nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, October 8, 2010

Why Your Doctor Won't Answer Email. A Personal View

A new survey says only 6.7% of doctors engage in email with patients.

The report, put out by the Center for Studying Health System Change (CSHSC), didn't look at why more docs don't use a modern tool to facilitate the exchange of information and guidance between doctor and patient.

The Center, which sounds like a part of the government, is actually a private think tank with financial ties to the unions and other progressive philanthropic organizations.  They try to be non-partisan but their results usually lean to the left a bit.

Back to emailing your physician:  there are a number of reasons why doctors don't do this.  There's an article in the Wall Street Journal Health blog (Oct 7) that talks about most of them:
This survey didn’t ask non-emailing physicians why they weren’t trading LOLs and emoticons with their patients, but the CSHSC brief has a host of previously cited reasons: “lack of reimbursement, the potential for increased workload, maintaining data privacy and security, avoiding increased medical liability and the uncertain impact on care quality.” (Given that list, it’s hard to figure out why any physician would choose to email patients.)
All of these things are certainly dis-incentives to use the printed word, I guess.

I don't practice by email.  That's not to say that I don't answer a quick question or deliver a result that doesn't need further inquiry ("Mr. Smith, your cholesterol is down to 180; keep up the good work.").  But anything further than that limits my ability to do the job.

For me, it has to do with the very personal, face-to-face, intimate nature of health care.  I can't see your face or your body movements when I ask a question or give information.  I can't see a question on your face, that says I'm not meeting your needs.  I worry that the words I use may be mis-construed in print (happens all the time with email), and I can't tell how you receive them.  If a question comes up, you aren't there so I can go back and physically examine the problem.  I can't see skin textue, swelling, clues to psychological status, etc.  I could go on and on, but the bottom line is, your bodily absence makes my job impossible.

Even a web video call doesn't cut it.

So, I'll use email for administrative things, but not for clinical practice.

Doc D

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