Patients looking for information on the Internet and seeking teleadvice: motivation, expectations, and misconceptions as expressed in e-mails sent to physicians.
OBJECTIVE
To analyze the motivation, expectations, and misconceptions of patients seeking teleadvice or medical information on the Internet. To explore the possible economics and problems of direct physician-to-patient teleadvice via electronic mails (e-mail).


METHODS
Exploratory survey of 209 unsolicited e-mails mostly sent to physicians by individuals seeking teleadvice.


METHODS
University dermatology hospital with a major Web site on the World Wide Web.


METHODS
Two hundred nine patients and information-seeking individuals, mainly with dermatologic problems.


METHODS
Previous contacts with live physicians, disease duration, level of frustration expressed in the e-mails, and type of information sought.


RESULTS
Many dermatologic patients who request teleadvice have a chronic disease (81%) and seek a second opinion. Seventeen percent express frustration about previous encounters with live physicians. Forty percent of all e-mails could have been answered by a librarian, 28% of all e-mails were suitable to be answered by a physician via e-mail alone, and in 27% of the cases any kind of consultation would not have been possible without seeing the patient. In at least 5 instances patients attempt self-diagnosis.


CONCLUSIONS
We found examples for the beneficial effects of the provision of medical information on the World Wide Web but also evidence suggesting that patients are trying to use information on the Internet as a supplement for physicians and that teleadvice might be overused by chronically ill and frustrated patients looking desperately for additional information. Telemedicine via e-mail could substitute a physician visit or telephone call in some cases, but many principal problems must be solved beforehand.
Department of Dermatology, University Hospital of Erlangen, Germany. eysenbach@derma.med.uni-erlangen.de
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Eysenbach
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Diepgen
D003880:Dermatology; D006801:Humans; D020407:Internet; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic