Select location
Membership information
0800 561 9000
Medicolegal advice
0800 561 9090
Menu
Refine my search

From the advice line

Post date: 03/11/2017 | Time to read article: 3 mins

The information within this article was correct at the time of publishing. Last updated 14/11/2018

Written by a Senior Professional
Dr Rachel Birch shares a recent case where a member asked for advice on how to deal with a patient who persistently emailed a doctor at the practice about medical issues, instead of attending for a consultation.

Mr B is a practice manager and telephoned the Medical Protection advice line to discuss a difficult situation. Dr H had sought advice from a neurologist about Mrs A’s symptoms a few months previously. She had forwarded the neurologist’s response to Mrs A as his specialist opinion had been reassuring. She used her NHS email account. Unfortunately, after a couple of weeks, Mrs A started sending emails to Dr H. The first two, she said were “for information” and detailed her various symptoms, which the neurologist had termed unexplained medical symptoms. Dr H had responded to these emails, suggesting that Mrs A come in to see her. Mrs A then sent an email to Dr H, asking whether she might benefit from a multivitamin. The following week she emailed Dr H, asking her for a prescription for her HRT, stating that it was always so difficult to get an appointment with Dr H as she was a popular doctor. Dr H felt concerned that Mrs A was starting to use email as an alternative to clinical consultations. She emailed Mrs A back again, advising her that her queries would be more appropriately addressed in a consultation and asking her to come and see her in the practice. Mrs A didn’t email Dr H for a few weeks. However, rather than making an appointment to see Dr H, she sent her a photograph of a rash on her abdomen and asked her for a cream for this. Since Dr H worked part time, she did not review this email for two days. Dr H discussed her concerns with Mr B, and they agreed that there were potential risks in Mrs A seeking medical advice by email.

Expert advice

Mr B called the Medical Protection medicolegal advice line and spoke to one of our expert medicolegal advisers, Dr R. Dr R considered that, since Dr H has already responded to previous emails, Mrs A may have the expectation that it was acceptable to correspond with her in this way. Dr R suggested that Mr B and Dr H may wish to invite Mrs A in to discuss their concerns about the use of email correspondence. As part of this meeting they should explain to Mrs A what the practice can and cannot address by email. Dr R also advised that it might be helpful to explain to Mrs A the process for arranging appointments and accessing advice, for example by arranging to speak with the duty doctor or leaving a message with reception for Dr H to telephone her when she is next in the practice. If the practice has a generic administrative email inbox, for example for prescription requests, it would be helpful to provide Mrs A with this email address. Minutes of the meeting should be taken and the practice may wish to consider providing Mrs A with a copy of these.

Learning points

  • Practices should discuss and agree their approach to email correspondence with patients. It is better for all clinicians to be consistent in their approach.
  • Only appropriate matters should be dealt with via email exchanges and the practice should consider how they wish to use email to communicate with their patients.
  • Some practices use email for appointment scheduling, others for the ordering of repeat prescriptions. In such situations, it is best to use a central practice email address, rather than a personal address, so that all members of the administrative team can access the emails.
  • If doctors are considering communicating with patients about their health, it is important to remember that there are potential risks with this process. Many of the subtleties of communication, including non-verbal cues, are lost when communicating by email. There is no opportunity for the patient to be examined. It may be difficult for doctors to ensure a patient has fully understood the advice provided. For these reasons, email should not be used as a replacement for a face-to-face consultation.
  • It is important to ensure that all emails to and from the patient are included as part of the patient’s medical record.

Share this article

Share
Load more reviews
Rating

You've already submitted a review for this item

|
New site feature tour

Introducing an improved
online experience

You'll notice a few things have changed on our website. After asking our members what they want in an online platform, we've made it easier to access our membership benefits and created a more personalised user experience.

Why not take our quick 60-second tour? We'll show you how it all works and it should only take a minute.

Take the tour Continue to site

Medicolegal advice
0800 561 9090
Membership information
0800 561 9000

Key contact details

Should you need to contact us, our phone numbers are always visible.

Personalise your search

We'll save your profession in the "I am a..." dropdown filter for next time.

Tour completed

Now you've seen all of the updated features, it's time for you to try them out.

Continue to site
Take again