Will email consultations improve patient care?

Making email communication part of routine medical practice may have unforseen consequences for the NHS, warns a doctor in a letter to this week's BMJ.

Responding to data drawn largely from the United States, showing demand to be mainly patient led, Geoff Wong argues that what Americans want may not be what UK patients want.

The policy goal of the NHS is generally accepted as equal access, based on need, he writes. Poor and elderly people are the most needy and the least likely to use the internet. Using email for communication may offer choice but probably at the expense of access.

He believes that full research into the impact of a new technology is needed before any steps are taken to adopt it as the norm.

"Give the patient a choice," urges IT expert John Charnock in a second letter.

All government departments, including the NHS, are required to offer their services both electronically and using traditional methods. The technology is available today, and it is inexpensive. The only way to measure its effectiveness is to pilot it, he writes.