| Abstract | BACKGROUND: Unsolicited electronic mail (e-mail) is e-mail sent to a physician from a
person unknown to the physician, who is seeking professional help. The purpose of this
project was to analyze unsolicited e-mails sent to a digital textbook author to: 1) characterize
the e-mails, 2) determine what resources would be necessary to answer the e-mails, and 3)
propose a standard approach to reply to e-mails in a helpful yet medicolegally-responsive
manner. MATERIALS AND METHODS: All e-mails (315) sent to a digital textbook
author from October 1995 through October 1998 were abstracted. Variables included: date
and location, sender type, patient age, subject, medical content, and resources necessary to
answer the question. Data frequencies were obtained. RESULTS: The most common
location was the.com domain (47.6%). The most common senders were laypersons (66%).
Overall, 44.4% of the e-mails concerned children. Detailed, patient-specific information was
sent in 63.2% of the e-mails. The most common subjects were overviews of a disease or
problem (32.4%), differential diagnosis (16.8%), and therapy/treatment questions (15.9%).
The medical content covered a broad range of specialties. Specialists were overwhelmingly
the resource necessary to answer the e-mails (74.9%). CONCLUSIONS: Pediatricians
with educational information on the Internet can expect an increase in the number of
unsolicited e-mails as Internet usage expands. Laypersons regard even short passages to
mean the author is an expert in that particular area. Pediatricians need to consider the
ethical and medicolegal implications of responding to unsolicited e-mails. A nonpersonalized,
standard e-mail reply is proposed that directs the sender to quality information resources
that may be of further assistance. unsolicited electronic mail, e-mail, medical informatics,
legal issues, ethical issues, digital libraries. |