There's a lot of talk out there about text messaging not being appropriate for many healthcare uses. The usual excuses are that SMS is not secure to healthcare standards, that you can't really prioritize delivery of text messages and that there is no way to "escalate" texts if earlier messages aren't acted upon.

Those are all valid points. In particular, anything involving personally identifiable, protected health information (as defined by HIPAA) certainly is not appropriate for an unencrypted text message. But let's not completely dismiss texting in healthcare settings.

As the Montreal Gazette reported last week, several walk-in clinics in that city have started sparing patients endless waits by sending a text or an automated voice message when it's almost their turn to see the doctor.

"The patients gain back their freedom. They don't have to wait for four or five hours in a waiting room full of sick people," Sara Michaels, the manager of one clinic, told the newspaper. "Instead, they can take a number, and then they can go out and do their groceries or whatever, and the system will alert them to come back," she added.

"In a sense, it's like coming in and asking for an appointment later in the day, something we couldn't do before."

The problem of long waiting times is particularly acute in the Montreal area, where, according to the Gazette, 300,000 people do not have a regular family physician. Say what you want about the government-run Canadian healthcare system that is plagued with provider shortages, but we have quite an access problem in this country, too.

Plenty of Americans wait for hours at similar walk-in clinics and hospital emergency departments, and those who do have a primary care physician might not be able to get an appointment right away when they're sick. Texting makes perfect sense to alert patients when the doctor is almost ready to see them or if the last-minute cancellation opens up an appointment.

A couple of years back, I remember Will Weider, CIO of Ministry Health Care in Wisconsin and author of the Candid CIO blog, musing about why physician offices should set up Twitter accounts. He said clinics should tweet whenever they get a cancellation or otherwise have an opening in their schedule. If you or your child is sick, just follow the Twitter stream and you'll know immediately if and when the doctor can take you.

I'm not sure how many practices have followed this advice, but anyone who doesn't is leaving money on the table. A schedule opening means lost revenue, and what primary care practice couldn't use the extra cash? That concept is not lost in Montreal, either. The clinic featured in the Gazette article charges a $3 fee for messaging service. The convenience is clearly worth it to a lot of patients.

As long as you stay away from sending personally identifiable information about a specific person's health, SMS is perfectly acceptable for plenty of healthcare communications. Some might even consider the extra revenue to be worth the small risk.