Patients looking for information on the Internet and seeking teleadvice - Motivation, expectations, and misconceptions as expressed in e-mails sent to physicians

Objectives: To analyze the motivation, expectations, and misconceptions of patients seeking teleadvice or medical information on the Internet. To explore the possible economics and problems of direct physician-to-patient teleadvice via electronic mails (e-mail). Design: Exploratory survey of 209 unsolicited e-mails mostly sent to physicians by individuals seeking teleadvice, Setting: University dermatology hospital with a major Web site on the World Wide Web. Patients: Two hundred nine patients and information-seeking individuals, mainly with dermatologic problems. Main Outcome Measures: Previous contacts with live physicians, disease duration, level of frustration expressed in the e-mails, and type of information sought. Results: Many dermatologic patients who request teleadvice have a chronic disease (81%) and seek a second opinion. Seventeen percent express frustration about previous encounters with live physicians. Forty percent of all e-mails could have been answered by a librarian, 28% of all e-mails were suitable to be answered by a physician via e-mail alone, and in 27% of the cases any kind of consultation would not have been possible without seeing the patient. In at least 5 instances patients attempt self-diagnosis. Conclusions: We found examples for the beneficial effects of the provision of medical information on the World Wide Web but also evidence suggesting that patients are trying to use information on the Internet as a supplement for physicians and that teleadvice might be over-used by chronically ill and frustrated patients looking desperately for additional information. Telemedicine via email could substitute a physician visit or telephone call in some cases, but many principal problems must be solved beforehand.