Would you email your Doctor?

Would you email your Doctor?

Now we spend so much of our time online and so many of use the internet to research their symptoms is it a good idea for us to be able to interact with our GPs by email?

Two Doctors go Head to Head in an argument published by the British Medical Journal.

Are email services are either more convenient for patients and clinicians’ time, or make more work for already hard pressed healthcare professionals and threaten patient safety, argue two doctors in a Head to Head published on thebmj.com  today.

The UK government sees the use of email contact and e-consultations as a means of boosting patient access to primary care and is piloting these services in 20 general practices in England. It has also authorised e mails for repeat prescriptions and booking appointments so that patients can communicate electronically with their Health team by 2015.
But wider use of email is not compulsory, and primary care doctors have been slow to embrace this form of technology for communicating with their patients.

Emma Richards, academic GP registrar and honorary clinical research fellow, Department of Primary Care and Public Health, Imperial College, London. Is worried that the government has failed to issue guidance for doctors on email communication with patients, she says.

“The idea that patients can email unlimited requests and questions fills many GPs with dread not only in terms of time but also clinical safety,” she writes. The evidence from telephone consultations indicates that they don’t replace face to face appointments; rather, they increase them, she says.

And unlike phone calls, where a doctor can pick up aural cues about a patient’s health and ask questions, that sort of exchange isn’t possible in an email, she insists.

The inevitable delay in answering an email could also prove disastrous for a suicidal patient or one with chest pain, she suggests. This could widen health inequalities, as those most in need of healthcare, such as the elderly, may struggle to use this option.
But Elinor Gunning, a locum family doctor in London and a clinical teaching fellow in the Department of Primary Care and Population Health at UCL Medical School, insists that email services can work well, when properly planned and managed.

Understanding the limitations of email services must be taken into account but there are types of enquiry which can be dealt with this way.

“Patients must be made aware that emails may not be read immediately. The terms and conditions of email use can be covered comprehensively when consent for email use is taken, and reiterated in each email response,” she writes.

Many of the concerns raised about email services can be applied to phone and fax – now regarded as established and trusted components of general practice, she says.

She agrees that not everyone will be able to access or readily use email, but it’s up to general practice to provide as many means of access as possible “to improve care for all,” she suggests.

“Although more research, investment, and official guidelines are needed, sufficient strategies already exist to support the safe implementation of email services,” she writes.

More to the point: email use will soon be inevitable, she says. If doctors don’t embrace it now, they may “miss out on a vital opportunity to shape [it], to the detriment of patients and clinicians.”

What do you think?  Would you or could you email your doctor?