Let’s face it, if you’re under 40 in mind, spirit, or body, you probably dread voicemail and calls. I’d rather just get a quick text and read it when I feel I have a spare moment. Voicemail has become so exhausting that my current voicemail message starts with “I don’t accept voicemail unless you are a family member, medical provider, or law enforcement…please text me instead.” I admit it’s gotten mixed reviews. But text messaging is a part of our society right now, and veterinarians should use it appropriately while understanding legal requirements around it. I’ll go through the legal hows below, and then let you know how we’re using texting at our clinic.
The AVMA model Veterinary Practice act has several sections, including patient confidentiality in Section 19 that expressly mention electronic authorization or waiver. ( https://www.avma.org/KB/Policies/Pages/Model-Veterinary-Practice-Act.aspx ). The Georgia Veterinary Practice Act has similar references to electronic records and consents in several places. It’s a sound position that an e-mail, text, or (gasp) fax, can act as client consent. Technically, a voicemail is an electronic storage of a voice, and is also an electronic consent. Further bolstering this is the now venerable Electronic Signatures and Records in Commerce Act of 2000, signed into law by President Clinton, that allows electronic signatures and records to have the same status as in person or paper records. Almost every state has an a version of this in addition to the federal law.
That was all very wordy, but what it means is that vet practices can accept consent for procedures, payments, boarding, and other routine communication with an electronic, rather than paper trail. It also means that you can use texts as part of your patient and client records. Many texting applications allow you to “capture” a set of texting, and then send it as an image to another person. This is a good way to capture client consent and put it as an attachment in your record(s). Some practices just put a line in the record that says “texted on x day, client consented, [client consent quote].” You’ll have to determine the right amount of detail. For our clinic I recommend you at least capture the question and the consent.
There are a lot of solutions out there. Google Voice, 2SMS, AT&T Business texting, Line2, etc…. You can also just ‘old school’ it and have a clinic cellphone or tablet with a separate number. We use Google Voice, because it can be accessed by reception and the back. It also allows our managers to see it off site, and to look through records of past texts. Most products have this same functionality, this isn’t an endorsement as much as letting you know what we use. I will say that Google makes theirs easy enough that our reception learned it quickly.
But just because something is legal, doesn’t mean it is appropriate to do. It’s legal to sing my conversations to everyone using only Adelle lyrics. It probably would destroy most of my personal and professional relationships. And by extension, it’s not the best idea to use texting in all situations. Your professional and business judgement should be used here.
Some of the things we use texting for:
- Setting up meetings with Employees
- Supply requests
- Notifying a client that the patient has successfully come out of surgery
- Notifying a client that they have an appointment the next day
- Notifying a client that their pet is available for pickup from boarding (or dry from a bath)
- Notifying a client that their dog food/prescription/supplies have come in
- Notifying a client of a billing issue
- Asking for consent for something already discussed
- Asking them to call for an unexpected complication
- Finding available times for an appointment
- Notifying an offsite doctor a client has come in and wants to see them.
- Letting a referring doctor know the outcome of a procedure.
This isn’t a complete list by any means, but the consistent theme is that we aren’t discussing new items by text, only things we have already covered in person. This really limits confusion or frustration.
Make certain you have clear written guidelines on how to use the text line in your clinic. It should include who can text, when you text, and what things you text about. I’d recommend that your reception or clinic manager review the texts each day to make certain you are communicating in a way that is positive and helpful for your clients and clinic. I don’t think reviewing every text before it is sent is helpful, assuming you have competent staff that you trust. Just keep some monitoring to adjust messaging and tone as you develop a texting presence.
Some clinics post their text numbers on their websites and advertising. I’m not a fan of this, primarily because a lot of time is wasted on price comparison. Texting is easily misread, so using it to resolve conflict or as a feedback line has lead to some ugly, public disputes with vet clinics. Some owners abuse the texting to try to get a consultation or information without seeing a vet, which is not good for the patient or the public. (See my blog on physical exams- There’s no relief from physical exams.)
My bit of advice is that everything you text can and probably will be copied and posted on blogs, forums, social media, or reviews. You have little to no rights of confidentiality in these texts. So anything sensitive, or that could be misinterpreted, is likely to cause you and your clinic untold concern. It may even give the veterinary community as a whole a bad name. And it will likely live on for years after the event, even if it’s just a misunderstanding.
Texting can have a lot of positive commercial and customer satisfaction benefits for your clinic if used appropriately. You just need to decide how you want to use it, and make sure your staff understands the boundaries.