An Email A Day Keeps Doctor Away
August 6, 2013

An Email a Day Keeps the Doctor Away

Brett Smith for - Your Universe Online

Although it would increase convenience and overall satisfaction among their patients, healthcare providers are not ready to embrace electronic communications because of the increased workload and lack of compensation, according to a new study in the journal Health Affairs.

"Leaders of medical groups that use electronic communication find it to be efficient and effective - they say it improves patient satisfaction and saves time for patients. But many physicians say that while it may help patients, it is a challenge for them," said study author Dr. Tara F. Bishop, a public health professor at Weill Cornell Medical College.

"The lack of compensation is one issue, and another is that unless the practice takes steps to reduce a physician's daily workload of patients, communicating with patients is extra work that makes some doctors feel that their day can never end," she added.

In the study, Bishop and her team talked to the heads of 21 medical groups. They also interviewed the physicians and staff at six groups that regularly use electronic communications. Five of these groups had at least 110 physicians. The sixth had a group of 15 physicians housed within a large academic medical center.

All six practices said they sent test results, accepted medication refill requests, made appointments and took patient questions electronically. Three of the groups had nurses, medical assistants or case managers sort and prioritize messages from patients.
The other three provider groups allowed patients to email their physician directly. In all six programs, physician said they received between five to 50 emails per day.

One group said they had negotiated a reimbursement system for "e-visits," or electronic consultations, with insurance companies and charged patients a copayment for the service. Another clinic had provided unlimited electronic communication for a $60 annual fee, but eventually dropped the charge after competitors began providing the service at no cost.

According to Bishop, the advantages of electronic communications far outweigh the disadvantages.

"We were told that patients love this model," she said. "Leaders and frontline providers also said the system was efficient, safe, and helped them provide high-quality care. Physicians also said it was an efficient form of communication for them."

Bishop noted one major drawback with the practice that her team kept hearing over and over: a bigger workload.

"One leader said that the work never ends," she said. "It takes a psychological toll on some people - the feeling of never being done."

"Another said that in one day, he sometimes sees 10 patients face-to-face but communicates with another 50, commenting that he works all the time," Bishop added.

The public health expert also noted a lack of financial incentive for practices to pick up the additional service. However, she said potential shifts in the industry's current pay-for-service model could pave the way for more doctors to start emailing their patients.

"Despite the fact that we found experiences with electronic communications were, on the whole, very positive in the groups we studied that have embraced this technology, we believe the big stumbling block to its widespread use around the country will be compensation," Bishop concluded.