Five email security priorities every private practice should adopt in 2026

Cybersecurity is not a concern reserved only for large hospital systems. Solo providers and small medical groups are now among the most vulnerable targets in health care. Attackers know private practices rely heavily on email, have limited IT support and cannot afford extended downtime.

As cyberattacks grow more sophisticated, the most effective protection often comes from focusing on the fundamentals.

Below are the five email security priorities that private practices should focus on in 2026 to reduce risk without adding unnecessary complexity.

1. Make sure every patient email is truly encrypted

Many practices assume their email provider encrypts every message by default. In reality, some platforms fall back to older encryption protocols or deliver messages without encryption when something fails behind the scenes.

This creates risk that clinicians never see.

If you send protected health information (PHI) over email, confirm that your system uses modern Transport Layer Security (TLS) standards and does not downgrade when encountering older or misconfigured recipient systems. Encryption should be automatic, consistent and not dependent on patients logging into portals or creating accounts.

PHI is not just lab results or diagnoses. It includes routine scheduling details, appointment confirmations, billing questions or messages that combine a patient’s name with a provider’s identity. Anything that links a specific person to their care, payment history or provider should be treated as PHI and protected accordingly.

2. Fix misconfigurations before they turn into breaches

Most health care breaches are caused by simple misconfigurations, not high-level hacking. Small practices are especially vulnerable because email settings were often configured years ago or by a third-party that is not currently involved.

Common problem areas include:

• Outdated or weak multi-factor authentication (MFA) settings
• Weak or ineffective Sender Policy Framework (SPF) or Domain-based Message Authentication, Reporting and Conformance (DMARC) records
• Email authentication policies that staff are not aware of
• Old vendor integrations that remain connected
• Inbox rules created without staff awareness
• Outdated encryption settings
• Password-only access to systems that carry PHI

Practices should also be aware of risks introduced by third-party vendors.

According to Paubox analysis of HHS breach data, 16% of health care email-related breaches involve business associates or external service providers. This includes billing services, imaging partners and outsourced IT vendors who access or route patient data on behalf of the practice.

Even when internal configurations are correct, a vendor’s misconfigured system can still expose PHI.

A configuration review often eliminates more risk than adding another tool. Practices should periodically validate how systems and vendor connections behave, not only how they appear in an admin dashboard.

3. Treat email as the front door of your practice

Email remains the easiest and most common entry point for attackers. Phishing and impersonation remain effective because attackers use details that feel familiar to staff — patient names, insurance carriers, pharmacy communications or internal leadership requests. Private practices often lean on staff judgment to spot these messages, but today’s phishing kits are designed to bypass that instinct.

A safer approach is to ensure your email system does more of the work automatically. Stronger authentication signals, better detection of forged senders and filters that remove dangerous attachments before anyone opens them can keep staff from being placed in a position where a single decision could lead to a breach.

When email becomes harder to exploit, everything else in the practice becomes easier to protect.

4. Get ahead of AI-powered targeting

Artificial intelligence (AI) is making it easier for attackers to craft messages that look legitimate. Some systems can imitate patient language, staff writing styles or vendor email formats. These messages often bypass traditional filters and are difficult for any employee to recognize.

Practices should strengthen authentication, limit how many systems rely solely on passwords and ensure staff do not have to guess whether a message is legitimate. Tools that automatically evaluate inbound messages and remove suspicious content before it reaches the inbox are increasingly essential.

5. Focus on resilience, not more tools

Most practices already feel overwhelmed by software. Adding more tools does not automatically create better security — resilience does.

A resilient security posture prioritizes:

• Fast detection when something goes wrong
• The ability to contain an issue before it spreads
• Clear processes for restoring normal operations
• Evidence that patient information was protected during an incident

This mindset helps practices avoid prolonged downtime, protect patient trust and maintain continuity of care.

What to look for in a security solution

Supporting these priorities does not require enterprise-scale platforms. Practices should look for communication tools that automatically encrypt patient messages, provide strong protection against impersonation and phishing and operate reliably in the background without adding extra steps for staff. Solutions should integrate cleanly with existing email systems, require minimal training and provide clear proof that messages are being protected.

Security isn’t an optional line item for small practices, but it also does not need to be overwhelming. With the right protections in place, private practices can reduce risk dramatically while keeping daily operations running smoothly.

Dawn Halpin is demand generation manager at Paubox.