E-mail access and improved communication between patient and surgeon

Objective: To examine the effectiveness of e-mail communication between surgeon and patient prior to elective surgery. Design: Prospective randomized study. Setting: Tertiary referral center. Patients: One hundred consecutive patients presenting for consultation prior to undergoing thyroid or parathyroid surgery. Intervention: All were randomized to either receiving an information sheet promoting e-mail communication as the preferred method of communication (group E) or a standard information sheet (group S). Main Outcome Measures: (1) Use of communication with the surgeon outside of the booked preoperative and postoperative consultation and (2) satisfaction questionnaire. Results: Overall, 26 of 100 patients (26%) initiated additional perioperative communication with the surgeon, 19 of 50 (38%) in group E and 7 of 50 (14%) in group S (P<.001). Of those who initiated communication, 22 of 26 (84%) did so by e-mail; 3 (12%), by fax; and 1 (4%), by telephone. For patients using e-mail, 18 of 22 (81%) were in group E and 4 of 22 (18%), in group S (P <.02). Overall, 34 e-mails were sent by 22 patients in the study group. Most e-mails sent focused on only I issue; however, some patients raised multiple issues, with the most being 4 issues in a single e-mail. There were no differences in any of the outcome measures in relation to patient satisfaction with communication. Conclusion: Despite concerns about potential medicolegal issues and other disadvantages, providing patients undergoing elective surgery with e-mail access to their surgeon results in improved levels of communication without any demonstrated impairment of satisfaction with outcomes.