Doctors without email? What year is it?

Doctors without email? What year is it?

Summary: I've been filling out a lot of paperwork at doctors' offices recently.  More than I should have to.

TOPICS: Health

I've been filling out a lot of paperwork at doctors' offices recently.  More than I should have to.  For example, at my new primary care physician's office, I filled out that same standard form that you've all filled out.  First name, last name.  Address.  Insurance.  Previous hospitalizations.  Allergies.  You know the one I'm talking about.   Dealing with my doctors could be handled much more efficiently and easily by email.Eventually, I was recommended to a specialist where, not much to my surprise, I had to fill out the same form.  But it gets worse.  After filling out the form and seeing the specialist, I was referred to another doctor -- this time a doctor in the same outfit as the one I had just seen and I had to fill out yet another form.  This form had a few additional fields, but some of the others were the same.  What's wrong with this picture? I'm sure someone will come back and tell me that it's a hippo standing in the way (or is that HIPAA?).  Malpractice is probably a factor too.  We've become such a litigious society that it stands in the way of getting healthcare.

Anybody who has had to deal with doctors regarding a serious health issue knows its really hard to get the information you want when you want it.  Doctors are almost never available when you call them and I've yet to find a doctor that's great about returning phone calls.  Oddly, with health care, even though you're the customer, you really have to stay on top of everyone you're dealing with to make sure your case doesn't slip through the cracks.  It's as if it's a privilege to be some doctor's customer, er, I mean patient.  Shouldn't it be the other way around?  Or, does "patient" mean "You have to be patient, even though that promised call never comes in after you've been waiting by the phone all day (so you could do something important like get your prescription refilled or to find out what time you're supposed to go get more tests in the morning)."  The thing that really steams me though is email.  Or lack thereof.  It's as if the entire healthcare profession is on email strike.

About 99 percent of what I get accomplished on the telephone when dealing with my doctors could be handled much more efficiently and easily by email.  I'm imagining the email where I write "Doctor, I was able to move my dentist appointment so I can take that 10:00am appointment on Thursday that you offered me.  Please confirm."  Maybe the doctor is too busy with emergencies to call back for something that, in her scheme of things is, well, trivial (even though it's very big for the patient). But with email and something like a Blackberry, a doctor can respond "confirmed" while walking from one emergency to the next.  Later on, she can add it to her book or cc: her assistant.   Not only is the patient happy, he or she doesn't have to wait by the phone all day.   But, either some of the health care professionals I'm dealing with are lying to me, or they really are in the stone age. 

In the tech industry and with most friends and family I deal with, email is the 24/7 communication channel.  There's are sort of unwritten "you can track me down by email and that's OK" rule.   Knowing how hard it is to stay on top of the health professionals I often deal with, I ask most of my doctors and even their assistants for their email addresses.   Never mind the fact that it should unequivocally be the other way around so they have the means to much more efficiently and proactively stay in touch with me (I'm imagining emails that keep me updated with new information that my doctor knows is relevant to my health), how is it that the answer to this question is almost universally "I'm not on the Internet" or "I don't have email?" Whether it is true or not, it makes me wonder what kind of world we live in.

Topic: Health

Kick off your day with ZDNet's daily email newsletter. It's the freshest tech news and opinion, served hot. Get it.


Log in or register to join the discussion
  • Drs & email...

    I recently asked my Dr. if he had email and could I communicate to him thru that. He gave me a very pained look...and explained that the firm he worked for clearly didn't like that because they were afraid of potential liabilities. As long as providers are gonna fear litigation, it'll never get better.
    • Id rather a text message

      Ive also spoken to a few clinics who are afraid of the privacy issue as well. Honestly, if I could get an SMS from my clinic reminding me of my appointments, Id be one happy patient!
    • Regular email is not secure, but there are alternatives

      I can understand a medical facility not wanting communications between a provider and a patient being sent over email. Traditional email is simply not secure enough for this purpose.

      However, there are alternatives. For example, many facilities have patient web portals, through which patients can send/receive secure messages to/from their providers--not sent via traditional email. Also, these messages are commonly required to become part of the patient's permanent medical record.
  • HIPPA is part of the problem...

    but the main thing that calls for is secure communication. Sending clear text and having it end up in the wrong persons hands is definitely a no-no. Protected health care information is NOT supposed to be left laying around. That actually can include your appointment information. You may not care but there are social and legal reasons why some people don't want information about the Doctor they visit to be widely known. In order to protect those worried about their privacy (or who should be worried about their privacy), pretty much everybody's appointments get treated as private.

