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Physician Guidelines for Online Communication with Patients: CMA Policy 2005

Physician Guidelines for Online Communication with Patients. (CMA Policy, 2005)


These guidelines are primarily concerned with email and physician websites (the two most common vehicles of online communications). The starting point norms and best practices are taken from those developed through the use of paper documents, mail, telephone, and facsimile in the setting of physicians’ offices.


Physicians should establish a protocol that describes how such communications will be used in their office. The protocol should address all of the points in the figure (figure in PDF, points listed below).

  1. Purposes for which the office uses online communications.
  2. Online (distant) patient-physician relationship.
  3. Response to patient enquiries – managing expectations.
  4. Conditions for patient use of online communications.
  5. Triage of communications.
  6. Access to patient enquiries.
  7. Retention, form, and organization of communications.
  8. Type and quality of information provided to patients.
  9. Privacy, confidentiality, and security.
  10. Specific jurisdictional provisions and requirements.

Each point is discussed and elaborated on in the document in terms of what is expected by the physician and what should be done at each point.


To ensure privacy and confidentiality, safeguards are required for electronic communication that are different from other mediums, such as paper and fax. Physicians are expected to establish guidelines in their practice on the use of this communication, and to act professionally in all communications with patients. They should also establish guidelines for patients around the use of electronic communications and give information to users on the expected responses they will receive, conditions for use of the system, who will have access to the emails, and the information that will be provided through their system. Privacy and confidentiality must at the same level as is currently expected for the paper record.


This guideline provides simple and practical expectations around online communication with patients and expectations for the physicians around this use. This guideline is primarily aimed at educating practicing physicians on the safeguards that must be put in place, and some of the pitfalls and challenges of online communication. This policy is put out by the Canadian Medical Association, laying the groundwork for safe and effective communication to patients by email. Though it does not cover physician-physician communication, this is still a valuable and much needed resource. 3/5 Checks.