Why doctors still use pagers (it's not what you thought)

I have to say, hearing my name pop up threw me for a loop, though I don't blame you for not taking my word for it! I work with NMR spectrometers (same tech as MRIs) and it's the same thing in my workplace - no phone reception in the building at all! It's doubly annoying when we need to get a two-factor auth code over SMS.

This guy is an excellent anesthesiologist. I started listening to this video and within a minute I was fast asleep. Please don’t bill me.

Just said this on a similar video yesterday (so sorry if folks seeing again 😂) but another big piece of the pager for Hospitals (and a couple other industries) is because the technology is so understood/stable that pager companies are willing to provide SLAs (Service Level Agreements) that guarantee delivery within a couple minutes or they have to pay potentially large fines. Cell phones for example refuse to do that for either phone calls or text messages they both don't want to guarantee delivery at all and explicitly say that messages can take days to be delivered. In a crisis situation that's obviously unacceptable and the SLA guarantee is worth millions of dollars to some hospitals.

Good video! I'm sure you're aware of two other benefits of pagers. (1) They don't have to be tied to a person. They can be assigned based on a role. When someone comes on duty as part of the code team, they can have the active code team pager passed along to them. That very obvious action is far less prone to mistakes than some scheme for altering which personal cell phone is activated at every shift change. (2) When a pager goes off, its meaning is clear. When a cell phone rings or makes some sound, it's not that clear what is meant. In a cellphone system time is wasted checking to see that call or beep means.

Here in the UK it has become common to use DECT phones instead of pagers. These are actual phones however they work on a local network with access points (usually wall or ceiling-mounted) similar to Wifi but on a drastically lower frequency, which provides the same penetration benefits of pagers, and because they use access points they can actually be used in locations where even pager signal is poor. The main benefit is they are actual phones as well so you can actually talk to other people using them, just using extension numbers. or if permitted by your organisation, they can call out to external lines. They are also encrypted ensuring the security of communications. because they are simple devices (similar to your old Nokia style phones) they too have long battery life, and are immediately easy to use. with access for contacts lists ect.

Up until very recently I carried a pager as an operator of a wastewater treatment plant. The most frequent page I got was from the local hospital mistakingly paging my number, sometimes with some very personal medical information. I tried for years to get them to correct this, but I still kept getting paged several times per week.

I miss our pager system that has been replaced by regular cell phones. I liked that it was asynchronous communication. It gave you a moment to think about the page before calling it back.

There is likely another reason for shielding. Sensitive devices such as EKG, EEG, etc. can be interfered with by electromagnetic radiation from such things as cell phones. Pagers only receive but cell phones constantly "ping" or transmit their location even if the owner is not doing anything with it.

As someone with a chronic health condition that frequently spends a lot of time in and around hospitals, it would be nice if hospitals put more Wi-Fi boosters in waiting rooms and hallways where patients often have to sit and wait for their turn to go in for a procedure. For the most part, there is good Wi-Fi on the wards, even if in some hospitals, you have to pay for it.

We use hospital issued VOIP phones. Everyone grabs one at the beginning of their shift (from a charging base) or if they are sitting at a desk all day they can log into a website that allows for messaging. If you’re on a code team, you click on that upon signing in and get appropriate RAP and code alerts that are hard to miss. It’s secure (as anything can be these days) and won’t work beyond the hospital Wi-Fi. There have been a couple of outages in the few years we’ve had them but in general, rather reliable.

Another reason pagers are useful. A location can have it's own transmitter / paging system with antennas in the building. Some restaurants / stores use this to alert customers that their table or items are ready.

Pagers use HIGHLY insecure protocols. The texts are sent in what is effectively plain text over the air. Not only can anyone intercept the message contents, but with $500 hardware, someone can actually send texts to any pager network.

This is so cool. I've been working in hospitals for over 10 years and I never understood why pagers were still used. Thanks.

My sister is a clinical engineer in charge of equipment orders/installations in hospitals who now works for an equipment company at many hospitals but she started out at a specific hospital dealing with different companies and I remember her having to borrow a bunch of equipment from a smaller offsite facility during the beginning of the pandemic when they had to create their own Covid ward and she was talking about the different communication systems they had in place then and pagers were still one of them, it was fascinating learning about some of the behind the scenes inner workings that you never think about as an outsider, thanks for sharing, great video!

I am a field engineer for an OEM that manages a few hospitals telemetry system. They also run cellular service over our same system so I had to learn how to work on cellular as well. What you said about the walls and shielding is so true. Had a doc complaining they were getting calls in the CT. Well yeah there is not an antenna in the room and you are in a lead box. Would you like an antenna installed in the room. Just about every hospital here has Wi-Fi phones that can work better than pagers because a pager can still be blocked by a wall and encrypted pagers can get enough interference to scramble the message.

Never thought about the frequency still plays a part in these situations. great video!

I’ve worked for a mobility provider on the pager side before, a couple decades ago. Way back when, before the age of cell phones, there were pagers called reflex pagers that you could receive AND send a response from. The original Blackberries used that service as well. Was a pain to program into the system though. Many steps, involving a network ghost pager to be linked and all that. The systems were old DOS based programs. Very NOT user friendly. Fun times!

Interesting to note. I have worked as a maintenance engineer at several hospitals throughout British Columbia, Canada and they have all had excellent cellular reception. Even on the second floor where the imaging suite was located and in the basement where the maintenance shop was located. Maybe things are designed differently up here.

Hi Dr. Feinstein you did a very good explication on why a pager is reliable. As a long time hospital employee that has a technical background on items like this in hospitals I just wanted to add that it’s very easy for a hospital to retransmit a pager signal in the facility via a hospital owned transmitter. Most paging system also has the ability to send its signal out twice to increase its reliability. If the pager gets the first signal it will ignore the second to keep it from going off twice. There is also one downside most staff do not understand about pagers. If for some reason you need to have 2 pagers at one time for call coverage the pagers should be worn one on each side of your hip. Having them next to each other can cause interference with each other and actually block one or both from getting a signal reliably.

No pagers in NZ, we have a personal and ward phone system. Just a regular cell phone. The only place I have encountered poor reception in the interventional radiology suites (as you would expect).