title: Can e-mail messages between patients and physicians be patient-centered?
abstract: This study explores the extent to which e-mail messages between patients and physicians mimic the communication dynamics of traditional medical dialogue and its fulfillment of communication functions. Eight volunteers drawn from a larger study of e-mail users agreed to supply copies of their last 5 e-mail messages with their physicians and the physician replies. Seventy-four e-mail messages (40 patient and 34 physician) were provided and coded using the Roter Interactive Analysis System. The study found that physicians' e-mails are shorter and more direct than those of patients, averaging half the number of statements (7 vs. 14; p < .02) and words (62 vs. 121; p < .02). Whereas 72% of physician and 59% of patient statements were devoted to information exchange, the remaining communication is characterized as expressing and responding to emotions and acting to build a therapeutic partnership. Comparisons between e-mail and with face-to-face communication show many similarities in the address of these tasks. The authors concluded that e-mail accomplishes informational tasks but is also a vehicle for emotional support and partnership. The patterns of e-mail exchange appear similar to those of in-person visits and can be used by physicians in a patient-centered manner. E-mail has the potential to support the doctor-patient relationship by providing a medium through which patients can express worries and concerns and physicians can be patient-centered in response.
authors.affiliation: Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. droter@jhsph.edu
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.forename: Susan
authors.initials: S
authors.lastname: Larson
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Sands
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ford
authors.forename: Thomas
authors.initials: T
authors.lastname: Houston
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D001294:Attitude to Health; D003142:Communication; D034742:Electronic Mail; D006801:Humans; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care