By Suresh S. Ramalingam, MD
The year was 1996. As a senior resident in training, I purchased my first desktop computer. Once the installation was completed, I connected to the internet through America Online (AOL), which opened up a whole new world. Less than a minute after I logged on, a voice announced, “You’ve got mail!” I’ll never forget that welcoming message, which listed all the wonderful services I would be privy to. In the ensuing days, I worked actively to connect with friends and colleagues, and exchanged email addresses with great delight. “You’ve got mail!” sounded like music every time I logged on, because I was able to connect with people I had not seen in a long time. The phrase became so popular during those years that it was the title and centerpiece in a movie featuring Tom Hanks and Meg Ryan.
Fast forward 21 years and so much has changed. The voice announcing the email is no more, AOL is a shadow of its former self, and checking email is now a part of our daily (or more like hourly) lives. The stress and anxiety that come with a full inbox is overwhelming beyond what words can express (at least, not the words one can use in public). My inbox is flooded with emails and the sheer process of catching up with them is becoming increasingly difficult.
The agony starts with going through the junk or spam email to make sure that I did not miss something important. During a recent check, these emails alone added up to nearly 50 or 60 each day. Then comes the task of acknowledging the “just FYI” emails. Is it really necessary to copy everyone when you re-congratulate a colleague who has been congratulated on a mass email for a significant accomplishment? Please! The good news is that these emails can be moved out of my inbox without much thought. However, the rest of the messages take a big chunk of time to sort through.
I find that every third email requires me to perform a task that might take anywhere from 5 minutes to over an hour, not to mention the “mandatory training required” emails. Every day, there is always a handful of emails that cause me aggravation and interrupt the flow of my schedule. Just getting through my inbox can be an accomplishment in and of itself!
I am sure that I am not alone in dreading the thought of coming back from vacation and finding an overfilled inbox. In fact, most of us spend an hour or two, often in the middle of the night during vacation days, to avoid returning to an impossible situation. In the past, signing over my pager to a colleague before leaving on vacation was sufficient to leave work behind, but now works travels with us wherever we go.
As clinicians, we also face growing expectations and demands in all aspects of our work. Completion of medical records, regulatory work related to patient care, professional recertification, and being responsive to the needs of our patients are also becoming increasingly complex and pose demands on our time. Nearly every physician that I interact with feels these pressures and acknowledges the additional burden posed by managing emails. I am often amazed that some physicians are able to use emails to communicate with their patients. Being perpetually behind in responding to emails, I have not resorted to using this medium for patient care. When some patients ask for my email, I feel guilty for not sharing it, but rather explain to them that for timely resolution of health issues, it’s much better to give me a call.
As I looked for guidance on managing emails, a number of colleagues had several good suggestions. Here are some of the solutions that have helped regain a bit of control over my inbox:
- Only open your email two or three times during the work day. Having a perpetually open inbox is a source of frequent distractions and interrupts your work.
- Resist the temptation to answer an email right away, because it has a high possibility of creating a back and forth conversation that could take away from other priorities.
- Wait a day before responding to aggravating emails. The problem may look a bit different after sunrise and could be managed in a less confrontational and more collaborative manner.
- Whenever possible, use the phone or walk to a colleague’s office to discuss key issues. (This is also good for DVT prophylaxis!)
- Using an out-of-office message when leaving for meetings or vacations for more than 1 or 2 days really works to slow down the email traffic.
There is no question that the advent of email has improved many facets of our lives, and that cannot be understated. Managing this technology and making it work to your benefit is still a work in progress. Needless to say, in the time that I was writing this blog post, my inbox filled up with another bolus of emails! If you have an opinion on email overload, please sign in and share your ideas and solutions in the comments.
Dr. Ramalingam is a professor of hematology and medical oncology, director of medical oncology, and assistant dean for cancer research in the Emory University School of Medicine. He holds the Roberto C. Goizueta Distinguished Chair in Cancer Research and serves as deputy director of the Winship Cancer Institute.