The Hidden “Deep Work” of Medicine: Why Your Inbox Is More Demanding Than It Looks
For many physicians, the electronic health record (EHR) inbox is considered “light work.” It’s necessary but unrewarded. The only metric that matters is whether it gets done within a prescribed time frame.
A closer look reveals more depth. A message from a worried patient. A lab result that’s a little bit off. A radiology report that raises more questions. A preauthorization for a needed test. They’re important and necessary, but something you’re expected to squeeze in between patients, or finish at the end of the day.
Let’s be clear: It’s not light work when you
⚕️take the time and mental energy to thoughtfully review a complex lab trend
⚕️interpret an imaging report in context of the past medical history and recent symptoms
⚕️advocate for your patient with a persuasive argument to a nameless utilization review auditor
⚕️respond to a nuanced message
In many cases, it’s exactly what productivity expert Cal Newport would call deep work.
What Is “Deep Work”—and Why Does It Matter in Healthcare
Cal Newport describes deep work as cognitively demanding high-value work that requires sustained focus, careful thinking, and meaningful decision-making.
Many inbox tasks fit the definition of deep work. They may be considered task completion, but in reality it’s clinical decision-making. And this work often requires the same level of focus as seeing a patient face-to-face.
The Hidden Cost: Attention, Energy, and Time
One of my recent coaching clients—a highly skilled subspecialist—put it perfectly: “It’s not only the volume, which is a lot. It’s the work of thinking.”
Patients are complicated human beings. Decisions about their care are rarely binary, and small, easily overlooked details can change management. Reviewing the chart, searching out records from the hospital or outside sources, and responding to a patient’s concerns takes time and mental energy.
Because inbox work is not formally structured into the clinical day, it often gets pushed to the margins. That usually means between visits, during lunch, at the end of the day, or at home, late at night.
One physician I know gets up in the middle of the night to work on his charts, because it’s the only time he can work without interruptions.
It’s easy to see how these strategies can lead to cognitive fatigue, and even burnout. Increased risk of errors, an anxiety-producing sense of always falling behind, and difficulty feeling finished at the end of the day are natural consequences of a perpetually replenishing inbox.
This physician-level work largely goes uncompensated. But because it happens in small, fragmented pieces, it’s easy for both institutions, and physicians themselves, to underestimate its true impact.
The Mismatch: Deep Work in a Fragmented Environment
According to Cal Newport, deep work requires:
🔺Focus
🔺Time
🔺Continuity
But the typical clinical environment offers:
🔻Interruptions
🔻Time pressure
🔻Constant task switching
This mismatch is at the heart of why inbox work feels so draining. You’re being asked to do cognitively demanding work in conditions that actively undermine your ability to do it well.
A Call to Healthcare Leaders
If we continue to treat inbox work as administrative overflow, we will continue to underestimate its impact on physician capacity, decision-making, and patient care.
It’s time to take a closer look:
⭕ How much cognitively complex work is being done outside of scheduled hours?
⭕ How often are physicians expected to perform deep clinical thinking in fragmented time?
⭕ How can this work be fairly compensated?
⭕ How can tasks be pre-screened and delegated to other qualified staff members when appropriate?
Instead of relying on physicians to absorb this work at any cost, how can systems better support them in doing it well?
Providing the time and space for deep work in all its forms is essential for both physician sustainability and high-quality patient care.
This post contains Amazon affiliate links. If you choose to purchase through these links, I may earn a small commission at no extra cost to you. Thank you for supporting the work I share here.
If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.
And if you’d like to schedule a complimentary introductory meeting with me, click the link below.