Frequently Asked Questions

Here are answers to common urology questions

Why don’t doctors give out email addresses?

Unfortunately there have been a couple of medico-legal issues which have influenced how physicians use email communication with patients.

he main one is the “expectation of immediacy”, meaning that the expectation is that since email is essentially “instantaneous”, an immediate response is expected. If a physician is operating, or involved seeing patients, and a communication is received to which is important to respond to quickly (e.g. I’m having crushing chest pain), the burden of responsibility is on the physician. By avoiding this entirely, it has the effect of having patients choose options that do indeed guarantee “immediacy” e.g. 911 or the emergency room, for true emergencies.

Many physicians try to temper this by putting disclaimers on the emails, but you can imagine that in a perceived emergency type situation, one is not as interested in reading disclaimers.

Some physicians who are entirely office based and have multiple physicians at the same site, or who have significant support staff will offer email communication. This is often done via a “portal”, which acts like a mailbox. Because of this, the “expectation of immediacy” is removed. The one caveat is that the system has to be secure, especially if sensitive medical information is being shared, and the cost of that is often downloaded onto the physician (it is essentially illegal to make patient fees for a service like this mandatory).

Interestingly, this “expectation of immediacy” is not as applicable to other common forms of communication such as the telephone (where messages may be answered some time after), the fax machine, and regular mail, and so physician offices tend to lean towards these means of communication.

How do doctors figure out when patients are going to be seen?

This is very variable between physicians, but most have a couple of basic criteria. The first is the nature of the problem – cancer and organ-failure related issues tend to be given higher priority. The second is how much information is available regarding the problem – this is why we often recommend tests the referring physician can do while the patient is waiting for appointments as it helps make sure we are not missing cancer and organ-failure related issues. Another is resource allocation – it is easier to see patients for whom the resources for treatment (training, equipment, personnel, etc.) are available as opposed to not. One of the interesting factors that tends to be minimized is patient availability – the day of the week and time of the year can significantly influence when patients can actually attend appointments. We try to weigh all of these, and other factors, in trying to see patients as quickly and efficiently as possible.