I'm considering making e-mail a part of my practice of medicine. Am I nuts?
--Eudora E. Mayley, MD, FAAP, Walla Walla, WA
Point: I spend lots of time in my practice helping people solve their e-mail problems...
Click: You idiot! She doesn't want to diagnose and treat e-mail problems... she wants to use e-mail to communicate with her patients. Am I right?
Yes, that's what I meant.
--Eudora E. Mayley, MD, FAAP, Walla Walla, WA
Point: But there are so many people who have legitimate, life-threatening e-mail problems... who speaks for them?
Click: Not us... not now. Anyway, do you use e-mail in your practice?
Point: Yes I do. I have my e-mail address printed on all my patient handouts and business cards. I encourage my patients to e-mail me any time they like.
Click: And do they?
Point: And do they! I spend two hours a day composing replies to the most amazing array of e-mail messages. It's great fun!
Click: You're the one who's nuts. How do you find the time?
Point: It's not a problem. My patients come first.
Click: Yeah right. Most physicians who use e-mail in their practice cannot afford to spend two hours a day replying to messages.
Point: Well, reading e-mail is a lot nicer than holding down feisty two-year olds for ear re-checks. So, Mister Smarty... how should a pediatrician go about using e-mail in practice?
Click: Don't ask me... ask the American Medical Informatics Association (http://www.amia.org). Their Internet Working Group is working on a guideline to help physicians approach the problem of e-mail in practice. Some of the principles of this guideline match pretty closely with Click's Questions to Answer about E-mail in the Office.
Point: Will this help me save time?
Click: You bet!
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CLICK's QUESTIONS TO ANSWER about E-MAIL IN THE PEDIATRICIAN'S OFFICE |
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WHO? Who is likely to see the messages? Is it "doctor's eyes only" or will other staff be reading the messages? Will other family members have an opportunity to read the mail (if a hard copy's in the chart, the answer is "Yes.")? |
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WHAT? What does your standard message format look like? Do you have a consistent and useful signature at the bottom of each message explaining your most important e-mail policies and alternate methods of contact? |
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WHEN? When's the usual time for reading e-mail and the expected turnaround time? How long should a patient wait for an acknowledgment before concluding something went wrong? |
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WHERE? Where does the e-mail go after it's finished being used? In other words, what's the relationship of the e-mail to the chart? Do hard copies go to the paper chart? Is there electronic storage? For how long? Is it secure? |
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WHY? What do you consider to be the appropriate reasons for using e-mail? What clinical situations are OK (non-urgent prescription refills, lab results queries) and what are not OK (urgent symptoms, highly sensitive topics)? |
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HOW? Do you and your patients rally understand how e-mail works? Do your patients understand and acknowledge your printed policies for how this all works? |
Point: So many rules! Picky, picky picky.
Click: Hey, it's like every other form of communication in the office. Both you and your patients need to understand the whole process or misunderstandings will crop up.
Point: People are always misunderstanding me in my e-mail.
Click: Well, that could be due to lack of good e-mail guidelines, or it could be due to your failure to employ the proper emoticons in your e-mail.
Point: Emoticons?
Click: Sure. Listen to this letter:
I use a lot of humor in my practice, but my jokes don't seem to work very well in my e-mail messages. People have a hard time figuring out whether I'm kidding or not! Help!
--Charlie Chaplain, MD, FAAP, Humor, ME
Point: I suppose you're going to tell him how to incorporate facial expressions, gestures, and emotional undertones into his e-mail?
Click: Sure! All it takes is the clever use of "emoticons" or "smileys," those little faces you can make with keyboard characters.
Point: You mean like a little smiling face like this:
:-)
Click: That's the original smiley. Just turn your head 90 degrees counter-clockwise and you'll see it. There are a lot more. Some of them are even relevant to pediatrics!
Point: Try me.
Click: OK.
Sad:
:-(Worried:
<:-(Just Kidding:
;-)Surprised:
:-oDrooling:
:-bDoctor's a Bozo:
*<:o)Smoking:
:-QDelicious:
:-9Excited:
8-)Santa Claus:
*<|:-))Spent too much time reading e-mail:
%-)Point: Wow! E-mail can be much more than I thought it could be. Thanks, Click!
Click: Don't mention it. Please.
If you would like to ask Point 'n' Click a question, mail them!