Are you an American in e-mail contact with your doctor?

No?

I didn't think so. (This fine bronze of a cadeusus, the medical profession's symbol, is by James Nathan Muir, who wants patrons for putting copies on all the world's continents.)

There are two reasons why you're probably not in e-mail touch with any of your physicians:

• Many doctors are afraid to put anything down, in writing, which might come back to bite them. This is often recommended to them by their peers and professions.
• Many doctors use a loophole in the HIPAA statute which makes them exempt from its requirements so long as they don't computerize.

As a result most doctors remain in the Land of Lud. And the cost to their patients is immense. I just spitballed a few:

1. Phone tag.
2. Lack of patient knowledge leading to missed diagnoses.
3. Reliance on paper and its costs.
4. Patient aggravation
5. Reliance on staff to communicate with patients, and the attendant mistakes.
6. Wasted time, meaning lower productivity.

I lampooned Jason Matusow of Microsoft in a short item early this week. He puts a little bit of legal boilerplate at the bottom of his blog postings. I thought it was silly. Maybe I was wrong.

If something like this were all it took to get my doctors on the Internet it would be a very small price to pay. And given the expense of computing solutions and their savings, the continued existance of this HIPAA loophole -- which up to 70% of doctors can take advantage of -- is nothing short of a scandal.

I don't want this criticism levelled entirely at doctors. I think they're victims in all of this, albeit sometimes willing victims.

Doctors want to be productive. They want to give the best care. They want to be in touch with their patients. But they are deathly afraid of lawyers and the government. Thus they are afraid to write anything down, and to provide any more documentation than the absolute minimal legal requirement on their thinking and diagnoses.

We need these professions -- law, medicine, bureaucracy -- to get together, not just to save money but to improve the practice of medicine.

We need this to save lives. (That's the old family gravestone in Rhode Island to the left.)

Before it will happen however, we, the people need to make it a priority. This is costing us tens of billions of dollars each year, and causing us to die before our time.

How's that for motivation?