but a long way from the art of medicine

    Harvey Castro, MD, MBA
  • The game-changing impact of AI regulation: Unlocking the potential in health care and society

    Harvey Castro, MD, MBA
  • Surviving TMI and AI: the importance of self-initiated self-learning for future physicians

    Deepak Gupta, MD and Sarwan Kumar, MD
  • Navigating the ethics of AI in surgery: Balancing bias and accountability for safer procedures

    Jag Singh, MD
  • Most Popular

  • Past Week

    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Schools Aren't Prepared to Treat Asthma Attacks
  • Closing the Diversity Gaps in Urologic Oncology Leadership
  • Certain NSCLC Patients May Be Able to Stop Immunotherapy at 2 Years
  • No Survival Benefit With Immune Checkpoint Inhibitor Rechallenge in Metastatic RCC
  • Happy Sleep, Happy Couple?

Meeting Coverage

  • Closing the Diversity Gaps in Urologic Oncology Leadership
  • Certain NSCLC Patients May Be Able to Stop Immunotherapy at 2 Years
  • No Survival Benefit With Immune Checkpoint Inhibitor Rechallenge in Metastatic RCC
  • Happy Sleep, Happy Couple?
  • Once-Nightly Narcolepsy Drug Preferred by Patients Over Twice-Nightly Dose
  • Most Popular

  • Past Week

    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Does electronic communication actually improve care?
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...