One more comment and then I will quit.
When a patient calls asking some questions that starts to get complicated my staff asks them to send the question as an email. Generally, the patients are agreeable to this although they sometimes will grouch. But, then the message is in their own words and has not taken up the time of the office staff who would otherwise be copying down what the patient is saying. The downside is that the staff know to ask leading, pertinent questions such as "what do you mean fever, how high is your temperature?" that the patient will omit.
I use dragon and can dictate my reply and can ask necessary questions pretty easily. All in all I think the email is convenient, and helps work flow. I do have a couple of patients who are frequent emailers, I tend to keep my answers to them very short.
I think that "internet care" will be accepted as as service earning reimbursement sooner than telephone medicine....maybe by then my patients will all be well trained!
What do you suppose a HIPAA policeman looks like? Something like the CLIA inspector who visited my office a couple of years ago?
She was overweight, not clean, looked like a real low-end convenience store customer and smelled horribly of cigarette smoke. Your tax dollars hard at work.
