What is your e-mail protocol for corresponding with doctors and other healthcare professionals?

Privacy Questions
1

1) Do you use an alias (as in Proton Pass/Simple Login) or do you have a dedicated email for it?

2) Whichever option you choose, why do you choose it? And what is your protocol?

I. USING AN ALIAS (PROTON PASS/SIMPLE LOGIN OR OTHER)

I would personally rather use a Proton Pass alias (@passinbox.com) for correspondence with my doctor, but I have some concerns.

a) It’s not clear to me if it’s possible to send end-to-end encrypted and/or password protected e-mails from aliases. Is it?

b) If I ever need to change my alias, I risk losing all my past correspondence tied to my original alias. At least with Proton.

II. USING A PROPER DEDICATED E-MAIL (PROTON/TUTA)

Let’s face it, the vast majority of health professionals don’t use end-to-end encrypted (E2EE) email. What’s worse is that I’ve seen quite a few who don’t have their own domain and use a G-Mail account for their practice.

That’s why I want to use E2EE and password protect all my e-mail correspondence with them. I intend to have a unique passphrase for each medical professional.

a) How do I send them the password if we have only one channel of communication?

I could call, but given that I use long passphrases, there’s a good chance that who ever answers the phone will make a mistake. A lot of businesses have WhatsApp these days (I know), including medical practices, but I have no idea if the reception or my doctor has access to it.

b) What should I do if my doctor uses G-Mail and needs to refer me to another doctor?

I don’t want details about my medical history with my full name attached to be on their G-Mail.

Would appreciate your advice.

Thank you.

2

Consider printing the documents out and handing them over in person, or faxing them.

3

Are you being serious or sarcastic? Based on the fax comment, I’m guessing the latter.

4

Serious. Faxing remains pervasive in the medical industry, at least here in the US. Although it’s usually used for correspondence between medical organizations, your doctor is likely to find it far less annoying than something like proton’s password protected email feature.

5

I would say just maintain a non-digital record with them. The only downside I see is that you would have to step into the office to pickup your documents. With that you do not have to worry about big Google snooping on your documents. I would recommend if you do go with this route, make sure to do the 3-2-1 backup rule, if you want to switch to another physician in the future.

The faxing comment by @Snowmanonahoe is pretty good, honestly.

6

I’m not familiar with doctors sending confidential info via email. What country are you in?

7

Maybe it’s a cultural thing, but email doctor-patient correspondence sounds weird - very informal.

I work in a position where I handle patient data and sometimes we do employ encrypted email, but it is service provider to service provider. All information in the emails is transferred to electronic health record software.

8

I’m not going to reveal my location, but where I am, if you’re not physically going to the doctor to make an appointment, you book it by calling, or via e-mail if you have their e-mail address which is usually on their business card, or on their website.

Have either of you ever been to an optometrist? If you want a quote on a pair of glasses, they often send it via e-mail. If they request your latest eye tests to determine the quote, they will expect it via e-mail if you’re not there physically with the printed document.

9

  1. I have a single dedicated email address at my domain for medical correspondence and other similar personal matters. I don’t use disposable aliases for high-importance, non-anonymous things like medical.

  2. When exchanging sensitive medical documents or information I use my doctors’ internal encrypted messaging services / upload portals when possible. When those are not available I upload files to my own personal encrypted cloud storage (Tresorit) and send them an expiring URL. Using a password and/or access logs I can monitor who accesses the file.

Generally the only plain text information in my emails, therefore, are things like appointment reminders, which I do not consider highly sensitive. Nobody could blackmail me with the mere fact that I saw a dermatologist, especially when they don’t even know why I went for an appointment or what happened there.

I don’t put in herculean efforts to avoid any of my emails ever going to Gmail addresses, because that’s basically impossible. I just don’t put sensitive info in those emails.

1 Like
10

Wow, I did not know that. I don’t have a fax machine, though. And going to a store that has one would mean revealing private info to them. I don’t want that.

I honestly don’t care if my doctor is annoyed by my password protected e-mail. I’ll be happy to explain why. I think it’s weird when a doctor’s office uses G-Mail.

Can someone confirm to me if Proton Pass aliases allows sending E2EE and password protected e-mails?

11

Thank you! This is very helpful.

I might create a Proton address just for medical correspondence.
So just to be clear, when you make an appointment via e-mail you don’t E2EE/password protect it, but when you discuss sensitive info in them, you do?

I hear you about the dermatologist. The thing is, I want to save the doctor as much time as possible, by discussing any condition I may have and my medical history in the e-mail, so that they are already informed when I meet them.

In regard to not putting herculean efforts to avoid sending any e-mails to G-Mail addresses, I hear you too. But I want to begin the practice of E2EE all e-mails I send to G-Mail and the like.

I’m currently reading Carissa Véliz’s Privacy is Power, and one thing I learned from it is that privacy is as collective as it is individual. Yeah it may be annoying to need a password to read an e-mail, but that’s a change to teach people about privacy.

12

I generally make appointments over the phone or via online portal, but when I do so via email I don’t EE2E/password protect it, correct.

For any other sensitive info - pre-existing conditions, medication history, etc - I’ll use the practice’s browser-based portal / encrypted messaging platform if they have one. Otherwise I’ll tell them I’m not comfortable sharing that info in plaintext in an email so I’ll upload it to my encrypted cloud platform instead, and then I send them the URL.

Lately I haven’t even been bothering putting a password on the URL, I’ll just set the URL to the file (usually a PDF or DOC) to expire in 24 or 48 hours and turn on access logs. The reality is that no competent medical professional is going to forward that URL around, and the expiring nature of the URL means that unless a data breach happens in that 24 or 48 hour period the URL is of no use to anyone. I understand this is technically more risky than using a password and calling them and telling them the password over the phone, but I’m willing to take that (minor) risk to make it as seamless as possible for my providers. I’ve looked at the access logs every time and have never had a single unexpected viewer.

So from their end they just get a URL via email, click it, and see the info they need. I think it’s reasonable to tell a provider “I want to use a more secure method” as long as the friction that secure method introduces is just an extra click or two (i.e. not making them sign up for a whole new email account or anything like that).

So far all of my doctors who may need to respond to my messages / send sensitive info to me have had a browser-based portal / encrypted messaging platform that their practice uses. If I were to encounter someone who needed to send me sensitive info (more than just appointment reminders) and didn’t have an encrypted platform for doing so … well, honestly, I’d consider switching providers because that doesn’t endear me to their concerns for patient privacy or data protections. There are certainly other ways to work around that, but as I said I haven’t encountered that issue yet.

1 Like
13

Most healthcare providers have an online portal where information is centralized. I log in and request an appointment to see a doctor and will usually get a response within a day.

1 Like
14

I asked because where I am it seems much more secure. Last time I needed to provide a medical form I got sent a link to a secure portal, I uploaded the form. When the results were available I logged back into the portal and downloaded the form.

In some countries health care info is protected to higher degree for compliance reasons.

15

I am using my regular email with doctors because they are only sending appointment confirmations and invoices. They refuse to send any kind of medical record via email. If they need a document, they request it via specific medical app or via insurance company‘s app but that is very very very rare.