Guidelines for Internet Use

E-mail recommendations

1. E-mail correspondence should not be used to establish a patient-provider relationship. Rather, e-mail should supplement other, more personal encounters.

2. When using e-mail communication, providers hold the same ethical responsibilities to their patients as they do during other encounters. Whenever communicating medical information, physicians must present the information in a manner that meets professional standards. To this end, specialty societies should provide specific guidance as the appropriateness of offering specialty care or advice through e-mail communication.

3. Providers should engage in e-mail communication with proper notification of e-mail�s inherent limitations. Such notice should include information regarding potential breaches of privacy and confidentiality, difficulties in validating the identity of the parties, and delays in responses. Patients should have the opportunity to accept these limitations prior to the communication of privileged information. Disclaimers alone cannot absolve providers of the ethical responsibility to protect patients� interests.

4. Proper notification of e-mail�s inherent limitations can be communicated during a prior patient encounter or in the initial e-mail communication with a patient. This is similar to checking with a patient about the privacy or security of a particular fax machine prior to faxing sensitive medical information. If a patient initiates e-mail communication, the provider�s initial response should include information regarding the limitations of e-mail and ask for the patient�s consent to continue the e-mail conversation. Medical advice or information specific to the patient�s condition should not be transmitted prior to obtaining the patient�s authorization.

Source: The American Medical Association, Council on Ethical and Judicial Affairs, Chicago.