No more hang-ups: With e-mail, the doctor is in

Patients send home-test results, avoid visits

When patients have something to say to Ann Arbor, MI, family physician Lee Green, MD, MPH, they don’t have to put up with getting a busy signal, an automated message, voice mail, or even a receptionist. They can simply send him an e-mail, and they’ll receive a response within the day.

E-mail makes Green seem perpetually available — even in the middle of the night when someone wonders about a prescription’s side effects or wants to tell the doctor about the latest blood glucose home-test.

E-mail also has reduced the overall phone volume to Green’s office, which frees up the lines for those patients who need to call to schedule an appointment. Green is working with a Chicago family physician [and former Ann Arbor resident] to study the impact of e-mail on patient satisfaction. While e-mail technology in general has been criticized as impersonal, Green says his patients seem to like it.

"I don’t know any of my patients who have access to e-mail who prefer to call," says Green, an associate professor at the University of Michigan. "I’m probably getting two or three e-mails per phone call or about half a dozen a day. That’s about what the average physician would get in terms of calls from patients."

Many of Green’s patients are university faculty and staff, so they feel comfortable with the technology. The University of Michigan was one of the original Internet sites — even before the network had that name. Green has been communicating with patients via e-mail for about six years.

But as use of the Internet expands, so does the interest in sending e-mail messages. Now, Green says his e-mail patients include "anyone who has a computer" — truck drivers, housekeepers, schoolchildren.

Perhaps the greatest impact has been on the treatment of patients with chronic conditions. Diabetic patients monitor their blood glucose at home and send the results weekly or biweekly, depending on their condition.

Patients with chronic hypertension but no organ damage take their blood pressure at least weekly and send Green the results monthly. That has cut down on the number of office visits required simply for routine monitoring, he says.

"Many of my patients are busy professional people," he says. "They don’t like having to make a trip to the doctor’s office if they don’t have to."

Of course, Green continues to see patients frequently if they have difficult cases or if they don’t feel comfortable with that self-management. But e-mail is growing more popular among patients.

That’s fine with Green, even as his e-mail box fills up. It spares him the frustration of missed phone calls and mixed messages. "I would rather everyone send me e-mail and I never get another phone call," he quips.