Ethics Forum: Thoughts on Managing Electronic Communication with Patients

Clearly, we must not overemphasize the idea that electronic systems alone may bridge the gap in healthcare inequality; they may actually exacerbate certain distribution imbalances.

In Sum

Electronic communications can help patients better access our healthcare system and improve healthcare equity. However, unchecked, this same system can overwhelm us and hamper our ability to care not only for our patients, but for ourselves.

To advance patient and clinician well-being, the healthcare system should recognize electronic communications as essential aspects of clinician productivity. Although billing for these services may be a good first step, further codification of the appropriate use of the inbox will be needed to balance both patient and clinician priorities. Electronic healthcare reform itself will need to be bundled with other initiatives to allow clinicians to thrive and optimize patient care.

James Topilow, MD, is a second-year rheumatology fellow at Johns Hopkins School of Medicine, Baltimore. Following his fellowship, he will join Hackensack Meridian School of Medicine, New Jersey.

Yvonne M. Golightly, PT, MS, PhD, is a professor and assistant dean for research at the University of Nebraska Medical Center College of Allied Health Professions, Omaha. She is a musculoskeletal epidemiologist and a physical therapist with 20 years of experience in research and over a decade of clinical practice.

References

1. Tiwari V, Kavanaugh A, Martin G, et al. High burdens of burnout on rheumatology practitioners. J Rheumatol. 2020 Dec 1;47(12):1831–1834.
2. Rittenberg E, Liebman JB, Rexrode KM. Primary care physician gender and electronic health record workload. J Gen Intern Med. 2022 Oct;37(13):3295–3301.
3. Holmgren AJ, Downing NL, Tang M, et al. Assessing the impact of the COVID-19 pandemic on clinician ambulatory electronic health record use. J Am Med Inform Assoc. 2021 Jan 29;29(33):453–460.
4. Emerson RW. Representative Men: Seven Lectures. SoHo Square: George Routledge & Co.; 1850.
5. Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract. 2021;30(1):17–28.
6. Okobi E, Adigun AO, Ozobokeme O, et al. Examining disparities in ownership and use of digital health technology between rural and urban adults in the US: An analysis of the 2019 health information national trends survey. Cureus. 2023 May 2;15(5):e38417.

Editor’s note: Got a question or comment? Email us at [email protected].