I'm not a hard core follower of GTD, but I do believe that working from the top of your inbox all day long is a recipe for disaster. However, accessing email is important and necessary. Problem is, with most email clients (I use gmail), you have to pass through the inbox (risking distraction) to do anything else you might need to do with your mail, such as composing or searching. Recently, I've developed a workaround for this, which allows me to a) send and b) search without ever seeing my inbox. It's working pretty well for me so I thought I'd share:
Sending: Using the Quick Compose w/ Gmail and Quicksilver technique, I can now fire up a new Gmail compose window from anywhere (even outside of the browser) by invoking command+shift+m. Now, when I think "Oh, I need to email Karl about our project", I don't go to the inbox, I go to the compose window directly from wherever I am. Priceless.
Searching: Using the Gmail Search chrome plugin, I can go directly to a Gmail search from a new browser tab, by starting out with g+s+ and then my search query. I get straight to what I was looking for; no trip to the inbox along the way.
The end result: I'm spending way less time in my Inbox, and doing a better job organizing my time around my real priorities. I think that's a good thing. The down side is that I've actually missed a few emails recently, as spending less regular time in the inbox means a bigger pile when you do get there. But I see that as a manageable problem, and less important than getting past the prioritization-by-inbox routine.