Evidence map›Paper›PMID 42128601›Full record

ArticleJournal of the American Board of Family Medicine : JABFM2026

Patient E-Message Character Limit Impact on Primary Care Clinician Burnout.

Christopher R Davis, Timothy D Riley, Benjamin N Fogel, Kathryn A Risher, Katherine E Shedlock, Makayla B Lagerman, Terrah M Keck-Kester, Matthew L Silvis

Abstract read
In one paragraph

Article in Journal of the American Board of Family Medicine : JABFM, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christopher R DavisDepartment of Community and Family Medicine Pennsylvania State University.
Timothy D RileyDepartment of Community and Family Medicine Pennsylvania State University.
Benjamin N FogelDepartment of Pediatrics Pennsylvania State University.
Kathryn A RisherDepartment of Public Health Sciences Pennsylvania State University.
Katherine E ShedlockDepartment of Pediatrics Pennsylvania State University.
Makayla B LagermanDepartment of Community and Family Medicine Pennsylvania State University.
Terrah M Keck-KesterDepartment of Pediatrics Pennsylvania State University.
Matthew L SilvisDepartments of Family and Community Medicine and Orthopedics and Rehabilitation Pennsylvania State University.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionBurnout is prevalent among primary care (PC) clinicians. One driver of this is asynchronous work, an important component of which is electronic messages (e-messages) between patients and clinicians in the electronic medical record (EMR). Studies have shown mixed results regarding the EMR's impact on clinician burnout and patient care, though none have been identified that investigate the impact of limiting the size of e-messages on PC clinicians.

methodsOur institution limited patient-initiated e-message length to 1000 characters across one health system. Impact on e-message burden and clinician burnout was assessed using anonymous, electronic, Likert scale-based questionnaires which were distributed to family medicine and general pediatrics PC clinicians before and after the character count limit implementation.

resultsApproximately 150 clinicians were invited to participate, and about 54% and 48% completed the pre-/post-intervention surveys, respectively. There were no significant sociodemographic differences between respondents in the pre-/post-intervention surveys and there were no significant differences in Mini Z burnout scores or measures of e-message burden before and after the intervention. DISCUSSION: These findings highlight that primary care provider burnout is a complex issue, and limiting e-message character counts alone may not be enough to make an impact.

Indexed as

Burnout, ProfessionalElectronic Health RecordsElectronic MailPhysicians, Primary CareAdultFemaleHumansMaleMiddle AgedPrimary Health CareSurveys and QuestionnairesElectronic Medical RecordsHealth WorkforceOccupational BurnoutPatient CarePrimary Health CareSurveys and Questionnaires

Identifiers

PMID42128601
PMCPMC13292082

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.