PT  - JOURNAL ARTICLE
AU  - Davis, Christopher R.
AU  - Riley, Timothy D.
AU  - Fogel, Benjamin N.
AU  - Risher, Kathryn A.
AU  - Shedlock, Katherine E.
AU  - Lagerman, Makayla B.
AU  - Keck-Kester, Terrah M.
AU  - Silvis, Matthew L.
TI  - Patient E-Message Character Limit Impact on Primary Care Clinician Burnout
AID  - 10.3122/jabfm.2025.250229R1
DP  - 2026 Jan 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 158410
VI  - 39
IP  - 1
4099  - http://www.jabfm.org/content/39/1/158410.short
4100  - http://www.jabfm.org/content/39/1/158410.full
SO  - J Am Board Fam Med2026 Jan 01; 39
AB  - Introduction Burnout 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.Methods Our 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.Results Approximately 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.