Attitudes, practices and experiences of medical specialists towards email communication with their patients

Abstract

Background: The medical profession has been slow in embracing email as a means of improving communication with patients.Aims: To explore the attitudes, practices and experiences of senior medical specialists towards email communication with their patients.Methods: A cross-sectional qualitative interview of 30 medical staff specialists employed by Canberra Health Services, administered through one-on-one interviews conducted between June and August 2020 (several months into the COVID-19 pandemic). Main outcome measures are the comments extracted from the interviews that were categorised into five domains: (i) integration of email use with patients; (ii) issues addressed through email; (iii) benefits of email communication; (iv) concerns and barriers to email communication; and (v) practice pointers for email use with patients.Results: Regular email correspondence with patients was not widespread. The main benefits identified were improved efficiency and flexibility, especially in the context of managing chronic disease and patient follow up. Participants also identified barriers, including time commitments, privacy and confidentiality, patient expectations and potential for misuse. Most participants were hesitant to endorse email with patients in their practices, citing concerns over the utility and safety of the medium and lack of established protocols and recommendations for email usage.Conclusions: There is a want and need for comprehensive and accessible professional guidance on email use with patients. Our results indicate opportunities to inform good clinical practice in respect of doctor-patient relationships, clinical workloads and risk management. There is also a need for formal guidelines on emailing with patients. The COVID-19 pandemic has heightened the need for such guidelines.

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“…We think that this result may be because the use of E-mail places special requirements on patients. A survey from Australia on E-mail communication with patients indicated that some patients with limited literacy or no access to the internet may be disadvantaged in accessing health care by E-mail ( Clark et al, 2021 ). Therefore, in our study, some patients, limited by economic conditions and education levels, may have been unable to use E-mail.…”

“…Among all follow-up methods, E-mail had the lowest follow-up rate, which is easy to understand. In addition to the above reasons, previous studies have proven that being able to use E-mail is affected by economics and education ( Clark et al, 2021 ), and some patients may withdraw from the study due to their inability to use E-mail.…”