April 1999 Bulletin
How to avoid drowning in e-mail
Keep messages short, deal with it promptly or put it in 'folders'
By Christopher W. Oliver, MD
Trauma and orthopaedic surgeons have only a limited daily amount
of time to use the Internet and e-mail effectively. For beginners
using new technologies, the enormous amount of data may be a "turn
off" to developing a useful way of using the technology.
It is so very easy to become information overloaded.
The reasons for information overload are due to:
- too much information.
- an inability to understand the information, often due to excessive
- knowing the information exists, but not being able to find
- difficulty finding the appropriate information once a useful
source is located.
- the coarseness of Internet search engines.
- insecurity of validation and quality of online material.
- When surgeons encounter information overload they will tend
- avoid using a particular resource.
- use the resource badly (often due to not reading instructions).
- waste online time.
- slow down development of their own projects.
- increase their own stress levels.
Electronic mailing lists are particularly liable to create information
overload. Orthopaedic surgeons who use mailing lists need to learn
how to manage their own computer and use the appropriate software
and hardware to handle messages effectively. Mailing lists may
- take up a lot of surgeons' time.
- cause encounters with irrelevant or "spam" messages.
- create long download times due to large image file attachments.
- be insulting due to "flames."
- contain frivolous chat.
- cause confusion over exact meanings of messages due to lack
of face-to-face contact.
- repeat basic questions.
E-mail lists may be improved by the users carefully considering
their replies and only sending them after due consideration of
their content and readership. Coping with the time it takes to
answer e-mail is often learning how to "let go" and
is often the most important factor when using mailing lists. E-mail
however, particularly useful in that it may be possible to contact
people in organizations that you may not have normally had access
to. For the person being accessed this may increase their workload.
It is often useful to have two e-mail accounts, one for business
and one for personal use.
My own policy for dealing with e-mail is to deal with it immediately.
I choose to use "folders" in my e-mail to sift my mail
automatically into subdivisions from known senders. I can deal
with my folders at my leisure. The remaining mail in my inbox
will be immediately deleted if they are irrelevant. I do not open
messages that are not relevant to me. I immediately reply to messages
if my answer is short or put it into a "tasks" folder
to act on later. I do not procrastinate; I find it is better to
be faster and more efficient to answer immediately and keep my
inbox clear. It may be possible to prioritize and delegate especially
where the surgeon has a secretary with a reasonable level of computer
literacy. Strategies to help time management are:
- a knowledge of personal "time management" is very
- setting goals to decide how much e-mail and Internet time
each day should be considered.
- a well-kept electronic address book will help locate e-mail
addresses. Storage of the address book on a server will mean it
can be accessed from any computer with the appropriate software.
- e-mail distribution lists will save time in sending messages
to the same frequently used group.
- careful use of directories to store files and e-mail on the
computer or server.
- use of searching and sorting facilities in the e-mail program
will help locate lost messages.
- a backup strategy for lost data using a floppy disk, tape
drive or re-writeable CD-ROM.
- regular archive of old e-mail messages.
- obsessive use of a virus protection program will help guard
against the loss of data.
Good practices when sending e-mail is:
- consider if the message is absolutely necessary.
- use good subject lines.
- keep messages short-no message should be longer than 100 lines
otherwise they are unlikely to be read.
- use a four line e-mail auto-signature giving your name, qualifications,
institution and contact details.
- distinguish business mail from non-business mail.
- watch where your replies are going, think who really may be
reading your message.
- check mailer options; do you really need to send a copy of
every message to yourself ?
- delete unnecessary parts of messages when replying.
- check validity of virus warnings; do not circulate hoax messages
without checking their validity with a online virus software website.
- don't send attachments to lists, it wastes everybody's time.
- avoid cross posting to lists, it wastes everybody's time.
- when going on holiday suspend mail from lists and do not use
a vacation mailer.
- never use obscene language and insults, and shun any racist
or sexist remarks. You never know if your mail will be archived
permanently by the recipient. Always remember confidentiality
at present is not guaranteed with e-mail.
New technologies are allowing seamless integration of e-mail,
the Internet and the personal computer which should make information
management easier and overload much less of a problem. Remember
that with e-mail, organizations can become less hierarchical and
the lines of communication open out. Recipients may, however,
lack the necessary background information so always be clear and
precise to avoid time-wasting misunderstandings.
Christopher W. Oliver, MD, FRCS (Orth) is consultant, trauma
and orthopaedic surgeon, Edinburgh orthopaedic trauma unit, Royal
Infirmary of Edinburgh, Edinburgh, Scotland.