How patients want to communicate with practices
Patients expect to handle simple things, like confirming or moving an appointment, the way they handle everything else: quickly, on their phone, at a time that suits them. They also expect a real person when something matters. Good practice communication is built around both expectations.
- About nine in ten U.S. adults own a smartphone, according to Pew Research Center.
- Most patients are now offered online access to their health information, and a majority use it, according to ONC.
- Controlled trials summarized by Cochrane found text reminders worked about as well as phone call reminders for attendance.
- Patients want speed for simple tasks and a person for complex ones; good systems route between the two.
- Short messages with numbered choices respect the patient's time and keep sensitive details out of texts.
What the research shows
A few well-sourced numbers set the context. Pew Research Center reports that about 91% of U.S. adults own a smartphone. The Office of the National Coordinator for Health IT (ONC) found that in 2024, 77% of individuals were offered online access to their medical records or a patient portal, and 65% accessed their information online at least once in the year. ONC also found that people whose provider encouraged portal use were more likely to use it.
On appointments specifically, a Cochrane review of controlled trials (Gurol-Urganci and colleagues) found that text message reminders improved attendance compared with no reminder, and that their effect was similar to phone call reminders, though the authors rated the evidence low to moderate quality. For routine scheduling tasks, a text can do the job of a call at a fraction of the staff time.
None of this means patients want only digital contact. It means the phone in their pocket is where routine conversations increasingly happen, and a practice that only communicates by voice during business hours is asking patients to fit its schedule.
Match the channel to the task
Different conversations suit different channels. A practical way to split them:
- Text: confirming, rescheduling, offering an open slot, a short note after a missed call. Fast, asynchronous and easy to answer with one tap.
- Phone: anything complex, sensitive or emotional; billing questions; patients who've said they prefer calls; anyone who seems confused by a text.
- Portal: results, records, forms and secure messages that include clinical detail.
- Email: longer, non-urgent information such as paperwork instructions. See email vs text for patient messages.
Seven design rules for patient messages
- Be brief. One purpose per message. A patient should understand it in a glance.
- Make answering effortless. Numbered choices (reply 1, 2 or 3) are faster than typing and impossible to misread. See numbered menu texting.
- Say who you are. Start with the practice name so the patient trusts the message.
- Leave out sensitive details. No diagnosis, no reason for visit, no patient name. Texts can be seen on lock screens and shared phones. Our guide to minimum necessary texting covers what to leave out.
- Respect timing. Send at reasonable hours unless the patient started the conversation.
- Honor opt-outs instantly. STOP should work on every message, every time.
- Always offer a person. Every automated thread should have a clear path to a human.
What a good exchange looks like
Here is an illustrative example of a cancellation-fill offer that follows these rules. The times are placeholders.
- Practice: [Practice name]: an earlier time opened up. Reply 1 for Thu 9:30 AM, 2 for Thu 2:15 PM, or 3 to keep your current time.
- Patient: 1
- Practice: Thanks. Our front desk will confirm Thu 9:30 AM shortly. Reply STOP to opt out.
Why the exchange works
The patient learned who was texting, saw exactly what was on offer and answered with one keystroke. Nothing in the thread reveals why they're being seen. The front desk stays in control of the actual booking.
Compare that with a voicemail asking the patient to call back during office hours. The patient would need to listen, remember, find a moment between 8 and 5, wait on hold and then negotiate a time. Every step is a chance to drop off.
Where practices go wrong
- Too many messages. Reminder, re-reminder, survey, newsletter. Patients start ignoring all of them.
- Messages that can't be answered. A no-reply text that says call us wastes the channel.
- Too much detail. Including the visit reason or provider specialty in a text creates privacy risk without helping the patient.
- No human exit. Patients who get stuck in automation lose trust in the practice, not just the tool.
- Treating all patients the same. Some patients strongly prefer calls. Record the preference and honor it.
Audit your own patient messages
Set aside half an hour and look at every automated message your practice sends, from every tool. Patients notice the difference between a practice that respects their time and one that simply sends a lot.
Any message that fails two or more of these questions is worth rewriting or retiring:
- Does it start with the practice name?
- Does it ask the patient to do exactly one thing?
- Can the patient answer by replying, ideally with a number?
- Does it contain anything a stranger shouldn't see on a lock screen?
- Does it explain how to opt out?
- Is another tool already sending a similar message to the same patient?
How DocsMD talks to your patients
DocsMD texts are built on these rules: the practice name, times and numbered choices, never the patient's name or the reason for the visit, with STOP honored on every message. Most replies are numbered menus that never reach an AI model, and confirmed bookings are handed to your front desk to enter, so a person always stays in the loop.
Questions
Do older patients respond to texts?
Many do, and smartphone ownership is high across age groups. Still, record each patient's preference and call those who prefer a phone conversation.
Is texting better than calling for reminders?
A Cochrane review of controlled trials found text reminders had a similar effect on attendance to phone call reminders, and texts take far less staff time.
What should never go in a patient text?
Diagnoses, the reason for the visit, test results and, ideally, the patient's name. Keep texts to the practice name, times and choices.
How many messages is too many?
If patients start ignoring or opting out, you've crossed the line. Send only messages that ask for a simple action or deliver information the patient needs.