Recently I began providing my email address to my patients.  I’m not the only one, either.  You can read about how surgeons are starting to stay in touch with their patients, and how both parties are generally happier about it.  There’s a quick article about this issue here.

One of the big-time medical blogs out there, Kevin M.D., also weighs in on the subject and points out that there are some problems with this new practice.  One of the big ones he mentions is that email communications are probably often not HIPAA compliant.  If you don’t know what HIPAA is, I recommend that you NOT educate yourself.  HIPAA is classic D.C. armchair policy-making that is meant to protect patient privacy, but in reality does less for this goal than intended.  I’d prefer the acronym HIPPO.  The policies are minute and voluminous, arcane, endless, cumbersome and impossible to follow perfectly.  Worse, they’re meant to apply to every single health system in America.  No regional variation.  No State individuality.  EVERYBODY. 

In general, of course, the idea (initiated in ’96 by Bill Clinton) is a good one.  Nobody wants their health info on YouTube.  But while health information certainly is sensitive, the frank truth is that it isn’t high-value stuff.  I’d be much more worried about someone using my identity information than my medical history to ruin my life.  HIPAA policy – and the enforcement of it (they call it compliance) – has become an entire career field…all to protect information that is almost never interesting to anybody, even to the guys in ski-masks and dark glasses.

At any rate, it appears that doctors may not be able to talk to their own patients by email unless the system is hyper-encrypted to keep bad guys from getting the info and…oh, selling it on the medical info black market in Paraguay or whatever. 

You can see that I have a dim view of government policymaking.  I think government policy is often nothing more than a cathartic exercise for people with an above-average need to feel important.  Writing stuff – even stupid stuff – that other people have to obey will make you feel important.  In fact, the more stupid, the better.  You’re in control.  “DO IT!” you can demand, “Even if you think it’s dumb.”  You’re The ALPHA.

Government wonks do this all the time, resulting in thousands of rules – which fulfills their own subconscious needs – that tend to be laughable and illogical when applied to every single human in America.  HIPAA is supposedly in place to protect patients from losing their info.  With respect to email correspondence between doc and patient, shouldn’t the actual patient themselves have the right to correspond with their doctor however they choose?  No.  You, dear ignorant patient (and doctor).  You have no idea what is good for you.  We here in Rached, D.C. will take care of you, whether you want us to or not.

The truth is that doctors, me included, HATE making phone calls.  They take forever.  The number is invariably wrong.  You have to find somewhere to talk where your conversation isn’t going to be overheard.  You NEVER get paid for them (unlike lawyers, who must have listened in their business classes).  And often the patient isn’t there and you have to fret over leaving a message or not, never knowing who is going to hear the message, etc. (violating HIPAA, again)  Ultimately, I feel bad that it takes me so long to get back to a patient when they leave me a message.  Email is a perfect solution. 

Or was…until policymakers totally remove this option from patients and their doctors. 

The number of people edging themselves between patients and their doctors over the past 30 years is truly amazing – government, lawyers, insurance agents, pharmacy, to name a few.  The evolution of this new army of medical middle-men, I believe, will be what is remembered about American medicine 100 years from now.  And I think it will be looked upon as a largely aggressive and capitalistic change that generally harmed patients, not helped them.