E-mails can be inadvertently deleted or placed on the "back burner" in a busy practice. Access to computers is not a given in the course of a psychiatrist's typical week. Patients who may be highly distressed and want to reach the psychiatrist quickly may find that the psychiatrist doesn't get to the e-mail until days later. One must always keep in mind that privacy can be compromised with e-mail. Every time an e-mail is sent there is a possibility that an unintended recipient may end up reading it. There is an illusion of privacy and confidentiality that lulls both sender and reader into a false sense of security. Computers are frequently left on both in the home and in the office, and a slip of the finger can result in a breach of confidentiality. Finally, the capacity to make clinical judgments is severely compromised when one's information is limited to words on a screen. One cannot see the patient, assess nonverbal aspects of the communication, and reach sound clinical conclusions from an e-mail. Moreover, e-mail communication, by its very nature promotes transference distortion. A busy physician may not have the time to respond to an e-mail message in a long and reflective fashion, and a terse response may be misread by a distressed patient.