How to handle unsolicited e-mails

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The ubiquitous use of e-mail has opened the proverbial “Pandora’s box” of access to psychiatrists. Our e-mail addresses are readily available online via search engines or on hospital Web sites. E-mail has become a convenient method of communicating with patients; however, it also has resulted in a proliferation of unsolicited e-mails sent to physicians from people they don’t know seeking professional advice.1 If you publish medical literature or make media appearances, you may be contacted by such individuals requesting your expertise.

Unsolicited e-mails present psychiatrists with ethical and legal quandaries that force them to consider how they can balance the human reflex to offer assistance against the potential ramifications of replying. These conundrums include:

  • whether the sender is an actual person, and whether he or she is asking for advice
  • the risks of replying vs not replying
  • the possibility that there is a plausible crisis or danger to the sender or others
  • the potential for establishing a doctor–patient relationship by replying
  • the legal liability that might be incurred by replying.2

Take preemptive measures

There is guidance on how to e-mail your patients and respond to solicited e-mails, but there is a dearth of literature on how to respond to unsolicited e-mails. Anecdotal reports and limited literature suggest several possible measures you could take for managing unsolicited e-mails:

  • Establish a policy of never opening unsolicited e-mails
  • Create a strict junk-mail filter to prevent unsolicited e-mails from being delivered to your inbox
  • Set up an automatic reply stating that unwanted or unsolicited e-mails will not be read and/or that no reply will be provided
  • Read unsolicited e-mails, but immediately delete them without replying
  • Acknowledge the sender in a reply, but state that you are unable to assist and decline further contact
  • Send a generic reply clarifying that you are unable to provide medical assistance, and encourage the sender to seek help locally.2

Despite the urge to help, consider the consequences

In addition to taking up valuable time, unsolicited e-mails create legal and ethical predicaments that could subject you to legal liability if you choose to reply. Even though your intentions may be altruistic and you want to be helpful, you may unknowingly create problems for yourself. Clinicians should carefully weigh the consequences of replying before clicking “send.”

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