A survey has found that nearly 90 per cent of Americans have never texted or emailed their doctor, indicating that face-to-face consultation has remained largely unchanged for many years.

The findings were remarkably generally consistent across geography, gender and ethnicity although income, unsurprisingly, was a major divide. Higher earners are more likely to have had electronic communications with their physicians than poorer patients.

The survey was conducted for The Atlantic magazine in conjunction with GlaxoSmithKline and quizzed 1,000 Americans about their medical and technology habits.

The magazine poses the question why more patients do not want to text or email their doctors. “Confidentiality is one concern, and not every patient wants to text – but more than ten per cent do.” The problem, it concludes, is that many doctors do not have the technical set-up to accommodate electronic communication with their patients.

Physicians also must be wary about being deluged with texts and emails. Also, billing for such services in the US is less clear cut than conventional patient visits.

One possible advance are websites where patients can log in and get test results or leave messages for their physicians within a secure system. Such a set up can be compliant with HIPAA regulations and keeps doctors’ personal mobile phone and email from being overwhelmed.