Richard Friedman, MD, writes in the New York Times about his initial high hopes when he began giving patients his e-mail address and the inevitable problems that followed. Friedman notes that for all the convenience and clarity of e-mail, it can be perilous for a clinician. He also notes that e-mail must comply with the Health Insurance Portability and Accountability Act, which has complex rules to safeguard patient privacy and confidentiality. These and other problems are all obstacles that can present huge problems for psychiatrists, he says.