title: Patient access to U.S. physicians who conduct internet or e-mail consults.
abstract: BACKGROUND
  E-mail communication has the potential to improve communication between patients and doctors.
  
  
  OBJECTIVE
  The objective of the study is to describe the access of patients to physicians who conduct e-mail consults.
  
  
  METHODS
  We analyzed data from the National Ambulatory Medical Care Survey (NAMCS), a nationally representative cross-sectional survey of office-based physician visits, in 2001, 2002, and 2003. The main outcome measure was the percentage of visits to a provider who reported doing internet or e-mail consults.
  
  
  RESULTS
  There was fewer than 1 in 10 outpatient visits in 2001 (9.2%) to physicians who reported doing internet or e-mail consults, and this did not increase in 2002 (5.8%) or 2003 (5.5%). Access to these physicians was greater among patients who were male, nonminority, lived in the Western United States, seen for pre-/postoperative care, seen by a primary care provider, and not seen by a nurse during their visit. Access to physicians who conducted internet or e-mail consults was independent of other patient (e.g., chronic conditions), provider (e.g., office setting), and visit (e.g., medications prescribed) characteristics.
  
  
  CONCLUSIONS
  Access to physicians who do internet or e-mail consults is generally low and did not increase between 2001 and 2003, despite growth in internet access and in other internet-related activities.
authors.affiliation: Department of Health Policy, Jefferson Medical College, Philadelphia, PA 19107, USA. Chris.sciamanna@jefferson.edu
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Sciamanna
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Rogers
authors.forename: Edmond D
authors.initials: ED
authors.lastname: Shenassa
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Houston
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003936:Diagnosis, Computer-Assisted / Q000639:trends; D034742:Electronic Mail / Q000639:trends*; D005260:Female; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D020407:Internet / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000639:trends*; D012017:Referral and Consultation / Q000639:trends; D014481:United States