Doctors welcome patient e-mail to offices

DATE It's a practice that's changing. Or maybe it's changing the practice.

E-mail communication between doctors and patients is very wide ranging. Some doctors shun it, thinking it will just be more non-medical work. Others embrace it, and for those who do, it's crucial to understand what it can and cannot do.

Bronx resident Anita Fleming, a retiree, has arthritis. Recently, she heard about new a medicine called hydroquinone and wanted to ask her doctor if he thought it might be something that might help her.

So instead of waiting until her next visit, she e-mailed him.

"I wrote the doctor and said could this help me?" she said. "I did research first about the hydroquroquiline, and it's for rheumatoid arthritis, but I wasn't sure which one I had."

Dr. Roy Michaelis returned her e-mail, informing her the drug was not for her kind of arthritis.

Dr. Michaelis has been Fleming's doctor for 20 years. But a few years ago, his hospital, Montefiore Medical Center, put in an e-mail program for patients. Fleming signed up for it and loves it.

"I get him to re-issue my prescription, tell me whether I need to come to the office or not," she said.

Dr. Michaelis says initially some of his colleagues were concerned about e-mail and time.

"I think patients are judicious on how they use the e-mail system and the kind of info that they are requesting," he said. "And if we find that we really need an appointment, face to face, patients are told to schedule an appointment."

Doctors using e-mail warn patients that it is not to be used for emergencies.

As e-mail communications adjust to their place in medicine, professional guidelines stress the idea that they be used to supplement a personal encounter, not to establish relationship.

It's a guideline Dr. Michaelis supports and agrees with.

"Nothing's replaced this yet, and what we have up here still, first and foremost, I'm not going to be replaced by a computer anytime soon.

Since the Internet is used more and more, it is very likely that e-mail communication between patients and physicians will increase. One study found that in spite of patients expressing interest, physicans have been slower to use it. But that practice may change. Dr. Michaelis says surprisingly, even senior citizens in his practice have adopted e-mail.

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