QUESTION: Why do we ask patients who come to see us to sign an e-mail waiver allowing us to e-mail them?

ANSWER: The nature of AcuDestress is such that a lot of questions arise in the process – questions about short-lived events which occur in our patients once they have begun ear acupuncture. There is no doubt about it - these events, which we end up calling "phenomena" are by definition, hard to understand from the point of view of the person experiencing them. But they are also the harbinger of the good news, that this process makes a real difference in the person's life in short order. In order to sustain patients through these phenomena we want to make sure that they can be in touch with us, and in touch in a fairly rapid way. We feel that our patient should be able to send us an email, and that we should be able to send an email to them. This is very fast and very convenient.

It also has a certain downside. Sometimes privacy is sacrificed, simply because of human error in sending an e-mail to the wrong person or the wrong address. E-mails are read by whoever is at the receiving keyboard - and it's not necessarily the person the email was addressed to. Nevertheless, we think it's a good trade-off to be able to communicate easily and quickly in return for a certain sacrifice of absolute privacy.

Not only do we want to be able to talk to our patients in the process of their treatment, but we also want to be able to talk to the health care practitioners who've sent them in the first place. We are working together with healthcare practitioners not in isolation. Sometimes we need their help, and sometimes they need ours. Sending e-mails back and forth is an efficient way of creating this communication link, but it's not always felt that it preserves privacy. This view is correct, so we think it comes down to the individual patient themselves to decide how they want their situation handled. No one is forced to sign the waiver we include in the history form, and no one has been turned away because they have failed to sign it. But if the patient signs the waiver, we intend to use the opportunity it provides to pass important information to where we want it to go.

Not everybody and not every institution follows such a policy, but we are using a waiver which was developed for all of the Toronto hospitals, so, suffice to say, a large large hospital system there is doing what we are doing, and for the same reasons. For this reason we don't think that what we are asking is odd or unusual. It's just what we need to do.

Some systems use faxing to pass information because it is somewhat more secure. But it's not absolutely secure either as there is no assurance who will be reading the fax. Patients themselves rarely have a fax machine, nor should they be expected to. To us this is the slow technology which ultimately makes information exchange a slow process. but, in the end, it’s a matter of opinion.

Since this is a controversial subject, you can be assured that wen we use e-mails we will be as careful and thoughtful as possible.