Whatsapp Doc? Instant messaging etiquette in medicine

Healthcare professionals and students are increasingly using instant messaging applications (usually Whatsapp) to communicate with each other.

Learning objectives

1. Consider how you currently utilise instant messaging applications with your colleagues

2. Reflect on how differences between members of a messaging group could impact on training

3. Devise rules of messaging etiquette

Imagine you have started a new job, rotation or module.


How would you feel if you were asked to join a Whatsapp group comprising of your peers (same grade or training level)?

How would you feel if you were invited to join a group which also included your senior colleagues (e.g. consultants) or tutors?

Would you find it awkward to say no to joining such a group?

Consider the following fictitious messaging conversation:

Time 21.32
Senior consultant 1: Hi everyone. Someone needs to cover the shift tomorrow as John called in sick earlier today with D&V.

Message sent
Message delivered

Time 22.41
Senior consultant 1: Come on guys, someone has to step up and cover this shift, we work as a team and cover for our sick colleagues.

Time 22.42
Junior 1: Ok, I could do part of the shift as I’m normally part-time and don’t normally work tomorrow but I have to collect my son from nursery at 5pm.

Time 22.43
Junior 2: I could do the shift after 5pm if you can’t find anyone else to cover it.

Time 22.56
Senior consultant 2: There’s also a rota gap next weekend. As you know, training numbers are down this year and we have to band together to fill the shortfall. The department aren’t able to approach any more locums this year so that isn’t an option.


Is this type of message appropropriate?

If you couldn’t do the extra shifts, would you message back?

If you couldn’t do the extra shifts, is staying silent an appropriate response?

In the UK, senior clinical colleagues are often asked to assess the performance of trainees in the department. Teamwork is usually one of the domains scored as part of work-based placed assessment (e.g. multi-source feedback).

Questions for senior clinicians

Is the failure to take on an extra shift a demonstration of a failure of team-work?

Should senior colleagues be asking their trainees about filling in vacant work shifts or should this be a job for human resources?

Are you clear about the distinction between employer and trainer?

Questions for junior clinicians

Would you feel at a training disadvantage if you said you couldn’t cover a vacant shift?

What does your answer tell you about the relationship between trainer and trainee?

What does your answer tell you about yourself?

Not all trainees face the same circumstances. Members of the same group may have very different working patterns and may be restricted in the way they participate either by contractual (e.g. flexible working hours) or personal obligations (e.g. caring commitments).

In the UK, bullying and harassment is behaviour that makes someone feel intimidated or offended. Harassment is unlawful under the Equality Act 2010.

One example of bullying given by the UK Government is denying someone’s training or promotion opportunities. In France, employees have the ‘right to disconnect’ and avoid emails outside of working hours.

Being ‘available’ on messaging groups without clear boundaries could increase stress, fatigue and burnout. This is particularly important in healthcare workers as these factors contribute to clinical errors and patient harm.


If you were to devise a Whatsapp group what would you consider as part of messaging etiquette?

Below are some of the rules you may have considered:

1. Messages should only be sent during specified hours

2. Messages should not be sent to members on their non-working days

3. Messages should only be related to certain issues (e.g. work)

4. Some issues should not be discussed (e.g. the social at the pub last night)

5. No identifiable patient details are to be posted

6. Pressure should not be placed on members to fill in rota/shift gaps

7. Some groups should only consist of members of the same training grade

8. New members are introduced to the group by the person inviting them

9. Member contact details are to be kept private and not used outside the group

Please enter your own ideas about medical messaging etiquette in the comments section.


Instant messaging may distort some of the traditional boundaries between work and life. Blurring this distinction could cause patient harm. The hierichiary between members of the same group could have implications on training opportunities and the fair completion of workplace based assessments. Healthcare workers should consider the purpose of such messaging groups before they are created and make these clear to all members.

Further resources

Workplace bullying and harassment

French workers get ‘right to disconnect’ from emails out of hours

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