Should patients be able to email their general practitioner?
pharmafile | September 3, 2014 | News story | Medical Communications, Sales and Marketing | BMJ, GPs, clinicians, econsultations, email
Email consultations with your doctor make better use of their time and are more convenient, or threaten safety and create more work for hard-pressed healthcare workers.
These are the arguments put forward by two doctors in a special ‘head-to-head’ published by the BMJ today.
The UK government currently sees the use of GP email contact and so-called ‘e-consultations’ as a means of boosting patient access to primary care and is piloting these services in 20 general practices in England.
It has mandated email communication for repeat prescriptions and appointment booking in the latest general practice contract, and stipulated that patients should be able to communicate electronically with their health and social care team by 2015.
But wider use of email is not compulsory, and primary care doctors have been slow to embrace this form of technology for communicating with their patients.
And with good reason, argues Emma Richards who is the academic GP registrar and honorary clinical research fellow for the Department of Primary Care and Public Health at Imperial College in London.
Despite its enthusiasm for the medium, the government has failed to issue guidance for doctors on email communication with patients, she says.
“The idea that patients can email unlimited requests and questions fills many GPs with dread, not only in terms of time but also clinical safety,” she writes in the BMJ.
“The evidence from telephone consultations indicates that they don’t replace face-to-face appointments; rather, they increase them,” she says.
And unlike phone calls, where a doctor can pick up cues about a patient’s health and ask pertinent questions, that sort of exchange isn’t possible in an email, she insists.
The ‘inevitable delay’ in answering an email could also prove ‘disastrous’ for a suicidal patient or one with chest pains she suggests.
Richards worries that email access will potentially widen health inequalities, as those most in need of healthcare, such as the elderly, may struggle to use this option because of lack of know-how or facilities.
Emails can work
But Elinor Gunning, a locum family doctor in London and a clinical teaching fellow in the Department of Primary Care and Population Health at UCL Medical School, insists that email services can work well, when properly planned and managed.
She says it is essential the service comprises: an email triaging system, a secure server, and patient consent, as well as ensuring that both patients and clinicians understand the limitations of email – and which kinds of inquiries are best suited to this medium.
“Patients must be made aware that emails may not be read immediately. The terms and conditions of email use can be covered comprehensively when consent for email use is taken, and reiterated in each email response,” she writes.
Many of the concerns raised about email services can be applied to phone and fax – now regarded as established and trusted components of general practice, Gunning says.
She agrees that not everyone will be able to access or readily use email, but that it’s up to general practice to provide as many means of access as possible ‘to improve care for all’.
“Although more research, investment and official guidelines are needed, sufficient strategies already exist to support the safe implementation of email services,” she writes.
More to the point: email use will soon be inevitable, she says. If doctors don’t embrace it now, they may “miss out on a vital opportunity to shape [it], to the detriment of patients and clinicians.”
Ben Adams
Related Content
Almost half of all cancer drug trials show bias and exaggeration
New research on clinical trials between 2014 and 2016 raise “serious concerns about low standards” …
NICE to set out new opioid prescription guidelines for GPs
NICE is set to develop new guidelines for GPs and healthcare professionals setting out rules …
More than 40% of GPs intend to quit within five years
More than 40% of GPs intend to quit within five years according to researchers at …
