Doctors don't meet patient demand for e-mail communication

Poll after poll shows that patients want an online relationship with doctors, but that doctors aren't obliging. The latest one from Harris Interactive is no exception.

The survey, sponsored by the California HealthCare Foundation, reports that more than 80 percent of California primary-care doctors—excluding those in the Kaiser Permanente system—rarely communicate with patients online. Doctors in large groups are more averse to a cyber relationship with patients than their solo colleagues, even though they're more likely to have an IT infrastructure that would make it possible. In contrast, 54 percent of Kaiser primary-care doctors said they communicate with patients by e-mail either often or sometimes.

The survey doesn't explain why Kaiser doctors take a different approach to Internet medicine, but how they're paid could be the reason. In the fee-for-service world, e-mailing a patient normally is uncompensated work that crowds out compensated work. Paid on the basis of capitation and oriented toward comprehensive as opposed to episodic patient care, Kaiser doctors arguably have less cause to see patient e-mail as bad for their paychecks.

And when it comes to healthcare, patients definitely want to hit the send button. A Harris Interactive survey published in February found that 74 percent of patients would like the ability to e-mail their doctors. Likewise, most patients want to receive test results and clinical-care reminders by e-mail, schedule appointments online, and electronically transmit home-monitoring data to the doctor's office. However, the percentage of patients doing any of these things is less than 5 percent, according to the February survey.