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Electronic consultations: a new art in clinical communication?
  1. Faye Gishen,
  2. Naomi Gostelow
  1. Clinical and Professional Practice, University College London Medical School, London, UK
  1. Correspondence to Dr Naomi Gostelow, Clinical and Professional Practice, University College London Medical School, London WC1E 6BT, UK; n.gostelow{at}

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Traditionally, doctors have relied on all of their senses to diagnose and treat patients; detecting subtle changes in body language, actively listening and applying their professional wisdom and experience to clinical cases. This traditional model may be threatened by the increasing use of electronic consultations (‘e-consultations’). This editorial focuses solely on the use of emails to conduct electronic consultations and does not consider other models, such as Skype or video conferencing. In this editorial piece, the authors consider the potential advantages and disadvantages of e-consultations for doctors, patients, health services and society.

The concept of the electronic consultation is barely a decade old and is evolving.1 A meta-analysis conducted in 2016 by Liddy et al was unable to confidently define the prevalence of their use in the UK, but concluded that e-consultations are becoming increasingly utilised globally, particularly in the USA.2 The explosion of information and digital technology combined with increasingly busy lifestyles has led to the quest for convenience in accessing professional services. In a US poll, 90% of respondents wished to communicate with their physician electronically3 demonstrating a public perception that email communication offers quick and effective access to healthcare.4 E-consultations are also increasingly being adopted by other healthcare disciplines, including nursing.5

We find ourselves in a rapidly changing healthcare climate driven by an ageing population, increasing survival and life expectancy and growing clinical complexity. Coupled with challenges to service funding, alternative cost and time-saving clinical measures must be sought. E-consultations may provide part of a solution to the growing volume of clinical work. E-consultations can be used to take a clinical history, diagnose, reassure and treat.6 Some uses are contentious, however, particularly as part of therapeutic treatment algorithms, leading to the remote prescribing of medications. This has been identified as a key …

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