Learning From E-Mail Hailstorms

Risks of e-mail communication with patients, legal dangers of online confidentiality breaches, and basic e-mail etiquette have been explored in medical and (at even greater length) insurance materials. However, after a couple of disruptive e-mail hailstorms recently, I believe further exploration of e-mail use between colleagues may be of merit. And, hoping to help others avoid the pitfalls I have encountered, I propose two new online communication guidelines.

First, several trainees failed to respond to e-mails promptly and consistently. I and others presumed this was a lack of professionalism and thus noted it on the trainees’ evaluations. After the trainees became distraught, however, it was clear that they were not aware that others so valued a prompt online response. With scattered work locations and full schedules, some used only voicemail or pages for significant communications. I thus discovered the importance of directly clarifying expectations around e-mail with colleagues just as I routinely do with patients.

Second, a recent casual and probably too quickly typed e-mail message meant to raise awareness was misunderstood and distributed widely. Guidelines widely advise avoiding use of e-mail when angry. However, this experience, which stemmed from an even-tempered e-mail on a good day when I was trying to be of use, leads me to suggest avoiding e-mail to communicate less-than-positive subjects. As with patients, where e-mail is quickly replaced by phone conversations and in-person appointments when difficult issues arise, communications with colleagues on complex or difficult topics should move away from the virtual.

In short, some of the same meticulous guidelines that psychiatrists tend to use with patient e-mail communications can improve communication between professionals. These include a careful discussion of e-mail procedures and a quick movement to in-person communication around tough subjects.