How to handle unsolicited e-mails

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How to handle unsolicited e-mails

Author(s)

Kaustubh G. Joshi, MD

Richard L. Frierson, MD

The ubiquitous use of e-mail has opened the proverbial “Pandora’s box” of access to psychiatrists. Our e-mail addresses are readily available online via search engines or on hospital Web sites. E-mail has become a convenient method of communicating with patients; however, it also has resulted in a proliferation of unsolicited e-mails sent to physicians from people they don’t know seeking professional advice.¹ If you publish medical literature or make media appearances, you may be contacted by such individuals requesting your expertise.

Unsolicited e-mails present psychiatrists with ethical and legal quandaries that force them to consider how they can balance the human reflex to offer assistance against the potential ramifications of replying. These conundrums include:

whether the sender is an actual person, and whether he or she is asking for advice
the risks of replying vs not replying
the possibility that there is a plausible crisis or danger to the sender or others
the potential for establishing a doctor–patient relationship by replying
the legal liability that might be incurred by replying.²

Take preemptive measures

There is guidance on how to e-mail your patients and respond to solicited e-mails, but there is a dearth of literature on how to respond to unsolicited e-mails. Anecdotal reports and limited literature suggest several possible measures you could take for managing unsolicited e-mails:

Establish a policy of never opening unsolicited e-mails
Create a strict junk-mail filter to prevent unsolicited e-mails from being delivered to your inbox
Set up an automatic reply stating that unwanted or unsolicited e-mails will not be read and/or that no reply will be provided
Read unsolicited e-mails, but immediately delete them without replying
Acknowledge the sender in a reply, but state that you are unable to assist and decline further contact
Send a generic reply clarifying that you are unable to provide medical assistance, and encourage the sender to seek help locally.²

Despite the urge to help, consider the consequences

In addition to taking up valuable time, unsolicited e-mails create legal and ethical predicaments that could subject you to legal liability if you choose to reply. Even though your intentions may be altruistic and you want to be helpful, you may unknowingly create problems for yourself. Clinicians should carefully weigh the consequences of replying before clicking “send.”

References

1. D’Alessandro DM, D’Alessandro MP, Colbert S. A proposed solution for addressing the challenge of patient cries for help through an analysis of unsolicited electronic email. Pediatrics. 2000;105(6):E74.
2. Friedman SH, Appel JM, Ash P, et al. Unsolicited e-mails to forensic psychiatrists. J Am Acad Psychiatry Law. 2016;44(4):470-478.

Article PDF

CP01703041.PDF

Author and Disclosure Information

Dr. Joshi is Associate Professor of Clinical Psychiatry and Associate Director, Forensic Psychiatry Fellowship, and Dr. Frierson is Alexander G. Donald Professor of Clinical Psychiatry, Vice Chair for Education, and Director of Forensic Psychiatry Fellowship, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina

Disclosures
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.

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March 2018

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41

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Pearls

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Author(s)

Kaustubh G. Joshi, MD

Richard L. Frierson, MD

Author(s)

Kaustubh G. Joshi, MD

Richard L. Frierson, MD

Author and Disclosure Information

Dr. Joshi is Associate Professor of Clinical Psychiatry and Associate Director, Forensic Psychiatry Fellowship, and Dr. Frierson is Alexander G. Donald Professor of Clinical Psychiatry, Vice Chair for Education, and Director of Forensic Psychiatry Fellowship, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina

Disclosures
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.

Author and Disclosure Information

Dr. Joshi is Associate Professor of Clinical Psychiatry and Associate Director, Forensic Psychiatry Fellowship, and Dr. Frierson is Alexander G. Donald Professor of Clinical Psychiatry, Vice Chair for Education, and Director of Forensic Psychiatry Fellowship, Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina

Disclosures
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.

Article PDF

CP01703041.PDF

Article PDF

CP01703041.PDF

The ubiquitous use of e-mail has opened the proverbial “Pandora’s box” of access to psychiatrists. Our e-mail addresses are readily available online via search engines or on hospital Web sites. E-mail has become a convenient method of communicating with patients; however, it also has resulted in a proliferation of unsolicited e-mails sent to physicians from people they don’t know seeking professional advice.¹ If you publish medical literature or make media appearances, you may be contacted by such individuals requesting your expertise.

