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E-mail access may improve patient-surgeon communication
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CHICAGO—Providing patients with e-mail access to their surgeon appears to improve communication without affecting patient satisfaction, according to a report in the February issue of Archives of Surgery, one of the JAMA/Archives journals.

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"The fundamental basis of the physician-patient relationship has always been face-to-face communication. However, advances in communications technology have, from time to time, challenged that assumption," according to background information in the article. Although e-mail has been used worldwide to transform communication in various industries such as banking and retail, little has been published regarding its use in health care "other than dire warnings about the potential minefield of legal disasters and litigation that might accompany its use."

Peter Stalberg, M.D., Ph.D., of the Royal North Shore Hospital, Sydney, Australia, and colleagues studied 100 patients prior to undergoing thyroid or parathyroid surgery. Of those, 50 (average age 45.1) were assigned to receive an information sheet including the surgeon’s e-mail address and a statement informing them that the surgeon’s preferred method of communication was e-mail. Another 50 patients (average age 48.2) received an information sheet that did not include an e-mail address or statement about the surgeon’s preferred mode of communication. The surgeon’s e-mail address was available to both groups on the appointment card and a website. Researchers assessed patient communication with the surgeon outside of consultation as well as information provided on patient satisfaction questionnaires.

In total, 26 of 100 patients (26 percent) initiated additional communication with the surgeon around the time of operation, 19 of 50 (38 percent) in the group provided with e-mail information and 7 of 50 (14 percent) in the group not given e-mail information on the contact sheet. "Of those who initiated communication, 22 of 26 (84 percent) did so by e-mail; three (12 percent), by fax and one (4 percent), by telephone," the authors write. For patients using email, 18 of 22 (81 percent) were in the group provided with e-mail information, while four of the 22 (18 percent) were in the group that did not receive e-mail information on their contact sheet.

Most e-mails sent addressed one issue, while only a few addressed multiple issues, with the most issues being four in one e-mail. Some of the most popular issues raised by email were general information (21 e-mails), postoperative recovery (eight e-mails), results (five e-mails) and reassurance (four e-mails). There were no differences in patient satisfaction with communication between the two groups.

"People who use e-mail certainly would like to have e-mail access to their physicians," the authors conclude. "Despite the many concerns, we believe that this study shows that the provision to patients of readily available e-mail access to their surgeon provides a very effective means of improving communication prior to patients undergoing elective surgery."
(Arch Surg. 2008;143[2]:164-169.

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at} .

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