Communication between patients and providers forms the backbone of the patient–provider relationship. Often such communication is strained due to time and space limitations on the part of both patients and providers. Many healthcare organizations are developing secure e-mail communication facilities to allow patients to exchange e-mail messages with their providers. Providers are worried that opening such lines of communication will inundate them with vast quantities of e-mail from their patients. Patients are worried that their messages will be intercepted and read by unauthorized people. In an attempt to determine how a group of internet-active, e-mail-ready patients currently use, or potentially view, the ability to exchange e-mail messages with their health care providers, we distributed a survey via e-mail to over 9 500 patients. After determining each patient's e-mail activity level (based on the number of messages sent each day), we asked questions such as: “Have you ever sent e-mail to your provider?” “What issues or concerns have prevented you from sending e-mail messages to your provider?” “If your provider were to tell you that someone in his/her office may screen, read or perhaps reply to your message before he/she sees it, to what extent would you be concerned about this?” and “How would you rate your overall satisfaction with the use of e-mail to communicate with your provider?” Results from the survey indicate that nearly 85% of the patients surveyed send at least one e-mail message per day, but that very few (i.e. 6%) of the patients have actually sent an e-mail message to their provider. Interestingly, over half of the patients indicated that they would like to send their providers e-mail, but that they do not know their provider's e-mail address.