Jarrod Shapiro, DPM
The Terrors of Texting:
Watch Out!

The regular pace of technology continues to roll on, and day-by-day, we see new advancements that help both our professional and private lives. Personally, I love new tech – once I figure it out. Usually, those first halting steps have me yelling for someone that knows better than me – most often my wife. One piece of technology I can no longer live without is my smart phone. I actually have a love/hate relationship with my phone. I love that it gives me access to my work and other people at any time. I hate that it gives me access to my work and other people at any time.

The one greatest piece of software I use on my phone is my text application. When texting first came out I, was one of those people that scoffed at the teenagers spending every spare moment texting their friends. I laughed at those television commercials that showed kids with 100,000 texts. Now, years later, I've become one of those heavy text users. Darn it!

Fortunately for me, I'm not alone. Just about everyone, it seems, at my base hospital uses texting as a major form of communication. The hospital administration is very responsible about this, and in order to prevent HIPPA violations, they use special texting programs approved for medical use. As physicians, we have an extra responsibility to be as careful with texts as possible. To that end, you might consider using one of the following programs:

	•	Doc Halo
	•	TigerText
	•	Sprint Enterprise Messenger
	•	Cortext

These programs provide components such as encryption and timed message erasure to prevent patient health information from getting into the wrong hands.

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Nevus vs Melanoma
Steve A. McClain, MD

Texting is excellent because it allows for rapid, seamless communication without the necessity of making a phone call. I can be sitting in a meeting on the university campus and receive a text by one of my residents about a surgical case they just finished. This makes me highly available to my residents (which is a good thing, despite what some of you may think). I love that my residents can easily keep me informed of what they are doing, and I can sometimes provide them advice in real time. It keeps my interactions with the residents vibrant and active. Texting also allows each of us more control of our time and social interactions. It takes more social graces to exit a phone or face-to-face conversation (ie,more work) than a text conversation.

However, there is a major downside to texting that we must consider: the absence of the complexity of verbal communication. Think for a moment about the nature of your direct face-to-face verbal communications. These situations are likely to be highly complex, rich interactions in which meaning is layered with variable tone, facial expressions, and body language that communicate so much beyond the simple contents of your message. All of this provides context.

Texting, on the other hand, does not have this capacity. First, the effectiveness of a text's true message depends a lot on the writing ability of the texter. If he is a weak writer, then it's unlikely the text will reveal clearly what he intends. Second, different people have different conceptions of how to text. For example, some people text abrupt commands when they would normally be more diplomatic in person. Others are more conversational in their texting. Third, text conversations are never actually in real time. The computer is unable to decipher the actual order of the comments by conversation flow, listing the comments in order of receipt. There is also a slight delay, depending on connection and typing speeds. If someone were to look at my text conversations, they would see a somewhat disjointed series of statements due to this time variation. Fourth, and perhaps most importantly, the context I mentioned above – tone, body language, etc. – is completely lost. This is all beside the possible autocorrect errors that may occur.

For more routine text issues, consider some of the following text etiquette suggestions

	1.	Don't text when it would be rude to speak. For example, don't text during a movie
	2.	Don't text the wrong person. Check the number first
	3.	Never communicate anything highly important by text. Use the phone. For example, I make my residents call me to discuss consultations.

	4.	Use caution with interpreting pictures sent via text. The images on a phone may be too small to appreciate the fine detail necessary for clinical decision-making.
	5.	Always be more polite by text than you would normally be in person. Be extra nice and polite to prevent misinterpretation of your intentions.

Perhaps the best piece of advice would be to use your common sense when texting. However, given how uncommon common sense actually is, caution should be advised!

Best wishes,

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]