These are both valid points marketers should consider when moving forward with any doctor-patient email plan. But unlike Pho, I believe the adoption of communicating with patients about their care over email is unavoidable, so it's in a provider's interest to move forward as best as possible.
Perhaps one way to prevent superfluous or confusing emails is to create guidelines to set expectations for both patients and physicians. At the outset, perhaps instruct patients to only email their physician when they are seeking clarification or asking a minor question. For example, "Is it okay to get a flu shot while pregnant?" versus "My chest has felt tight lately, what should I do?"
Patients and physicians should understand that email must never be used for diagnosing symptoms. And, of course, doctors should be empowered to tell patients to schedule an appointment if they are using email incorrectly or excessively.
It won't be an easy road ahead, for marketers or physicians, but healthcare can't continue to lag behind other industries in using email to communicate with its customers.
Remember what happened to Blockbuster when it refused to upload streaming movies online? Make sure your organization is the Netflix of this metaphor.