Re: preferred contact
The preference for letters by such a big number of doctors really shows, in my mind, the comfort level some practices have with the old ways of doing things and their discomfort with trying new, more efficient means of communication. When you think about it, letters are expensive: They take time to personalize, print, and stuff into envelopes, and they're expensive over time -- paper, print, envelopes, labels, stamps, and staff time. You also have to ensure patients' mailing addresses are kept current (which billing requires too, of course).
That said, a lot of doctors' offices still rely on fax a lot. In dealing with two specialists recently, I was surprised to learn that one doctor faxed his records over to the other doctor's office; the other doctor, in turn, wanted to send her records back electronically but was forced to fax them back because the first doctor didn't have the capacity to receive them electronically (despite using an electronic health record in his practice). Unsurprisingly, during our first visit to the second specialist, part of my daughter's record was missing because the first doctor's assistant hadn't sent over the complete file.