Viewpoint: eConnecting with your patients

However, as children grow older, direct communication between physician and patient may provide an opportunity to recognize the growing independence of children, and to encourage a sense of responsibility for their own health.

A personal example: My son has asthma, and when he was 8 years old my husband and I were having trouble convincing him about the importance of using his albuterol inhaler only as recommended.

As I observed my three adult children practically glued to their laptops during their recent holiday time at home, it occurred to me that pediatricians may be missing opportunities to communicate directly with their patients-except that in the 21st century, direct communication would mean electronic communication. The Internet has provided a means for sending messages and assuring availability that can be applied much more broadly than any method available to my son's pediatrician 19 years ago.

It may be that some pediatricians have already begun electronic communication directly with their child and adolescent patients.

Collecting email addresses at the time of preventive health care visits would allow for timely blast messages to connected patients. I suspect, for example, that an email message from their pediatrician, sent at the beginning of the summer, reminding kids about the importance of wearing a bike helmet, use of sunscreen, and safe swimming practices, would be more effective than posters in the office.

Age-appropriate email lists would also allow messages about the benefits of specific immunizations, the dangers of smoking and other risk-taking behavior, and office availability for private discussions between teen and physician.

Plans for direct electronic communication would probably require advance parental permission. But with careful explanation of the nature of future messages direct to their children, I suspect most parents would agree that any help they could get in maintaining their child's health and safety would be welcome.

If you've developed a mechanism for direct electronic communication with patients in your practices, we'd welcome advice and suggestions that could be passed on to other readers. I fear that most of us will need coaching in our efforts to participate completely in the 21st century-I don't even have a Facebook page!

Dr. McMillan, editor-in-chief of Contemporary Pediatrics,is professor of pediatrics, vice chair for pediatric education, and director of the pediatric residency training program, Johns Hopkins University School of Medicine, Baltimore.