Why your inbox fills up after every visit, and what helps

Dr. Nina finishes clinic at five. Forty messages are waiting. Three are from patients she saw on Monday.

"Which pill did you tell me to stop?"

"Was I supposed to skip breakfast before the blood test?"

"Do I call the heart doctor, or do they call me?"

She answers all three. She said every one of those things in the room. Then she answers the next thirty-seven.

Names and details are made up. This is not a real clinic. But if you see patients, you have had this evening.

Why this happens

It is not that patients don't listen. It is that visits are fast and the words are hard. People forget 40 to 80 percent of what the doctor said right away, and almost half of what they do remember, they remember wrong. (Kessels, 2003)

That forgetting lands in your inbox. One study found primary care doctors get about 243 inbox messages a week. (Tai-Seale, Health Affairs, 2019) Many of the ones from patients are questions you already answered in the room.

What helps

1. Close with a say-back. Ask, "Tell me what you'll do when you get home." Thirty seconds now saves a message later.
2. Write down three things. What changed. What to do next. When to come back. In short words, on paper they take home.
3. Welcome a second set of ears. A family member in the room or on speaker catches what the patient misses.
4. Say yes when a patient asks to record. It is their copy of what you said, and it means fewer calls about what you said.
5. Ask for the bottles once a year. One real medicine list beats three half-remembered ones.

How Keeybod helps

A patient asks you first. If you say yes, Keeybod records the visit on their phone and gives them an easy-to-read summary and medicine list, with the next steps. There is nothing for you to install. We are looking for community clinics and veterans' programs to run the first pilot.

For providers

By Dr. Jim Besong, family medicine doctor. This is general information, not medical advice.