I love texting on cell phones. It used to be, if you wanted to ask the chief a question, let alone the attending, you thought about it long and hard. Is this worth calling or paging them, distracting them from what they’re doing, making an incident out of the fact that I can’t figure it out for myself, or worse yet, can’t remember what they told me to do?

I’m sure for the chiefs, there was also an element of wanting to know things (how’s that patient in the unit doing; is the new admission here yet; did the attending agree with my plan to operate on this patient tomorrow), but not wanting to keep paging the junior residents repetitively for minor things.

Now we just text each other. Forget about waiting for answered pages, or spelling out your message to the operator. Text messages range from brief notes (“rounds at 8;” “meet me in OR 12;” “urine output better?”) to complex instructions and algorithms. Even some of the younger attendings have cell phones that they’re comfortable with us texting them on with brief messages, though of course not a first-time presentation of a new patient (“CT normal, will admit for pain control;” “OR got an emergency, your case is being pushed back”).

Although in general I would make a philosophical case against the rise of text messaging (it encourages communication without commitment; you want to say something, but don’t want to have to listen to the other person’s answer), in this case it dramatically improves real-time communication, and relieves stress for the junior team members, since texting is not as big of an intrusion or an admission of inadequacy as paging would be.