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Inbox Time Linked to Reduced Odds of Physician Turnover

And increase in mean total messages received per day seen for physicians during March 2020 to June 2021

MONDAY, Oct. 18, 2021 (HealthDay News) -- Inbox time is associated with a reduction in physician turnover, and the COVID-19 pandemic saw an increase in mean total messages for physicians, according to two studies published online Oct. 12 in JAMA Network Open.

Edward R. Melnick, M.D., from the Yale University School of Medicine in New Haven, Connecticut, and colleagues examined the correlation of physician productivity and electronic health record (EHR) use patterns with physician turnover in a retrospective cohort study including 314 unique physicians. The researchers found that the turnover rate was 5.1 percent per year. Physicians completed a mean of 2.6 appointments/hour and 206 appointments/month; for every eight hours of scheduled patient time, there were 5.5 hours of EHR time. Variables associated with physician turnover included inbox time, teamwork, demand (proportion of available appointments filled), and age 45 to 54 years versus 25 to 34 years (odds ratios, 0.70, 0.68, 0.49, and 0.19, respectively).

In a second study, Bidisha Nath, M.B.B.S., M.P.H., also from the Yale University School of Medicine, and colleagues conducted a cross-sectional study to examine inbox message volume during the pandemic versus prepandemic levels. The researchers observed an increase in the mean total messages per day from 45.0 to 46.0 for primary care physicians between March 2020 and June 2021; increases from 29.3 to 32.0 messages per day and from 16.6 to 23.3 messages per day were seen for medical and surgical physicians, respectively. Patient-originated messages also increased, including patient medical advice requests.

"The additional inbox burden reported here warrants additional exploration to assess the nature of pandemic-related medical advice requests and the generalizability of these findings," Nath and colleagues write.

Abstract/Full Text - Melnick

Abstract/Full Text - Nath

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