You've got mail from a doctor?

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It is not unusual for friends to e-mail each other often in a day or for co-workers to e-mail back and forth regularly, but e-mailing doctors about medical concerns has yet to become a frequent form of communication.

The ability to connect electronically to your doctor within seconds seems to make perfect health sense. Such communication could, for instance, ensure proper prescription drug purchases. But adoption of e-mail has been slower than expected in the health care world.

However, the trend has been up in recent years. This year, 31 percent of physicians surveyed said that they communicate with their patients via e-mail, up from 25 percent last year and 24 percent in 2005, according to a new study by Manhattan Research, a health care market research and services firm that surveyed about 1,400 physicians across the country.

"Despite the fact most physicians are not using e-mail with their patients today, the trend has been up in recent years and is expected to increase at a measured pace for the next several years," said Manhattan Research president Mark Bard.

Long-held concerns such as liability for a mistake -- like a typo -- while responding to a patient via e-mail are barriers to making cyberspace chat with doctors more commonplace. It is reasonable to assume that eventually a patient will sue a physician for something stated in an e-mail response.

And doctors legitimately fear that confidentiality will be compromised in messages sent over the Internet. The Manhattan Research study found that 69 percent of doctors surveyed said these concerns outweighed the benefits of e-mail contact with patients.

A possible solution: Pay doctors to e-mail their patients, either via insurance or direct pay by patients, or some combination of both. And install secure Web sites that patients and doctors can only access with a password and ID.

Patients say they are willing to pay for e-visits, according to the Harris Interactive survey done last spring. "They figure that even paying for e-mail, they'll come out ahead: To see the doctor, a patient often winds up missing half a day of work."

"For the trend of increased e-mail use by physicians with patients to continue an upward path in the future, three things need to happen -- increasing availability of reimbursement for online visits by insurers, clear guidelines between physicians and patients with regard to what is appropriate for e-mail, and legal precedent to define the scope of liability when using e-mail to offer medical advice," Mr. Bard said.

And patients are clamoring for the opportunity to establish electronic contact with their doctor. The Harris survey showed that nearly 90 percent of people with constant Internet access want to communicate with their physicians online to ask questions, set up appointments, refill prescriptions and get test results. Manhattan Research says that 80.4 million people are "interested" in doing online communication.

c Health Care runs Fridays. Contact Gregory Lopes at 202/636-4892 or gregorylopes@washingtontimes.com.