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Electronic Communication With Patients

When physicians engage in electronic communication they hold the same ethical responsibilities to patients as they do during other clinical encounters.
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Code of Medical Ethics Opinion 2.3.1

Electronic communication, such as email or text messaging, can be a useful tool in the practice of medicine and can facilitate communication within a patient-physician relationship. However, these channels can raise special concerns about privacy and confidentiality, particularly when sensitive information is to be communicated. When physicians engage in electronic communication they hold the same ethical responsibilities to patients as they do during other clinical encounters. Any method of communication, virtual, telephonic, or in person, should be appropriate to the patient’s clinical need and to the information being conveyed.

Email correspondence should not be used to establish a patient-physician relationship. Rather email should supplement other, more personal encounters.

Physicians who choose to communicate electronically with patients should:

(a) Uphold professional standards of confidentiality and protection of privacy, security, and integrity of patient information.

(b) Notify the patient of the inherent limitations of electronic communication, including possible breach of privacy or confidentiality, difficulty in validating the identity of the parties, and possible delays in response. Such disclaimers do not absolve physicians of responsibility to protect the patient’s interests. Patients should have the opportunity to accept or decline electronic communication before privileged information is transmitted. The patient’s decision to accept or decline email communication containing privileged information should be documented in the medical record.

(c) Advise the patient of the limitations of these channels when a patient initiates electronic communication.

(d) Obtain the patient’s consent to continue electronic communication when a patient initiates electronic communication.

(e) Present medical information in a manner that meets professional standards. Diagnostic or therapeutic services must conform to accepted clinical standards.

(f) Be aware of relevant laws that determine when a patient-physician relationship has been established.

AMA Principles of Medical Ethics: I, IV, VI, VII

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