title: Clinical e-mail in an academic dermatology setting.
abstract: BACKGROUND
  Use of e-mail among patients and physicians is limited by reservations over issues such as medicolegal aspects, reimbursement, and time-management.
  
  
  OBJECTIVE
  Our purpose was to identify the content of patient-related e-mails in an academic dermatology practice and determine whether clinical questions could be answered by e-mail.
  
  
  METHODS
  The first 100 e-mails received each year that related to patients from January 1, 2000 to June 1, 2005 (plus any messages received in e-mail threads started in the original 100) were studied (N = 614). E-mails were sent by patients, potential patients, or physicians in reference to a patient. E-mails were divided into 8 categories on the basis of content. E-mails were subdivided as relating to new (patients who had never been seen in-person) or established patients. All clinical questions were categorized as to whether they were answered by e-mail. The average number of e-mails received per e-mail thread was tallied.
  
  
  RESULTS
  E-mails were distributed as follows: clinical question from a physician (20%), clinical question from a patient (17%), appointment request (18%), request for referral to another physician (7%), prescription refill (3%), research inquiry (2%), thank-you correspondence (31%), other (17%). Percentages do not equal 100 because some e-mails contained more than one subject. Clinical questions were more likely to be answered when posed by physicians (100%) than patients (70%; P = .001), and when from established (79%) versus new patients (60%; P = .02). There were fewer e-mails per thread for queries from physicians (1.6 messages received) versus patients (2.2; P < .001) and for established (1.6) versus new patients (2.2; P < .001).
  
  
  CONCLUSIONS
  This study was limited to the experience of one dermatologist in an academic setting.
  
  
  CONCLUSIONS
  E-mail broadens communication between patients and their dermatologist. E-mail may facilitate consultation with other physicians and management of patients with chronic disease. "Thank-you" responses engage a substantial amount of e-mail resources.
authors.affiliation: Department of Dermatology, University of Michigan Medical School, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Kia
authors.forename: Anna
authors.initials: A
authors.lastname: Tavakkoli
authors.forename: Charles N
authors.initials: CN
authors.lastname: Ellis
mesh_terms: D003880:Dermatology; D034742:Electronic Mail / Q000706:statistics & numerical data*; D006801:Humans; D012871:Skin Diseases