Re: Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

To the Editor: In “Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?”¹ the authors concluded that in fact, electronic messaging between patients and providers is associated with increased phone calls, counterintuitive to the notion that electronic portals might help decrease overall workload. Although this is an important distinction to make, I will argue that patient satisfaction and doctor-patient communication are ultimately better reasons for on-line portal use than decreasing workload. We would all like to reduce administrative burden; however, studies show physicians value a manageable workload more than working fewer hours,² and electronic portals offer many benefits to patients.³

Patient portals improve patient self management of chronic disease and improve quality of care, especially patient-provider communication.³ Access to electronic messaging between patients and doctors is significantly associated with improved clinical outcomes and enhanced patient satisfaction.⁴ Intuitively, patient satisfaction may lead to an increased personal accomplishment in physicians. Doctors with an increased sense of personal accomplishment are happier.²

Conventional wisdom states that doctors are unhappy because they are overworked.⁵ Physicians and other members of the health care team may be resistant to using patient portals if it is shown that they do not reduce workload. However, the number of hours worked is not related to physician happiness. Rather, workload manageability is significantly related to happiness.² The concept of workload manageability is open to interpretation, but some options include increased support staff, flexible scheduling, and a greater voice in workplace matters. Future studies should explore this idea of a manageable workload, what it means to doctors, and how to best support us in this endeavor.