082310_rg_InboxZero_04In this digital age, it is somewhat assumed that you know how to manage all the digital information coming at you in the forms of email, Facebook, Twitter, blogs, podcasts, RSS feeds. Even if you only partake in email as your primary communication platform, information still can be quite overwhelming as a trainee or practicing medical provider. At a the annual Bay Area EM residency conference last week, Dr. Charlotte Wills (Highland), Dr. Rebecca Smith-Coggins (Stanford) and I were invited by Dr. Esther Chen (UCSF-SFGH) to share some our personal insights and advice on a panel. We quickly realized that this is indeed a hot topic which often gets subsumed under the larger umbrella of “Wellness”.

I wanted to continue our focused discussion on managing digital information overload. Many people had more great questions and intriguing tips after the session. Everyone seems to be looking for find better ways to work more efficiently. What better place to discuss this than in a digital forum? I would love to hear perspectives from students, residents, and practicing clinicians.

Questions to get your thoughts started

  1. Whether you get 10, 100, or 1000 emails a day, how do you “process” all your emails without it consuming your whole day?
  2. Do you have a To-Do list? If so, how do you manage it (paper, digital, cloud-based)?
  3. How do you manage your Calendar(s)?
  4. How do you get in a little learning each day amidst the chaos of your shifts, project deadlines, and home life?
  5. How does social media ADD more time to your day rather than DETRACT from it?
  6. If you work on team-based projects, do you have non-email approaches to communication and collaboration?

InboxZeroSome of my personal tips

  1. We should all strive NOT to work harder, but rather more efficiently.
  2. Minimize the number of mouse clicks you use — learn the keyboard shortcuts. This will save you lots of time in the long run.
  3. I try to subscribe to the “Inbox Zero” principle by Merlin Mann and “Getting Things Done” approach published by David Allen. In general, the idea is that you should either respond (if it takes <2 minutes), delegate, move into an Action (to-do) list with a due date, or delete the email on first pass. Leaving emails in the inbox only leads to taking up precious cognitive processing space in your brain, whether you realize it or not. For those of us in Emergency Medicine, this is right up our alley — it’s all about triaging! It takes some work to change how you’ve been doing things for years, but it’ll be like a heavy weight off your shoulders if you get it right.
  4. It has always troubled me that we keep emails, communications, to-do lists, project files, and calendars all in relatively separate areas. For instance, you see on your calendar that you have a committee meeting today on interprofessional education at 3 pm. You then go to your computer’s folder on IPE projects to find the agenda. Then you open up your email to ask where the meeting is. Why do all these exist in different places? Although I haven’t found the perfect platform to merge all these together, I have been using IQTell for the past 2 months. It has definitely improved my workflow and exceeded my expectations especially given that it is free. I tried Omnifocus, Wunderlist, and Orchestra (before the company retired the platform…) which were ok, but the fact that IQTell has Evernote-sync’ing caught my eye. The major downside to IQTell is that the iPhone app only syncs with your Actions and Projects list (not email), so I have to still check my email through the Mail app.
  5. I keep my Action list, Calendar, Project folders, and emails all in one place (in my case – in IQTell). Each extra click toggling between different systems adds up over your day, week, month, and year! No matter what approach you use (for instance, it may all be in Gmail), it definitely takes an organized and systematic approach (includes building clear folder labels). It also requires checking your To-Do/Action list every day. Here are some great tips on how to write an effective to-do list. If done wrong, it can actually be counter-productive.
  6. I use Twitter and RSS feeds to get in a little learning each day. These little nuggets of timely knowledge saves me a lot of time in the long run, because I would otherwise need to find more structured time to sit down to read a journal or text online. As for responding and engaging in Twitter conversations, I keep that to a bare minimum for the sake of time.
  7. For team-based projects, I am increasingly sold on the use of team-only accessible Wiki sites to maintain a historical log of the 3D’s of projects which are commonly lost and scattered throughout various email threads  — Discussions, Decisions, and Documents. I used this to launch my online computer-based simulation project for the Lupus Initiative/American College of Rheumatology. I noticed that the EM Milestones project uses a public Wiki. Does anyone else use Wiki’s for team-based projects?
  8. In order not to get consumed by constantly addressing emails and small tasks, I reserve a portion of each day to focus on PROactive activities. I define REactive activities as those addressing questions, emails, and tasks which are in reaction to others. PROactive activities are those driven by your passions and long-term goals. In Scott Scheper’s blog post about “The To Do List Secret Everybody Ought to Know”, he states:

“Reactive tasks will make you a living. Proactive tasks will make you successful.”

Need help with commenting below?

It’s easy! Just comment as a Guest (don’t need password) as below. When done, hit the large, right-pointing Gray arrow.

Screen Shot 2013-08-30 at 2.57.45 PM

Disclaimer: I have no financial affiliations with Inbox Zero, Getting Things Done, Gmail, IQTell, Omnifocus, or Orchestra.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD