Patient-physician e-mail: passion or fashion?

This article surveys the nature, prevalence, and risks and benefits of patient-physician e-mail as a prelude to critically evaluating what will be required for it to become a truly transformational technology. Diverse materials from both the popular press and various clinical domains are consulted in order to appraise patient-physician e-mail's efficacy in different contexts and among different patient and physician users. Early evidence that patient-physician e-mail has lasting power includes its use in niche clinical applications, appearance of unsolicited patient e-mail, historical patterns of medical technology adoption, and increasing use of the Internet in general. Patient-physician e-mail will become genuinely transformational if it affirmatively improves the patient-physician encounter, contributes to better clinical outcomes, makes patient-physician communication more convenient for both parties, demonstrably transcends existing reimbursement and medicolegal concerns, and promotes patient empowerment. Like all technologies, use and misuse of patient-physician e-mail will determine whether its possibilities will become realities.