Endless phone tag, after-hours messages left with an answering service, disjointed conversations?there must be a better way for patients to correspond with their doctors.Well, there is, at least as far as the patients are concerned: e-mail. Ninety percent of doctors use it, according to a 2001 national survey of physicians conducted by Medem, a San Francisco-based provider of online communications and services for the medical industry. The problem is that only 10 percent of those physicians use e-mail for corresponding with patients. Ed Fotsch, Medem\u2019s CEO (who is an MD), says that resistance comes from doctors\u2019 preoccupation with "love, loot and limited liability." E-mail has yet to enhance the doctor-patient relationship (love), it can lead to more work without reimbursement (loot), and insurance carriers have not adequately addressed issues of security, privacy and coverage (limited liability).By providing secure communications networks with provisions for authentication and encryption, Medem and other companies such as Healinx and Requesthealth.com hope to usher in a new age of doctor-patient electronic communication. Besides free services such as prescription refills, referrals and appointment requests, secure network providers could facilitate online consultations and second-opinion services for which patients or their insurers would pay. According to the results of Medem\u2019s survey and other similar studies, 30 percent of patients are willing to pay an online consultation fee of $20 to $30 per e-mail consultation. Since patients avoid taking time off from work and paying for gas and parking, "that price, even if it\u2019s entirely out of pocket, is a bargain," says Fotsch.Pediatrician Eugenia Marcus of Newton, Mass., receives six to 10 e-mails from patients each day. "It\u2019s a huge benefit to me because I can handle so many more questions in the same amount of time," she says. At the moment, Marcus uses e-mail to answer routine questions. Later this year she\u2019ll start using Requesthealth.com\u2019s secure network, through which her practice will offer patients access to electronic medical records and fee-for-service consultations. (Marcus serves as a consultant to Requesthealth.com.) Although insurance payments are yet to be settled, Marcus is certain many patients will pay for online consultations themselves. After all, they\u2019d be saving themselves time and money.