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Is Your Texting as Caring as Your Bedside Manner?


Test your knowledge to see if your patients would consider you an efficient texter.

In modern health care, texting patients is becoming as crucial as having good bedside manners. This quiz explores your "screenside" manners, a vital skill in digital patient communication. Whether you're a clinician, medical staff, or just curious about health care digital communication, this quiz offers insights into the best texting practices.

By the end, you’ll have a clearer understanding of good texting manners, ensuring your text messaging enhances the patient experience rather than detracts from it. So, are you ready to see if your patients would consider you a good texter? Let's dive in!

1) Which text message feels personal and avoids sounding like spam?

So, why does this all matter?

The widespread adoption of technology and in health care in the United States is evident. Approximately 97% of Americans now own a cellphone of some kind, with 9 in 10 owning a smartphone.1 The adoption of Electronic Health Records (EHR) is nearly universal among clinics, with rates soaring to around 90%.2 Furthermore, the federal government is actively promoting interoperability—the ability of IT systems to communicate and exchange data.3

This digital shift means physician assistants (PAs) can use texting effectively to enhance patient relationships. Proper texting can prevent misunderstandings and missed opportunities, improving patient satisfaction and health outcomes.

It's crucial to recognize that not all texts or short service messages (SMS) are the same. In the Figure below we break down the 4 common ways SMS using the 4A’s framework: Alerts, Autonomy, Assistance, and Assessments. Our focus for this article is on the Assistance piece.

SMS figure: Alerts, Autonomy, Assistance and Assessments | Image credit: Michael Rubio, PA-C

Figure. Alerts, Autonomy, Assistance, and Assessments

For PAs, setting the stage for streamlined patient communication is essential. Differentiation is the cornerstone of this process. To assist with this and maintain authenticity while remaining professional, you can use the mnemonic S.T.R.E.A.M.S (Set Expectations, Timing & Trust, Response Quality, Empathy & Engagement, Avoid Miscues, Messaging Content, Slow & Steady Wins) to navigate this new world effectively.

Setting Up Patients for Texting Success

We've all received and ignored cold, promotional, and spam-like texts from CVS that read, "You WON'T believe this DEAL!🔥🚨 You’ve been SELECTED for an exclusive 25% OFF." Contrast this with a message that clearly states its purpose and origin, perhaps starting with, "Hello, Emma, this is Michael Rubio, PA-C, your provider at Infinity Dermatology, reaching out..." This approach immediately distinguishes the message from common spam and clarifies the sender’s identity.

If you are a pro, you can prime your messages (if your organization allows), "Quick note: We'll use texts for updates and check-ins about your health, upcoming appointments, and more. Expect a follow-up text this week! For any questions, feel free to message us here anytime—a team is ready to assist."

Tip: Avoid beginning to send important information via SMS without prior notice, as this might confuse or overwhelm patients. Instead, during their first visit or contact, encourage them to save your number with a message like:

"Hi, Michael! We're here to assist you anytime. Save this number as 'Well Revolution' to reach us quickly 😊."

Timing & Trust

The timing of messages can significantly impact how they are received. To maintain trust and respect for patients' time, messages should be sent during appropriate hours, mirroring the rhythm of a normal, respectful conversation. Note that immediate responses might be perceived as insincere or automated, so balancing responsiveness with a human touch is crucial. Lastly, ensuring that messages come from a recognizable number solidifies trust and reduces confusion.

Tip: Texting over the weekend can enhance your brand and rapport, providing a more concierge-like service.

Response Quality

Doctor texting on a phone | Image credit: Malik/peopleimages.com - stock.adobe.com


In the world of instant communication, quality should never be sacrificed for speed. Thoughtful, informative responses that provide value and support to patients are essential. Focus on delivering meaningful information that empowers patients rather than quick, less informative messages. Relying solely on automated, generic responses can fail to address specific patient needs and can feel disingenuous.

"Hello, Sam, if you’re experiencing mild symptoms from tretinoin, you might find this article helpful [link]. For anything urgent, reply to this message!"

Tip: Using a texting platform that incorporates AI assistance can help tremendously in crafting personable messages efficiently and timely.

Empathy & Engagement

Empathy lies at the heart of effective communication. Tailoring messages to address the patient’s current situation with understanding and care encourages a more meaningful exchange. Engaging patients with context-specific questions invites dialogue, making them feel heard and valued.

"Hi, Jordan, it’s Michael Rubio, PA-C again from Infinity Dermatology. Just checking in to see how you feel after your Dupilumab injection yesterday. How is your itch feeling?"

Avoid Miscues

Ensure consistency in communication by having designated staff members manage SMS dialogues, which helps build a stable, consistent relationship. Be cautious of allowing multiple staff members to send messages without tracking previous interactions, which can lead to a confusing experience.

Messaging Content

The content of messages should be personalized and engaging, starting with the use of the patient's preferred name. Keeping content relevant and personalized to each patient’s health journey reinforces the message that their care is a priority.

"Hi, Zoe! Just a gentle reminder about your upcoming wellness check-up on Thursday. Looking forward to seeing you.😊"

Tip: Salutations like Mr. or Ms. are generally better than just the name if age-appropriate.

Slow & Steady Wins

Building a relationship through SMS should mimic the pace of a growing friendship, where communication flows naturally and without pressure. Avoiding aggressive or overly frequent messages respects the patient’s space and time, allowing the relationship to develop organically.

Tip: In texting, every word counts, so keep it brief. Try not to bombard patients with long messages, pressuring them for immediate responses.


In the digital age, PAs have an immense opportunity to join in on the digital care boom, although your screenside manner is equally important as your bedside manner. As we've explored, getting your texting tactics right can significantly enhance patient relationships, ensuring that every message sent not only conveys information but also care and professionalism. With the right approach, your texts can extend your bedside manner into the digital realm, making each patient feel valued and understood right from their own devices. So, when offering support, remember that a thoughtful text can make a world of difference in your patient’s lives. Keep these tips in mind, and you're all set to lead with empathy and efficiency, one message at a time.

Michael Rubio, PA-C, is a dermatology physician assistant at Infinity Dermatology in Brooklyn, NY. He is the vice co-chair of the Society of Dermatology Physician Assistants Communication Committee and a contributor to the National Commission on Certification of Physician Assistants development of the Certificate of Added Qualifications in Dermatology. He is also a co-founder of Plait (plaithealth.com), an innovative communication platform that helps dermatology practices communicate better and work more efficiently.


1. Mobile fact sheet. Pew Research Center: Internet, Science & Tech. January 31, 2024. Accessed April 9, 2024. https://www.pewresearch.org/internet/fact-sheet/mobile/.

2. FastStats - electronic medical records. Centers for Disease Control and Prevention. November 3, 2023. Accessed April 11, 2024. https://www.cdc.gov/nchs/fastats/electronic-medical-records.htm.

3. Public health data interoperability. Centers for Disease Control and Prevention. May 16, 2023. Accessed April 11, 2024. https://www.cdc.gov/datainteroperability/index.html.

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