title: E-mails in a Psychiatric Practice: Why Patients Send Them and How Psychiatrists Respond.
abstract: BACKGROUND
  Little is known about what prompts patients to use e-mail with their physicians and how physicians respond to these e-mails.
  
  
  OBJECTIVE
  To identify the main reasons why patients e-mail and to learn how psychiatrists manage these e-mails as part of these patients' overall care.
  
  
  METHODS
  One hundred patient-initiated e-mails to each of two psychiatrists in a group practice were studied retrospectively for primary reason for the e-mail and for psychiatrists' handling of each e-mail. Other data were collected to assess how representative the e-mailing patients were of the psychiatrists' patient panels.
  
  
  RESULTS
  Age, sex, and diagnoses of the e-mailers were similar to our overall panels. The most common reasons for e-mailing were refill requests (19.5%), questions about prescribed medication (16.5%), and worsening of symptoms (11.5%). The modal e-mail was a patient with attention-deficit/hyperactivity disorder requesting a refill. The psychiatrists' most common responses were authorizing a refill (25%), reassurance (22%), and making or moving up a scheduled appointment (16%). For all patients who reported a worsening of symptoms, responses, communicated by e-mail or telephone, included a combination of an earlier appointment and/or change in medication or dose and/or referral for psychotherapy. Both psychiatrists found e-mail to be an efficient enhancement of their practice, and it was inferred that this was also a satisfying mechanism for patients.
  
  
  CONCLUSIONS
  Physician-patient communication via e-mail is timesaving for both, and the benefits to patient care should reassure physicians who are wary of using e-mail in their practice. Potential risks to patients without face-to-face or telephone contact appear to be minimal.
authors.affiliation: Psychiatrist at the Aliso Viejo Medical Offices in CA. richard.j.moldawsky@kp.org.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Moldawsky
authors.affiliation: Psychiatrist at the Santa Ana Medical Offices in CA. pranav.v.shah@kp.org.
authors.forename: Pranav V
authors.initials: PV
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D003657:Decision Making; D034742:Electronic Mail; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011570:Psychiatry; D012189:Retrospective Studies; D055815:Young Adult