Monday, January 20, 2014

Why email is better than a phone call when you need to talk to your doctor

Patients will often have many questions to ask their doctor, and the standard way of getting answers to these was by meeting him face-to-face after taking an appointment at his clinic . While this can be very important during the first consultation , it's often not worthwhile for the patient to travel all the way to the clinic for follow-on questions ( for example, when they want to ask a query about their lab results; or need to know if they should continue their medications). Most of these questions were best handled by phone, because this was much more cost effective for patients. Patients are used to being able to talk to their doctors on the phone , and when patients call, they expect their doctor to take the call – or to return it if he is busy. When doctors don’t do so, patients get upset , and they feel that the doctor is rude or is not accessible ; or doesn't care for them .

When my patients have questions , I request them not to phone me. I prefer that they e-mail me – and I promise that I will reply within 48 hours. Some of them don't like this , because they feel that email is impersonal . They expect their doctor to be available on the phone; and it’s true that it can be quite reassuring to hear the doctors voice on the phone . However, the fact is that the signal-to-noise ratio of a telephone conversation is extremely poor . For example , if I'm busy doing a consultation . and I then have to answer a phone call from another patient , it disrupts my flow of thought . I am likely to be quite curt in my replies, because I don’t have the time to sit and chat and fulfill social niceties. Also, the patient sitting in front of me is likely to think I am rude, because I have interrupted her consultation. The telephone call is actually an intrusion , and as a result of my tone, the patient may get even more upset after talking to me on the phone , because she may conclude that I am curt , unhelpful and uninterested.

Also, the quality of information which is exchanged in a phone call can never be good . For example, the patient may not communicate her concerns very well ; or I may not remember her exact medical details , as a result of which the advice I give may not be of high quality . While SMS ( texting) is not as disruptive, because of the shorthand it uses, the information content in these messages is often limited .

This is why I tell patients that if they do need to talk to me , rather than do this by a telephone call , it’s far better to do this by email. This way, everything is documented ; and I can check her medical records before giving her advise.

The major benefit of e-mail is that I can copy and paste answers to similar questions which patients have previously asked me ( and after so many years as an IVF specialist, I don’t come across questions which haven’t been asked before !). I can also provide links to websites which have more information , so that patients can go through these and get more depth and context.

Of course, when patients have questions , sometimes they don't just want information - they require a bit of handholding or emotional support . In these situations , an email is not as effective as a telephone call. However,  often a phone call is not a good tool either, and if you find that you need to talk to your doctor not because you need information , but because you need a shoulder to cry , then it’s far more sensible to go to the clinic and do this face to face !

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