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With the advent of the EMR, physicians have had increasingly more tasks to incorporate into their workflow. In recent years patient portal messaging has become a large component of these EMR related tasks. The effects of EMR workload on physician well-being have been well studied. However, literature is not as robust regarding the specific effect of patient portal messaging on physician well-being. This study aims to review current literature regarding patient portal messaging and its effect on physician well-being. We conducted a scoping review of published literature on patient portal messaging and physician well-being. Relevant keywords were searched on both PubMed and PsycINFO yielding 13,084 articles, 7,965 articles remained after duplicated articles were removed, and 1,893 articles remained after removing articles published prior to 2021. Of the remaining articles, titles were then screened for relevance leaving 50 articles. Abstracts of these 50 articles were screened, leaving 6 full text articles to be reviewed. Conference proceedings from the 2021-2023 International/ American Conference on Physician Health were also reviewed and 1 additional full text article was added. Of these 7 full text articles, 5 met inclusion criteria of being a quantitative study that occurred in the post pandemic era and were included in the final results. Of the articles evaluating this topic, the majority showed a correlation between patient portal messaging and negative effects on physician well-being. Burnout was the most prevalent outcome studied but other indicators of wellbeing varied widely including job satisfaction, feelings of value, heart rate variability indicators of stress, electronic health record confidence or stress, and alignment in values with clinical leaders. Most of these articles examined the amount of time spent responding to patient messages as a predictor of wellbeing. One study also focused on the time of day that responses were made. Another study used natural language processing to conduct a sentiment analysis with no significant results. The results of this scoping review highlight the potential important implication of patient portal messaging and its role in physician burnout. Future research will benefit from examining the use and characteristics of patient portal messages in a post-pandemic era. Specific areas for study include combining length of time and quality of messages as predictors of physician wellbeing.

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Patient Portal Messaging and Physician Well-Being: A Scoping Review