Unsolicited e-mails present psychiatrists with ethical and legal quandaries that force them to consider how they can balance the human reflex to offer assistance against the potential ramifications of replying. These conundrums include:

whether the sender is an actual person, and whether he or she is asking for advice
the risks of replying vs not replying
the possibility that there is a plausible crisis or danger to the sender or others
the potential for establishing a doctor–patient relationship by replying
the legal liability that might be incurred by replying.²

Take preemptive measures

There is guidance on how to e-mail your patients and respond to solicited e-mails, but there is a dearth of literature on how to respond to unsolicited e-mails. Anecdotal reports and limited literature suggest several possible measures you could take for managing unsolicited e-mails:

Establish a policy of never opening unsolicited e-mails
Create a strict junk-mail filter to prevent unsolicited e-mails from being delivered to your inbox
Set up an automatic reply stating that unwanted or unsolicited e-mails will not be read and/or that no reply will be provided
Read unsolicited e-mails, but immediately delete them without replying
Acknowledge the sender in a reply, but state that you are unable to assist and decline further contact
Send a generic reply clarifying that you are unable to provide medical assistance, and encourage the sender to seek help locally.²

Despite the urge to help, consider the consequences

In addition to taking up valuable time, unsolicited e-mails create legal and ethical predicaments that could subject you to legal liability if you choose to reply. Even though your intentions may be altruistic and you want to be helpful, you may unknowingly create problems for yourself. Clinicians should carefully weigh the consequences of replying before clicking “send.”

The ubiquitous use of e-mail has opened the proverbial “Pandora’s box” of access to psychiatrists. Our e-mail addresses are readily available online via search engines or on hospital Web sites. E-mail has become a convenient method of communicating with patients; however, it also has resulted in a proliferation of unsolicited e-mails sent to physicians from people they don’t know seeking professional advice.¹ If you publish medical literature or make media appearances, you may be contacted by such individuals requesting your expertise.

Unsolicited e-mails present psychiatrists with ethical and legal quandaries that force them to consider how they can balance the human reflex to offer assistance against the potential ramifications of replying. These conundrums include:

whether the sender is an actual person, and whether he or she is asking for advice
the risks of replying vs not replying
the possibility that there is a plausible crisis or danger to the sender or others
the potential for establishing a doctor–patient relationship by replying
the legal liability that might be incurred by replying.²

Take preemptive measures

There is guidance on how to e-mail your patients and respond to solicited e-mails, but there is a dearth of literature on how to respond to unsolicited e-mails. Anecdotal reports and limited literature suggest several possible measures you could take for managing unsolicited e-mails:

Establish a policy of never opening unsolicited e-mails
Create a strict junk-mail filter to prevent unsolicited e-mails from being delivered to your inbox
Set up an automatic reply stating that unwanted or unsolicited e-mails will not be read and/or that no reply will be provided
Read unsolicited e-mails, but immediately delete them without replying
Acknowledge the sender in a reply, but state that you are unable to assist and decline further contact
Send a generic reply clarifying that you are unable to provide medical assistance, and encourage the sender to seek help locally.²

Despite the urge to help, consider the consequences

In addition to taking up valuable time, unsolicited e-mails create legal and ethical predicaments that could subject you to legal liability if you choose to reply. Even though your intentions may be altruistic and you want to be helpful, you may unknowingly create problems for yourself. Clinicians should carefully weigh the consequences of replying before clicking “send.”

References

1. D’Alessandro DM, D’Alessandro MP, Colbert S. A proposed solution for addressing the challenge of patient cries for help through an analysis of unsolicited electronic email. Pediatrics. 2000;105(6):E74.
2. Friedman SH, Appel JM, Ash P, et al. Unsolicited e-mails to forensic psychiatrists. J Am Acad Psychiatry Law. 2016;44(4):470-478.

References

1. D’Alessandro DM, D’Alessandro MP, Colbert S. A proposed solution for addressing the challenge of patient cries for help through an analysis of unsolicited electronic email. Pediatrics. 2000;105(6):E74.
2. Friedman SH, Appel JM, Ash P, et al. Unsolicited e-mails to forensic psychiatrists. J Am Acad Psychiatry Law. 2016;44(4):470-478.

Issue

March 2018

Issue

March 2018

Page Number

41

Page Number

41

Publications

MDedge Psychiatry

Current Psychiatry

Publications