Congested and fever-stricken at his Wicker Park home, Eli Howayeck clicked on the link to consult with his doctor online about his symptoms and what he should take for them — all without the hassle of taking time off work, driving to the doctor’s office and sitting in the waiting room.
Less than 24 hours later, he had an e-mail from his doctor with attached prescriptions for antibiotics, which he forwarded to the pharmacy near his home.
“At the end of the day, for a sinus infection I really don’t need to waste half a day of work to get downtown,” said Howayeck, 30, who works near O’Hare as director of corporate development for Access Medical Group.
“It eliminates the need for that live appointment when it’s really not that necessary,” he said of online consultations.
Some doctors communicate with their patients online for non-urgent medical issues and to schedule appointments and refill prescriptions. Others are reluctant to e-mail or do online consultations with patients because of a lack of reimbursement from insurance companies, potential for miscommunication, preference to do in-person examinations and the idea of a flooded e-mail inbox.
“It’s one thing to respond to an e-mail about office availability next week, but it’s another thing to respond to an e-mail from someone who has complaints about shortness of breath,” said Dr. G. Caleb Alexander, assistant professor in the department of medicine at the University of Chicago.
“It’s hard enough figuring out diagnoses and treatments over the phone, let alone by using e-mail,” Alexander said.
Still, a 2006 poll showed a majority of patients surveyed – 74 percent – would like to use e-mail to communicate directly with their doctors.
“There’s no question the young population overwhelmingly loves to have this access and this as an option,” said Dr. Lyle Berkowitz, associate professor of clinical medicine at Northwestern University’s Feinberg School of Medicine.
“They do their banking online. They make reservations for travel online. This is another part of their life they want to access on the Internet, and it makes sense,” said Berkowitz, who also is the medical director of clinical information systems for Northwestern Memorial Physicians Group.
While some patients like the convenience of e-mail for minor questions, they still prefer being diagnosed in person.
“I would e-mail my doctor for the convenience if I had questions about the medicine I was already on or the condition I was diagnosed with,” said Bridget Bolger, 21, of Wicker Park. “As far as a primary diagnosis, I would worry about the variables and probably end up following that with an actual doctor’s visit just to confirm.”
Access to online doctor-patient communication is improving.
“Patient-practice messaging is a national trend that’s growing rapidly, and that includes physician Web sites,” said Dr. Edward Fotsch, CEO of San Francisco-based Medem, which was founded by the American Medical Association and several national medical specialty societies to provide a secure, online communications system between health-care providers and their patients.
Nationwide, Medem’s iHealth system has 70,000 doctors with Web sites, representing a 15 percent average yearly growth since 2000; 13,000 physicians who use a secure form of e-mail, which has grown roughly 41 percent a year since 2001; and 10,000 doctors who use online consultations, up an average of 23 percent a year since 2002, Fotsch said.
To consult their doctors online, patients might have to pay a fee similar to the amount charged as a co-pay for an office visit.
“It doesn’t cost the patient any more or less … but they save their time and their gas and their parking,” Fotsch said.
The messaging and online visits are for simple, non-emergency issues or to get second opinions, said doctors who use online services to communicate with patients.
“I try to keep it to garden-variety things: common colds, dosages for Tylenol, dosages for some of the over-the-counter medications, behavior problems like sleep >>
problems,” said pediatrician Dr. Armand Gonzalzles, who practices in Lincoln Park.
Being accessible over the Internet has proved helpful to new parents when they want to know what formula to feed their baby or what to do if the baby has a diaper rash, he said.
“They have lots of questions. They can put them all in one e-mail,” Gonzalzles said. That way, they can get their questions answered within 24 hours and “don’t feel like they’re bothering me,” he said.
Generally, patients talk to their doctors online by logging on through their doctors’ Web sites and using a password to request appointments or prescription refills, get test results or leave a secured message for their doctor. Patients are notified of the doctors’ response time to the message and online consultations.
For the online visits, patients can list their symptoms to help their doctor determine the problem and whether the doctor needs to see the patient. Messages between doctors and patients could include attached photos or documents.
“The doctors who use it a lot find that it actually makes their life easier because there’s less phone tag. They clearly state what they want the patient to know,” said Northwestern’s Berkowitz. Patients can refer back to the written message instead of remembering what the doctor said at the office, he said.
“It’s clearly not for long, complicated issues. It’s for isolated, minor problems,” Berkowitz said.
Alexander, of the University of Chicago, said he is hesitant about using e-mail in corresponding with patients. E-mail is a poor means of communication when it comes to medical care, he said.
“It has one huge benefit, which is speed, but it has a number of drawbacks as well,” Alexander said. “The physical exam is important in making diagnoses and developing treatment plans, and that’s entirely eclipsed by e-mail and phone conversation.” lvivanco@tribune.com
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Log on
If you want to talk to your doctor without going to the his or her office, you’re not alone. A 2006 Wall Street Journal Online/Harris Interactive Health-Care Poll showed that most people would like to use technology to communicate with physicians. Of the 2,624 U.S. adults surveyed online:
would like to use e-mail to communicate directly with their doctor.
said physicians’ use of e-mail to communicate directly with them or a family member would influence their choice of doctors a great deal or to some extent.
would like reminders via e-mail from their doctors when they are due for a visit or some type of medical care.
would like to have the ability to schedule a doctor’s visit via the Internet.
said they use e-mail to communicate with their doctors and 4 percent said they have it available but do not use it.
would like to receive the results of diagnostic tests via e-mail.
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On YouTube
Last week , Medem announced that doctors who use its Web-based services will be able to post YouTube-hosted videos on their Web sites.
Physicians will use the videos to educate patients, explain treatment plans or procedures and introduce their practices to new patients.
“By incorporating video in practice Web sites, we have created a dynamic new way for physicians to connect with their patients, strengthen the physician-patient relationship and grow their practices,” said Dr. Edward Fotsch, CEO of Medem.
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lvivanco@tribune.com
