Quantifying the impact of telemedicine and patient medical advice request messages on physicians' work-outside-work

Soumik Mandal, Batia M. Wiesenfeld, Devin M. Mann, Adam C. Szerencsy, Eduardo Iturrate, Oded Nov

Research output: Contribution to journalArticlepeer-review


The COVID-19 pandemic has boosted digital health utilization, raising concerns about increased physicians’ after-hours clinical work ("work-outside-work”). The surge in patients’ digital messages and additional time spent on work-outside-work by telemedicine providers underscores the need to evaluate the connection between digital health utilization and physicians’ after-hours commitments. We examined the impact on physicians’ workload from two types of digital demands - patients’ messages requesting medical advice (PMARs) sent to physicians’ inbox (inbasket), and telemedicine. Our study included 1716 ambulatory-care physicians in New York City regularly practicing between November 2022 and March 2023. Regression analyses assessed primary and interaction effects of (PMARs) and telemedicine on work-outside-work. The study revealed a significant effect of PMARs on physicians’ work-outside-work and that this relationship is moderated by physicians’ specialties. Non-primary care physicians or specialists experienced a more pronounced effect than their primary care peers. Analysis of their telemedicine load revealed that primary care physicians received fewer PMARs and spent less time in work-outside-work with more telemedicine. Specialists faced increased PMARs and did more work-outside-work as telemedicine visits increased which could be due to the difference in patient panels. Reducing PMAR volumes and efficient inbasket management strategies needed to reduce physicians’ work-outside-work. Policymakers need to be cognizant of potential disruptions in physicians carefully balanced workload caused by the digital health services.

Original languageEnglish (US)
Article number35
Journalnpj Digital Medicine
Issue number1
StatePublished - Dec 2024

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Informatics
  • Computer Science Applications
  • Health Information Management


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