After I purchased a new smartphone during the COVID-19 pandemic a few years ago, I paid little attention to one item on the Settings menu: Digital Well-being. At some point, perhaps after a system update, I started getting prompts to inform me of how many more minutes (or hours) I used my smartphone compared to last week. Tapping on that reminder led me to a screen that would then tell me how many minutes I spent on various apps. Although the nudges and pointers have not necessarily changed my behaviors over the years, I started noticing how much additional time I will spend working my day job by continuing to use work-related apps on my phone. Naturally, after-hours workload for physicians is no surprise: numerous published papers on audit log or user action log data from electronic health records (EHRs) reveal what physicians have known all along. We work during business hours (and beyond to finish work), and then we often keep working after leaving the workplace. Although the American Academy of Pediatrics acknowledges that children spend an average of seven hours daily on electronic entertainment media1 and recommends age-based limits on screen time, what about physicians? How much time do we spend on digital media, including required work activities and home life? What about physicians’ digital well-being?
In routine physician work, after-hours workload (also known as work after work, or pajama time) has been closely linked with burnout.2 Additionally, female physicians may spend more screen time with an EHR than male physicians.3 I remember working on my university computer, apart from the clinic or hospital, just a few years ago, when a required bit of software on the workplace computer would push me with a pop-up throughout the day: a reminder to take a pause from the computer, regardless of what I might be working on at that moment, whether in an EHR or something else. As well-intended as that might have been, you can imagine what the large majority of my responses were, given research that has examined physician desensitization to repetitive clinical decision support alerts.4 (Click “OK.” Keep working.)
While audit log data for EHRs and additional so-called productivity tools on a computer may provide insight about our screen time and what we spend our time looking at during work, could it be helpful to flip the perspective and instead look at physician screen time? Admittedly, I only quickly searched PubMed and Google Scholar to find some data on this, but I did not readily find what I was looking for. Perhaps physicians’ screen time is under the umbrella of various surveys on physicians’ personal health behaviors. One inquiring mind wants to know.
Since I discovered Digital Well-being on my phone, I’ve already taken advantage of settings that limit how much time I spend on certain apps and transition the screen to monochrome at night to remind me to stop using it before bedtime. I’ll take the following measures for my own digital well-being for now:
1) monitor my digital device use with the help of my phone’s my digital well-being tool and respond by reducing my usage behaviors, especially of work-
related apps; and
2) finish writing this column and go bake that apple crumble recipe I saved last week.
What do you do to promote your own digital well-being?
- American Academy of Pediatrics. Media and children. AAP. . Accessed February 15, 2023. /
- Saag HS, Shah K, Jones SA, et al. Pajama time: Working after work in the Electronic Health Record. J Gen Intern Med. 2019; 34, 1695-1696.
- Tait SD, Oshima SM, Ren Y, et al. Electronic Health Record use by sex among physicians in an academic health care system. JAMA Intern Med. 2021;181(2):288–290.
- Ancker JS, Edwards A, Nosal S, et al. Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system. BMC Med Inform Decis Mak. 2017; 17, 36.
Clinical Practice, COVID-19, Medical Education, SGIM, Wellness
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