A Response on Email Etiquette

In October’s Editor’s Corner, Editor-in-Chief Mikkael A. Sekeres, MD, MS, and his colleague at Cleveland Clinic, Jennifer Lonzer, MA, provided “A Primer on Email Etiquette,” with helpful tips like “Turn off CAPS LOCK” and “Don’t email when angry … or drunk.” The column struck a chord with ASH Clinical News readers who admitted to committing some of the email-related sins described in the editorial, or who offered other sins to add to the list.


Dear Dr. Sekeres,

I liked your commentary on the use of email, and it reminded me of my own experiences with the “reply all” function.

Some years ago, when I was vice chair of our department and in charge of medical grand rounds, I wrote a somewhat snippy email to the housestaff program director regarding flagging housestaff attendance at rounds. He wrote that he was thinking of serving lunch to the housestaff just before rounds so he could corral them into the amphitheater. I replied that, knowing them, they would take the lunch and skip rounds.

Since I noticed that he had copied one of his colleagues who helped with the housestaff program, I hit “reply all.” Little did I know, the email actually went to the entire Brigham and Women’s housestaff. My inbox was full for the next few days with emails asking “How could you say that?” (along with a few agreeing with the original email).

Things eventually calmed down, though my misdemeanor earned me a cameo appearance in the housestaff’s end-of-year video. I had to repeat my speech while a line of housestaff paraded off with their lunches.

With the passage of time, most of them have forgiven me, but I still look at the cc’d list very carefully before I hit “reply all.”

Robert I. Handin, MD
Senior Physician, Hematology Division, Brigham and Women’s Hospital
Professor of Medicine, Harvard Medical School
Associate, Department of Stem Cell and Regenerative Biology, Harvard University
Boston, MA


Dear Dr. Sekeres,

I read with interest the recent editorial regarding email etiquette. I believe some key points of discussion were missed, including the following:

  1. Use of colons – and other excessive punctuation – and abbreviations in the body of the email, should be avoided (for ease of reading).
  2. Disingenuous use of the exclamation point (often more than one) at the end-of-message salutation (i.e., “Thanks for your editorial!!! – Steve”). This is extraordinarily tedious and even, frankly, heavy-handed with a touch of passive-aggressive.
  3. The initial decision to use email versus another method of communication is critical. For example, use of email to send acute clinical or research events which, when received and reviewed at late hours – say, on a Friday after a night out in Cleveland – then acknowledged, may subject the principal investigator to a higher risk of FDA reprimands (like the dreaded Form 483). The reporting clock starts ticking.

Thanks (no exclamation point – implicitly sincere),

Stephen D. Smith, MD
Associate Professor, University of Washington
Associate Member, Fred Hutchinson Cancer Research Center
Seattle, WA


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