Freedom from the Inbox: Strategies That Give Physicians Their Time Back

Another clinic day. Your schedule is packed, double-booked several times. You are doing your best to see each patient and take care of their needs while trying to stay on schedule. It is as if you are running a race – sometimes you feel as if that race is never ending. Just when you are finished with seeing the last patient of the day, just when you think you finally have time to sit down and take a breather, you realize that you have not looked at your inbox the whole day. It is 5 pm and you have thirty unread messages. You are thinking that it is going to be another long night. There are two choices – to ignore the inbox or to stay late to take care of all those messages.

Does this sound familiar? That was me, the version of me from several years ago. Sometimes I would stay and tackle the more important messages. Sometimes I would go home because I was beyond exhausted.

If you are a clinical physician, you will always have messages in your in-basket. How do you tackle it such that the tasks are addressed timely and well? There are two main approaches: one is to minimize the number of messages in your inbox, and two is to device protocols to minimize the time you spend handling each message.

Inbox messages come from multiple sources – patient phone calls, pharmacy requests for refills, test results, phone calls from other clinicians, and staff messages, to name a few. Any phone calls or messages can be triaged by a nurse. The nurse can decide if this is something the staff can handle or it is something that the physician needs to address. If it is something you, the physician, need to review, you will already have more information about the issue. There should be no direct message from any patient to you that says “patient wants to talk to you, please call back”. The message needs to include what the patient’s question or concern is. By having someone filter the calls and messages, with standard protocols of how to handle certain types of messages, you are reducing the number of tasks in your inbox.

To be more efficient in handling the in-basket tasks, look for ways to incorporate more automation? For example, if there is a request for refill of a medication, instead of getting a secure message about the renewal, your staff can initiate the process of med refill, so that when you receive that med refill request, all you need to do is click “approve” or go to that med refill page to change the prescription. Explore things you can automate. The more you find, the more efficient you will be.

Instead of opening your in-basket at the end of the day, check it several times throughout the day. This may be challenging at first. It is also important not to open each message as it populates your inbox. Although you have a full schedule, make sure you set times to review your inbox. For example, set aside five minutes in the mid-morning to open your in-basket, again before lunch, and once or twice in the afternoon. Make sure you check the inbox at least thirty minutes before your staff leaves.

Teamwork and delegation are essential in efficient patient care. Utilize your team. Allow them to make phone calls for you. Allow yourself to train and trust others to do the work they are here to do. Imagine how much time you are saving by having your team make ten phone calls. That is easily thirty to sixty minutes of your time. If you check your in-basket after your staff members leave, you will have no one to delegate that day.

Good patient care takes teamwork. Teamwork enhances the quality and efficiency of healthcare. The in-basket may be flooded with tasks to do. Explore ways to filter and minimize the number of tasks ending up in your in-basket. Streamline, automate and delegate the tasks. Make sure you check your inbox several times a day, so that messages are taken care of promptly. It also ensures that delegation is possible. Even though you are capable of doing everything, it is more efficient to have a team approach.