Patient and doctor interactions are one of the cornerstones of medical care and with the advent of modern technology, there is now more than one way for doctors and patients to communicate with each other. With the rise of the mobile phone, instant two way communication has become even easier. I have found that having a patient’s a mobile phone number a great resource when I need to contact them urgently when they have an abnormal test result. In addition, the general and widespread availability and use of e mail both within the healthcare setting and in society as whole, you would think patient and doctor e mail interaction is common.

In my personal experience, apart from pockets of enthusiastic doctors using email, I don’t hear about a lot of email exchange between patients and their doctors. Part of the reason is time. Doctors simply don’t have time to have multiple email exchanges with a large number of patients. Furthermore email does not always allow a doctor to evaluate patient responses fully. Think, for example, of witnessing patient emotions and reactions. There are also risks for security and privacy breaches in email exchanges. All these factors make doctors uneasy in adopting widespread e mail use when dealing with patients.

Part of the reason for poor uptake may be financial. If doctors are squeezed for time and are not reimbursed or given some form of advantage for using email to communicate with their patients, they have little practical incentive to use it as a form of clinical interaction. Interestingly, patients are not willing to pay to have email access to their health care provider.

A recent blog in the Los Angeles Times stated that about 12% of Americans with internet access have had online communication with their doctor’s practice. That may include other modalities such as secure websites, Twitter and Facebook. The blog article does indeed mention Twitter as a potential way of communicating with patients. A recent New York Times article also looked at medicine in the modern communication age, and also made the valuable point about overloading doctors by opening up yet another line of communication such as Twitter.

With evolving methods of online interaction such as Facebook, new dangers can lurk round the corner. An excellent, recent article in The New England Journal of Medicine warned of potential dangers of social networking sites.

Would you be happy if a patient or future employer gained access to your Facebook profile, especially if there is anything that would embarrass you? It is easy to let your guard down on a social networking site’s profile, and professionally this may not be good for your image. For example, a group of doctors and nurses were recently suspended for posting pictures of a prank in Facebook.

The online world is a rich and versatile communications medium and we as health professionals will have to learn and adapt to this new environment. New interactions will be possible with our patients and for that matter everyone else. With the pace of change so rapid, we medics will have to learn how to play our role in this new order. We will have to do it properly and sensibly and be prepared to learn from mistakes. However there is no getting away from the fact that we cannot ignore this on line communications revolution.

Harry Brown is a GP in Leeds

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