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Is The Internet Creating a New Gap Between Physicians and Patients?

Editor's Note: Editor's Note: This article is reprinted from Disabilityworld, a bimonthly web-zine of international disability news and views, Issue no. 14, June-August 2002.

Almost at the same time, The New York Times and the BBC News came with interesting stories about using the internet: "Why Doctors Don't E-Mail" by Katie Hafner and "Website unites patients," by Sarah Frost.

According to Katie Hafner of the New York Times, some doctors are very advanced in using computers and internet for quick access to reference materials and medical records or just a visit to the web. But they simply refuse to communicate with their patients through the internet. Face-to-face interaction is first and a pitiful second is the phone. But e-mail is out of the question. Many doctors have added e-mail to their daily rounds. But most physicians are very reluctant to exchange e-mail with patients. Most patients, on the other hand, are very much in favour of communicating with their doctors through e-mail.

Why are doctors so reluctant? They worry about the confidentiality of the doctor-patient relationship. Others are concerned about the mail-trail they are creating; a malpractice liability is always around the corner. And some think that it will hit the core of medical practice: time seems to be the most essential and scarce attribute of a physician and e-mail will just add to the workload instead of unloading it.

But there are also technical reasons for not using e-mail. Every question and answer can develop the need for more questions and answers. Perhaps e-mailing is not fast enough for the sometimes dynamic interaction between doctors and patients.

But there are also some emotional reasons: it is a relative new way of communication. Many physicians have a tendency to stick to the things they know.

The American Medical Association adopted a set of guidelines for e-mail between doctors and patients. Whether anyone else will be reading the message, how to avoid group e-mail and how the messages are going to be archived are some of the questions answered in these guidelines.

There are, of course, a lot of doctors who are very experienced in using e-mail to communicate with their patients. The doctor-on-line can prevent stress among patients because they have easy access to their physician. And it is very easy to monitor on a day-to-day basis the development of patients in specific circumstances. Also for patients with a disability, e-mail could break down a lot of barriers between themselves and their doctors. Especially when those with fragile health and mobility problems suddenly find themselves having a doctor on hand.

BBC News reported about the way websites unite patients and gave as an example of new communication. This website enables people, who are coping with a disease or injury, to contact others in the same situation. An instant peer-to-peer site to exchange experiences, to share common grief over their situation.

And maybe to join an advocacy group to improve their situation.

The founder of this site, Sarah Frost, dreamed up the idea following a serious skiing accident. She had compressed vertebrae in her spine and was left bed-bound and immobile. She felt the urge to communicate with people who had been through the same experience, to share her problems with people who understood what she was going through. When you are bed-bound or housebound, the internet and e-mail are very liberating. You can orchestrate your own communications as though you were getting around at work or in a mall. For her, using e mail to consult her doctor or talk over her daily life with a friend is as normal as can be. She has never been so close with some many people on so many issues as she is now using the internet.

Closing the gap before it gets any bigger is a real priority for the medical world. People have a need for instant answers, zapping through life makes it necessary to have all resources quickly available and accessible. Come on Doc give it a try: reach out and touch your keyboard and mouse. Create your own website and start to be just a part of the World Wide Web. Get rid of your high chair or your fear of liability. E-mail is here to stay; make sure you stay with it!

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