Dear Doctors,

Can we talk a little about your “Patient Portal”? I know that as a practicing physician you do not have a lot of input into what data comes to the portal, but there is one incredibly powerful piece that you do have control of — the message to the patient. The message that goes to the patient can be critical in keeping patients in your practice, building relationships and engaging with patients in a real way that supports thier overall healthcare.

When I was first getting diagnosed with an autoimmune disorder, I was the recipient of some really bad communication. I received some lab results back through my patient portal with the following comments:

Wbc and neutrophil count
? Of flare
If so let me know

I was so new at this. My provider had not explained to me what a flare was, and this shorthand came to me in the portal with some abnormal results and it led to a lot of confusion. The time I spent calling the office staff and playing phone tag with people in the office probably cost more in time and labor than if the provider had given me some real communication. I did end up leaving this practice in part because of this type of communication.

Today, I travel to a big-city academic medical center for my specialty care. I have only seen my new Rhumetologist a couple of times, but I feel like we both have a better sense of each other, because of the way we communicate. He sends me letters, usually at the end of the day. It is not uncommon for me to get an email from him at 6 or 7 pm (when I imagine he has finished for the day and is gathering his thoughts for notes). A letter from my new doc goes something like this:

I am starting to get some of your results back.
So far the only abnormality is that your vitamin C is very low.
This can cause diffuse aching and bone pain all over the body. I would like you to take a high-dose vitamin C supplement pill once a day to try to correct this issue. This can be done over-the-counter, without a prescription. You should take 1000 mg (1 g) of vitamin C daily.

or where my old doc may have written take 2 muscle relaxers BID, my new Rhumetologist writes:

The first and simplest thing to do it to try the muscle relaxer for the back pain and see if it helps (of course, do this at a time when not needing to work or drive).
Definitely keep up with the gentle stretching, every little bit helps.
Let me know how that goes.

These are very simple messages, and yet the simple fact that he is using full complete sentences to respond to my thoughts and concerns, that he is using a salutation and signing his name — these mean something to me. It also encourages me to be honest and to write back when things are not working. I do not feel like I am a bother to him or he has no time for me. He finished his note with “let me know how that goes” so I can infer that he would actually like to know how it goes.

So please, be mindful about your communications. When you are on the patient side, sometimes that periodic email with your provider is a lifeline. I can be filled with worry and anxiety about a new symptom and when I get a note back from my provider with his thoughts, recommendations and the implied message that he wants to hear how I am doing…it makes it better for today.

Use salutations, call your patient by their preferred name, use full sentences and do make the assumption that if your patient is new, they may not understand all of the terms that you use and it is ok to explain them.

Your Friend,

Hobbled Chick