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How well do hospitalists use emojis in texts with other doctors?

A study found that emojis made real contributions to the conversation

June 2023

A STUDY LOOKING at how hospitalists use emojis in messages exchanged with other health care professionals found that the symbols often help advance the conversation.

While other studies have looked at the impact of using emojis in text exchanges between physicians and patients, the impact on communication between physicians and other health care professionals has received considerably less attention. The new study, which was published last week in JAMA Network Open, found that when hospitalists—which included physicians and NPs/PAs—at one large teaching hospital used emoji and emoticons (images created with keyboard characters like 🙂 for a smiley face), they added information to the thread.

Researchers found that among hospitalists who utilized emojis, 61% used them to express an emotion. But in 32% of message threads, hospitalists used emojis to start, maintain or finish conversations.

The study looked at more than 1,300 message threads exchanged by 80 hospitalists via a secure messaging platform between July 2020 and March 2021 at one large Midwest hospital. Message threads on average contained five messages and about 7% used an emoji. Hospitalists used 42 different types of emoji in messages reviewed by the study, and 9% of messages contained more than one emoji.

The most common emoji used was the thumbs up symbol (used in 39% of messages with an emoji), which researchers said conveyed approval or “OK.”  The smiley face was used in 9% of messages, the tears-of-joy face was found in 6% of messages and the heart was used in 5% of messages.

Researchers found that of the 59 emojis used where the symbol’s skin tone could be changed, 53% were modified. Eight of nine emojis that allowed gender to be changed were altered.

About 3% of the messages used emoticons. Among those, 73% used the smiley face emoticon.

While the conventional wisdom has held that inserting emojis into message threads exchanged by physicians might cause confusion, the research found no signs of that. The authors instead concluded that emojis were being used by hospitalists to “convey new and interactionally salient information.”

They also found that concerns that using emojis would somehow affect the professionalism of the senders “may be unwarranted.”

The study gave several examples of how hospitalists inserted emojis and emoticons into message threads to communicate important information. A hospitalist used an emoticon in the following message to reinforce directions about medications: “just add flagyl for anaerobes and ditch the clinda! :).”

Because so many of the message threads with emojis were used to convey emotions, researchers looked at the tone of those messages. In most threads that contained emojis—69%—hospitalists used the symbols to convey a positive emotion, typically happiness or humor.

In the other 31% that used emojis to convey a negative emotion, the message often contained an apology: “Sorry about the direct from hell 😊.”

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