Richard J Moldawsky1, Pranav V Shah2. 1. Psychiatrist at the Aliso Viejo Medical Offices in CA. richard.j.moldawsky@kp.org. 2. Psychiatrist at the Santa Ana Medical Offices in CA. pranav.v.shah@kp.org.
Abstract
CONTEXT: Little is known about what prompts patients to use e-mail with their physicians and how physicians respond to these e-mails. OBJECTIVE: To identify the main reasons why patients e-mail and to learn how psychiatrists manage these e-mails as part of these patients' overall care. DESIGN: One hundred patient-initiated e-mails to each of two psychiatrists in a group practice were studied retrospectively for primary reason for the e-mail and for psychiatrists' handling of each e-mail. Other data were collected to assess how representative the e-mailing patients were of the psychiatrists' patient panels. RESULTS: Age, sex, and diagnoses of the e-mailers were similar to our overall panels. The most common reasons for e-mailing were refill requests (19.5%), questions about prescribed medication (16.5%), and worsening of symptoms (11.5%). The modal e-mail was a patient with attention-deficit/hyperactivity disorder requesting a refill. The psychiatrists' most common responses were authorizing a refill (25%), reassurance (22%), and making or moving up a scheduled appointment (16%). For all patients who reported a worsening of symptoms, responses, communicated by e-mail or telephone, included a combination of an earlier appointment and/or change in medication or dose and/or referral for psychotherapy. Both psychiatrists found e-mail to be an efficient enhancement of their practice, and it was inferred that this was also a satisfying mechanism for patients. CONCLUSION: Physician-patient communication via e-mail is timesaving for both, and the benefits to patient care should reassure physicians who are wary of using e-mail in their practice. Potential risks to patients without face-to-face or telephone contact appear to be minimal.
CONTEXT: Little is known about what prompts patients to use e-mail with their physicians and how physicians respond to these e-mails. OBJECTIVE: To identify the main reasons why patients e-mail and to learn how psychiatrists manage these e-mails as part of these patients' overall care. DESIGN: One hundred patient-initiated e-mails to each of two psychiatrists in a group practice were studied retrospectively for primary reason for the e-mail and for psychiatrists' handling of each e-mail. Other data were collected to assess how representative the e-mailing patients were of the psychiatrists' patient panels. RESULTS: Age, sex, and diagnoses of the e-mailers were similar to our overall panels. The most common reasons for e-mailing were refill requests (19.5%), questions about prescribed medication (16.5%), and worsening of symptoms (11.5%). The modal e-mail was a patient with attention-deficit/hyperactivity disorder requesting a refill. The psychiatrists' most common responses were authorizing a refill (25%), reassurance (22%), and making or moving up a scheduled appointment (16%). For all patients who reported a worsening of symptoms, responses, communicated by e-mail or telephone, included a combination of an earlier appointment and/or change in medication or dose and/or referral for psychotherapy. Both psychiatrists found e-mail to be an efficient enhancement of their practice, and it was inferred that this was also a satisfying mechanism for patients. CONCLUSION: Physician-patient communication via e-mail is timesaving for both, and the benefits to patient care should reassure physicians who are wary of using e-mail in their practice. Potential risks to patients without face-to-face or telephone contact appear to be minimal.
Authors: Steve Koh; Gwyn M Cattell; David M Cochran; Aaron Krasner; Frederick J P Langheim; David A Sasso Journal: J Psychiatr Pract Date: 2013-05 Impact factor: 1.325
Authors: Adam Schickedanz; David Huang; Andrea Lopez; Edna Cheung; C R Lyles; Tom Bodenheimer; Urmimala Sarkar Journal: J Gen Intern Med Date: 2013-02-20 Impact factor: 5.128