Two newspapers on Monday featured articles that examined how few physicians use e-mail for patient consultations. Summaries appear below.Denver Rocky Mountain News: The Rocky Mountain News examines how many physicians "don't like to use e-mail" for patient consultations because "there's no way for them to be paid for their time" and because they "fear adding a big slug of e-mail correspondence to the end of their day." Jay Krakovitz, medical director of Anthem Blue Cross Blue Shield of Colorado, said, "From a physician's perspective, we are taught that in order to get a proper gauge of the problem you have to take a history, and you can't do that over e-mail. Physicians also feel that the time it takes to do this doesn't get reimbursed enough." In addition, electronic patient consultations pose "technical challenges" because medical privacy rules "require that medical communications go through encrypted e-mail or a secure Web portal," the Rocky Mountain News reports. Technologies that offer secure Web portal access "add expenses for physicians, further discouraging their use," according to the Rocky Mountain News (Brand, Rocky Mountain News, 10/2).
Los Angeles Times: The Times examines how many physicians do not use e-mail, which is "arguably the most common form of communication in the Information Age," for patient consultations. According to a recent report released by the Center for Studying Health System Change, only about one-fourth of physicians use e-mail or other electronic means for patient consultations. Health care experts attribute the trend in part to a lack of reimbursements from health plans for electronic patient consultations. David Cutler, a health economist at Harvard University, said, "Most businesses have e-mail because that's what their customers want. Customers want convenience, but nobody in health care gets paid for it." Some health plans "have begun reimbursing doctors who interact with patients on specially created Web sites, but the numbers are still negligible and, for the most part, doctors are not paid unless they see patients face to face," the Times reports. Health plans maintain that, although they "are not averse to paying doctors for electronic consultations," they "would like a more structured setting, such as a secured Web site that screens patients for symptoms and differentiates clinical consulting from administrative questions, such as whether lab tests are in," according to the Times (Yi, Los Angeles Times, 10/2).
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