For a long time I started every clinic day by checking the inbox.

It seemed like the responsible thing to do. Something urgent might have come in overnight. A result might need action before patients started. Staying on top of it felt like staying on top of the job.

What it actually did was start every day with an uncontrolled demand on my attention before I'd seen a single patient. Some mornings nothing urgent. Some mornings several things that pulled me sideways before clinic even started. The day was already reactive before it began.

The change that made the most difference was simple and took two weeks to feel normal: I stopped checking the inbox first.

Not permanently. I still address the inbox — twice during the clinic day, at defined times that I chose rather than whenever it pinged. Once mid-morning, once end of day. Genuinely urgent things — results that require immediate action, messages flagged by my team as time-sensitive — get routed to me through a different channel. Everything else waits for the batch.

What changed: the inbox stopped being something I had to manage continuously and became something I worked through deliberately. The triage burden didn't disappear, but it moved to a time I allocated for it rather than colonizing time I needed for patients.

The first week was uncomfortable. I kept feeling the pull to check. By week two it had become the new default. By week three I couldn't remember why I'd been doing it the other way.

The principle is batching: grouping like demands into defined windows rather than allowing them to arrive continuously. It's not a new idea. It's used everywhere in operations management. It's almost entirely absent from how physician workflows are designed.

You don't have to redesign everything at once. Start with the inbox. Define when you check it. Hold the boundary for two weeks.

— Ryan

P.S. The charting tips PDF covers some of the inbox workflow pieces: mededwell.com/chartingtips