    PS: For those who don't know, HIPPA is a US law intended to protect the privacy health care information. As a statistician, that mainly means that personally idenifying information is removed from any data given to me for work. It also means that I get several hours of overhead... er... training in HIPPA each year.
  • Some advice for you David

    The extremely high turnover of your blogs makes it very hard to motivate and write a talkback. One of the (needed) features of talkback, is to write something, and then COME BACK LATER to see what others have added. The problem here is that your blog has a queue of 3 "old" articles - but the turnover on your blog must be 12+ a day. THERE IS NO "come back later" - its already gone!

    I like you David, and I know you respect me - so heres some advice - GET YOUR OWN STINKING BLOG! You DON'T have to share with your boss and his quickie 3- (that's 3 "or less") paragraph entries. If you can't write a blog entry and have it stick around in your queue for AT LEAST a single day - you won't even get me to take a look. And I haven't.
    Roger Ramjet
    • Agreed, and then some

      The ZDNet blogging/commenting system just plain stinks. What it also really needs is a "notify me when someone has replied to my comment" system. I also have severely limited how much effort I put into the comments, because I simply don't have the time or energy to be checking back every 30 minutes to every article I've recently left comments on to check for follow ups.

      I would love to see what ZDNet's reaction would be if they did a mashup of ZDNet's content and an actually usable and useful interface, without ZDNet's ads...

      Justin James
  • I agree

    Everything I do is much more efficient through email. It doesn't get lost to the back of my mind when something important comes up. I can always go back and get it later. I'm not trapped to someone else's conveiniance, but I get my own.

    It's hard to deal with people who insist on calling me because I can't take calls while in a meeting.

    What bugs me more is when people I work with don't use anything but MySpace. I work with a lot of bands and they pretty much don't use email, they don't have their own website, and I hate MySpace. MySpace is a scourge on the internet I wish would go away.

    I'm not sure how I got from medical people to MySpace. But certainly you don't want your doctor only communicating through MySpace. GODFORBID!

    I do wish I could set up appointments through email though. I don't have time in the day to call and sit on hold waiting to schedule something.
    glocks out
  • Switch providers

    David, If you want a physical that is willing to deal with you on a personal level then you are going to need to pay a lot more than you are paying now. Besides, no one changes appointments with a doctor, they change it by calling the assistant. If you think that the doctor wants to deal with something like changing appointments just because it is you then you need to revaluate your relationship with your doctor.

    I have a HMO, I am not crazy about it but that is what the employer provides. On the other hand they have a web portal that enables you to make or change appointments, order refills on prescriptions and a phone number where you can ask advised from a RN.

    If you don't like the service that you receive do what you would do if you didn't like your ISP, switch service providers.
  • Test


    <br>why isn't this

    <p> working

  • So, what else is new?

    A while back, I wrote about how difficult it is to keep medical devices updated and patched in this world of viruses and worms (not the biological kind).

    I think that this is an extension of that same problem. On the one hand, you have incredible advances in medical technology. On the other, you have people and institutions that are not capable of working with, supporting and being a partner with that technology. When they have to use it, they want it to work and never fail. Otherwise, most do not want to have anything to do with it at all.

    There is an amazing amount of resistance within the medical community to computer technology. The comments usually are it is too expensive, to much extra work, too hard to understand (I am not a geek) and we don't trust it. The government insists that hospitals start making use of an EMR (Electronic Medical Record) to help improve service and decrease errors. Last I heard, less than a third do.

    With so little use of the easily available technology, you expect to get an email from your doctor? You expect your records to transfer from one office to another?

    BTW, HIPAA rules do not prevent this communication, in fact, it should facilitate it. What it should do however is keep your information private and only in the hands of those who should have it.

  • email is too much, sometimes

    Some doctors are so busy seeing patients face-to-face that spending a couple of hours a day replying to long, rambling emails (all too easy to include pages and pages of various symptoms) is simply not feasible.

    However, a heads-up before an appointment can be useful
  • Convenience of Email vs. HIPAA Confidentiality

    First the mandate - HIPAA mandated that Patient Health Information (PHI) be secured and handled in a confidential maner.

    Second - By now everyone should know that ISP delivered email is not, generally, private, secure or confidential.

    Third - One possible solution, to be explored and details worked out, would be a password protected file attachemnt emailed to the patient by the Health Care Provider (HCP) with instructions to the patient to call the HCP to get the unique password for that file, so the patient can open it, fill it out, save it with the password intact and resend it to the HCP as a file attachement.

    Conclusion - based upon the above scenario the older and less geeky of the general public would likely find this difficult to deal with and its easy to imagine how it might generate a high volume of calls into the HCP burdening available staff with more to deal with.

    We can't have it both ways. We have to choose between confidentiality and what it takes to attempt to achieve it vs. convenience for the patient.
  • I expect better

    Mr. Berlind, am truly surprised by this post. I know that you know better. "I'm sure someone will come back and tell me that it's a hippo standing in the way (or is that HIPAA?)."

    Yes, and that "person" is the United States Congress. Guess what? If a doctor has a bad hard drive, they have to perform a low level format, preferably a degaussing before sending it back to Seagate or Maxtor or whoever for RMA. Anyone who touches their data has to sign agreements regarding the privacy of that data. And so on and so on.

    Do you really want the details of your personal health being passed around in plain text (actually, from a recent post, you don't mind too much). Imagine if your health problems weren't with your back, but a chemical dependency, or a secual dysfunction, or some other sort of incredibly embarassing or potentially blackmailable problem. How would you feel then?

    Here's an example: a psychologist sends his information back and forth via email. His secretary gets a virus that goes through the email and sends it to a "malicious user". Or someone goes to the doctor's office late at night and taps into their DSL or cable modem line, and sets up a little box to record all port 25 and 110 traffic (easy enough to do with under $500 in hardware and $0 in software). That guy now knows about your problem with looking at children in the wrong way that you are seeking help for, and sends you a letter threatening to tell your wife and the police if you don't pay him money.

    Now, just how badly do you want your health files going through email?

    If you seriously think that sending health data through email is a good idea, I have a bridge to sell you. To quote myself regarding insourcing/outsourcing, "you are off your rocker".

    I expect better judgement from a leader in the IT world such as yourself.

    Justin James
  • A lot of medical offices are stuck in the 1980s at best

    A few years ago I heard about how a local nursing home had an entire office building in Virginia filled with bureaucrats whose sole job was to make sure the nursing home was within Medicare compliance. This is how major businesses used to be run 20 or 30 years ago. They've gotten past that, but the medical profession is very resistant to change. It seems to me that a lot of those bureaucrats could be replaced by an computerized expert system, a 1980s technology, in fact.

    The brother of a friend of mine is a medical doctor, and he's complained to me about it. He said he knows that there are newer, more full-featured instruments (that have some electronics in them) his medical office at the hospital could be using, but the more senior staff won't hear of it. They're using medical instruments designed from the time when they were in medical school. And more than likely, what you experienced happened for the same reason: When the managers of the facility were trained on how to run a hospital, they were trained to use forms like this, not computers.
    Mark Miller
  • My HMO supports...'s email.

    Kaiser - Northern California
    Big Steve_z
  • $$ is the foundation of the problem

    HIPPA (Highly Incompetent Public Policy Applied), is nothing but a knee-jerk reaction to rampant paranoia that is pervasive in the US now. How in the world did we survive for so many years without the ?benefit? of something like HIPPA? Patient confidentiality has always been a stanchion of the Dr / Patient relationship, without the need of a ?document? issued by the government. And if you read the ?full? text of the HIPPA paperwork, you?ll find that your choices that you mark to direct the doctors office as to how you will allow your information to be used/released, is only a ?suggestion?, as they can use the information however they see fit (of course within certain boundaries), but they don?t particularly ?have? to follow your instructions. So much for your control over your ?own? information.

    I believe that the biggest ?roadblock? to the doctors offices moving into the modern era, is cost. The doctors will (for the majority of them) never have the time to deal with extra-examining room contacts with absent patients (someone who is not sitting on the table in front of the Dr. at the moment). Since with most HMO?s and other insurance-driven practices, the doctors are booked like an airline flight (well over capacity) for the entire day. And their staff is likewise occupied with the tasks of maintaining the ?paperwork? that is required to be coded, copied, filed, forwarded, folded, stapled, spindled, mutilated, etc. How many times have you filled out the ?forms? prior to seeing the doctor and then when the Dr comes into the examining room, sits there and looks at your ?file? and then proceeds to ask you the exact same questions that you just answered on the ?form?? And then during the exam, asks some of the same questions that he just wrote down after asking them for the 2nd or 3rd time since you walked into the office. I really worry about a doctor that has a memory no longer than 7 seconds, especially when all this happens again every 6 months during follow-up visits.

    The privacy issues with email are completely valid, though there are alternatives, they would require staff and cash that most practices don?t have the budget for, or wouldn?t budget for if they did have the resources. Doctors (with the exception of some specialists) don?t make the huge incomes that many people think they do. The cost of operating a practice in today?s world is astronomically high for most doctors. And unless they can find solid justification for any ?extra? expenditures, they just won?t make them.

    Until the medical profession gets back to being driven by ?service? of it?s profession to it?s clientele, rather than by the numbers pursued by it?s managing CPA, doctors will continue to have a 10-15 minute ?window? of consultation with each of their ?customers?. ?Good? doctors get behind with their ?rounds? by taking a little extra time with patients that ?need? that little ?extra? association.

    Email and the 21st century are not at the top of their ?to-do? lists.
  • Not that simple

    You are all oversimplifying what is a much more complex issue. Google EHR or "electronic health record" or "electronic medical record" to get a better idea.