BACKGROUND. Informal (curbside) consultations are central to clinical
medicine. Typically,these exchanges between health professionals occur
face-to-face or by telephone, but both of these methods can be ineffi
cient. We created an electronic mail (E-mail) service for curbside con
sultations between family physicians and other health care specialists
at an academic medical center. METHODS. Family physicians had access
to the E-mail Consult Service (ECS) from 20 computers at three office
practice sites, one hospital, and their personal offices. Informal con
sults could be obtained from 26 different consultants at the Universit
y of Iowa using standard E-mail. Data on the content of the consults a
nd the use of this service were collected and both family physicians a
nd consultants were questioned about their perceptions of the service.
RESULTS. In the 18 months that the service was available, the ECS han
dled 237 consults. The median response time for a consult by using the
service was 16.1 hours. Consultations in the area of adult medicine w
ere the most common, followed by consults in obstetrics and gynecology
Nearly 90% of the consults were about a specific patient, and the maj
ority of the questions were about management issues. Consultants answe
red 92% of the questions asked by family physicians using the ECS. Fam
ily physicians reported that this service was helpful, and most consul
tants reported that they enjoyed E-mail curbside consults. CONCLUSIONS
. E-mail was successfully used for curbside consults. Both the family
physicians and consultants found that an E-mail consultation service c
ould be integrated into their practices.