Research companion · interactive
How many portal messages does a physician like this get — and what do they cost after hours?
Pick a specialty group and a clinical FTE. The curve shows the full distribution of patient medical-advice-request (PMAR) messages across comparable US physicians. Click anywhere on it — or use arrow keys — to see estimated after-hours EHR time at that point in the distribution.
Specialty group
Clinical FTE
Share of comparable physicians receiving fewer messages (%) vs. messages per week. Click to select a point.
Methods & caveats
Data: de-identified Epic Signal EHR metadata for 181,704 US ambulatory physicians (Oct 2021–Apr 2022) with non-missing scheduled hours, message, and after-hours time measures; physician-level means of monthly observations normalized to weekly values. Companion to Holmgren et al., “The Uneven Distribution of Patient Portal Messages Across Patients and Physicians,” Health Affairs (2026).
Clinical FTE is proxied as scheduled ambulatory patient-care hours ÷ 36; each estimate pools physicians within ±20% of the implied scheduled hours. PMAR messages are patient-initiated medical advice requests received directly by the physician (administrative, refill, and pool-routed messages excluded). After-hours EHR time (“work outside of work”) is active EHR time outside scheduled hours — including unscheduled days — with a 30-minute buffer around clinic; measured with a 5-second inactivity timeout, so a conservative floor. Estimates at a selected point are unadjusted conditional means within 5-percentile bins of message volume. Associations, not causal effects.