If Symptoms Persist, Text Your Doctor

By James Hamblin

Ninety percent of Americans have never emailed or texted with their doctor. Should they?

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 1906 concerns about the isolating nature of communication technology  [Image via kottke.org]

The average American writes a novel's worth of email every year. They also read a novel's worth of trend stories about how all we do is text -- how 15 million texts sent every minute are destroying the art of conversation, rotting our souls. Still, only about one in ten Americans has ever emailed or texted with their doctor. The formal in-office face-to-face patient-doctor dynamic is largely sacrosanct.

In a survey conducted for The Atlantic in conjunction with GlaxoSmithKline, 1000 Americans talked about their health tech habits:

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That's among a sample where 73 percent said they had "doctors and dentists whom [they] can access regularly."(Please feel free to speculate as to the nature of the "Don't know" responses in the comments.)

So why isn't access to doctors more electronic? Confidentiality is one concern, and not every patient wants to text -- but a lot more than ten percent do. Many doctors just don't have a system to accommodate texting and emailing with patients. How often is too often? During what hours? When is it a billable service? 

Of course a patient should still come into the office for any substantial concern. No one's recommending attaching an image to an email, subject line "this is tumor?" 

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But checking in with quick questions can allow doctors to triage what really warrants an in-person office visit -- which costs, on average $130 - $180; $580 - $700 if it's in an emergency room -- and what can be accommodated remotely. All by the means of communication that have defined the rest of modern society for a decade.

Tech-savvy practices and hospitals are increasingly using remote access systems for patients, where they can log in to a website and get test results or leave messages for physicians, within a secure system, in a limited capacity. That's a good place to start. It keeps all interactions in one HIPAA-compliant place and keeps doctors' personal phones and emails from being overrun by concerned patients. If a busy primary care physician has 1,500 patients, even if each one only emailed him every six months, that would be eight emails 365 days a year.

But some doctors, especially specialists with a smaller patient base who manage fewer chronic conditions, have been able to integrate texting into their practice. There are HIPAA-compliant text and email platforms, and most major insurers are figuring out ways to cover "digital visits."

For people who don't have that sort of access to a doctor yet, the increasingly immediate option is Internet self-service. This survey found that people are generally reasonable about taking medical information from the Internet for what it's worth, not acting on it until they've talked it over with a doctor. Surprising to me, though, a third of people said they have never looked up their symptoms or conditions online:

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What do people use the Internet for, if not to figure out things about the nature of their bodies? Of those who do, though, here's where they go:

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If you've been getting your health information from Men's Health, text your doctor. 

Here's how people generally use these sites:

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And even though a third of people haven't gone online to read about medical things at all, a significant number are on board with paying to consult their doctor via text or email. Wealthy and rural people, especially. 

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And some go so far as to be willing to communicate with their doctors primarily online. That includes about a third of people under 30.

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We didn't ask, but presumably few people would be willing to communicate with their doctor via telegraph. Times are changing. What's next? Doctors stop carrying giant one-way pagers? Training IBM's Watson -- the one who beat Ken Jennings on Jeopardy -- to be your robot doctor?

This article available online at:

http://www.theatlantic.com/health/archive/2013/03/if-symptoms-persist-text-your-doctor/273721/