We assume that technology will improve communication between doctors and patients.

But not always. Look at the 2,000 word email.

While it isn’t yet the standard means of communication in our clinic (it will be soon) we occasionally take email from patients. My experience has been that they’re sometimes long and unfocused with tangential information irrelevant to the problem at hand.

Of course we can’t blame the patient. They are acting in what they think is their best interest: put it all out there so the doctor has the information.

But too much information can cloud good communication.

In person I can pull the wandering interview back to center. Within a limited time frame I can help a patient understand what information I need to get the job done. But I’m not on their shoulder when they pen their email.

When a patient hits the send button with a 2,000 word email it’s the responsibility of the receiving office to act on what’s been suggested, alluded to or hinted. An interpreting human has to get to the bottom line: Is there one simple question buried here or is there a new problem that requires an office visit? Consider a practice with 10,000 patients all wanting to email at 2am when they can’t sleep. This can create real problems for a tightly staffed medical office operating on a slim margin.

Consider too that every one of those 2,000 words is subject to legal discovery.

Shortly my clinic will begin using a HIPAA-compliant email system integrated with our EMR. And at that point we’ll realize email as a standard means of communication. With my patients I’ll insist that email be used with tightly defined boundaries that specify the kind of problems and questions considered as well as their appropriate length and format.

The 2,000 word email illustrates just one challenge that doctors face when adopting new technology. Expect similar discussions surrounding other social media formats.