Patient Portal Confession

I have a confession to make. I just finished sending a portal message to my doctor that I knew would most likely require an appointment to resolve. 

I wanted his opinion about some medication changes I was considering and didn’t want to bother with the hassle of going in to see him or schedule a video appointment. 

This seems innocent enough. It probably happens to many patients like me who are familiar with using the portal to look up test results, request refills, follow up on referrals, and send similar notes. But the reality is that most primary care physicians receive up to 100 in-basket messages a day. I know this because my coaching clients complain about the task of managing this in-basket as one of the major causes of overwhelm and burnout. I work with them to develop strategies to decrease the emotional impact of this on their daily lives and try to delegate in-basket tasks to other staff members. 

But how many other patients realize that their doctors are swamped with these messages? How many know how discouraging it is to open the EHR and see the number of messages mount up throughout the day always wondering which ones are truly urgent?

I believe, if patients realized how overwhelmed their doctors were with administrative tasks, they would be willing to do whatever they could to lessen this burden, especially if they knew it would help their doctors be more present to them in the exam room.

It turns out that Internal Medicine and Rehabilitation physician, Michael Stillman believed this also. He became so overwhelmed by all the inappropriate messages he was receiving through the patient portal that he sent out a portal message to all his patients describing how this was contributing to his burnout and imploring them to be more considerate of his well-being. He included a few simple guidelines for the use of the portal.     

Guess what? It worked! Within a few hours, he received over 50 responses from patients apologizing and pledging to follow his guidelines in the future. His portal messages have since decreased dramatically, and his patients are appreciative of his openness and attention when they come in for their visits. 

His story was published in JAMA and can be found here along with his letter: Stillman M. Death by Patient Portal. JAMA. 2023;330(3):223–224. doi:10.1001/jama.2023.11629

I have now added Dr. Stillman’s story to the list of in-basket strategies I use with my coaching clients. Who knows? If it worked for him, I’m confident it will work for them and you.

In the meantime, I scheduled an appointment to discuss my medication changes directly with my doctor and will be more considerate of his time in the future. 

Compassionately,

Dr. Joe