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Successful message delivery: navigating your way to the patient’s inbox

November 23, 2021  By mindZplay Solutions Staff

Photo credit: © Feng Yu / Adobe Stock

Today, automated messaging is a reality for any business that offers appointment-based services. Avoiding having your message intercepted by network and corporate spam filters has become tougher and tougher as these entities fight to protect their users from malicious senders. Many people believe they can bypass the problem of spam filters by switching to text notifications rather than email. This assumption is incorrect, however, as text messages are also subject to the scrutiny of spam filters. A better strategy is to double your chances of successful message delivery by using both email and text notifications together. In this article, we will examine the best practices for ensuring the delivery of both e-mail and text message notifications.

As mentioned, text messages must pass through spam filters to reach your clients, just like email messages do. This filtering is generally invisible to the receiver because it is done by the carrier themselves. If the carrier decides your message is spam they will simply discard it and the recipient is not notified in any way – they cannot simply check a spam folder to look for lost messages as they might do with e-mail. The recipient will have no idea you sent them anything at all. It is therefore critical to understand how to avoid looking like spam.

A big spam trigger to avoid with text messaging is excessive message length. Unlike e-mail, where you can pack in as much message content as you like, text messages are designed (and expected) to be short, concise communications. The character limit for a standard text is 160 characters or less. Phones only appear to send longer messages. What actually happens with larger messages is that the sending device breaks the message down into 160 character chunks before transmission. Typically, the receiving device then reassembles them back into what looks like one long message. In most cases, it appears from both the sending and receiving perspectives that a long message was sent and then received but this is not the case.

More importantly, however, long messages – especially long commercial messages – face additional scrutiny by the carrier’s spam filters because they are outside the norm. This means they will be judged more harshly and are less likely to be delivered. It is recommended that you keep your text messages short and under the 160 character limit. Remember, the only really important details in an appointment notification message are:

  • Who is sending the message (i.e. who you are or what your business name is)
  • The appointment time and date
  • A number to contact the clinic

For anything more, refer clients to your website for further information or add it to their e-mail notification where you will have more room for details like clinic policies and intake forms. Keeping your text message clear, concise, and well structured will have a bigger impact than going into too much detail and not having them delivered. It is best to keep these messages as brief as possible.

Just like text messaging, e-mail has its own set of spam issues to deal with. One major e-mail exclusive concern is the “health” of your client database. Sending messages to broken or non-existent e-mail accounts can cause numerous problems. If you are not routinely checking that your client contact information is up to date, your e-mail address (and any others associated with your domain) will develop a bad “sending reputation” over time. For example, providers like Hotmail and Gmail will take notice if they are receiving a lot of messages from you that are directed at non-existent accounts on their service. The more messages you send to dead e-mail addresses, the more likely you are to be flagged as a spammer or even blacklisted by one or more email providers. Sending to dead accounts is an indicator that you are not paying attention to the health of your mailing list and you are likely a spammer.

A good practice is to verify your client’s contact information before heading to the treatment room each time they come in. It takes only a moment and can save you a lot of hassle and embarrassment later. Additionally, if an e-mail bounces back to you with an “undelivered” or “return to sender”message, you should always take a moment to go locate the client and remove that e-mail from their profile.

It is important to also understand that what clients do with your email once it is received matters. Many people are unaware that e-mail providers gather data about senders (i.e. you) based on what the recipients (i.e. your clients) do with your messages – whether they open your e-mail or not matters. If too many of your messages to a client are left unread, your messages to them may begin to get routed to their spam folder. If multiple clients using the same email provider (like Gmail for example) are ignoring your message, this can hurt your “sending reputation” and land you on their internal blacklist. 

Of course, the content of your message itself is also a big factor. When it comes to e-mail, you want to keep it simple and avoid adding too many bells and whistles. Just because you can use all kinds of different fonts and colours does not mean you should. Too many formatting changes, even too much bold text can have an impact on your delivery rates. Much like with text messaging, structuring your message appropriately is the best way of keeping your client’s attention.

The same thing goes for images – one reasonably sized image is OK. Just keep it simple and watch your file size. If your image is too big or if you have too many images, this may have a negative impact on your chance of making it to a client’s inbox.

When it comes to the actual wording of messages, the best practices are similar for both e-mail and text messages. Some of the key points are:

  • AVOID USING CAPS FOR EMPHASIS, as inappropriate use of CAPS is a signal to spam filtering that your message is questionable. 
  • Do not use multiple exclamation marks for the same reason.
  • Refrain from listing prices as this is considered overly commercial behaviour and will make your message look suspicious.

Remember, spam filters are just robots grading your message according to a set of criteria they are programmed with. They follow strict rules, so if your message contains elements considered common in spam messages, they will categorize you as a spammer and not deliver your messages.

The best way to make sure certain information “sticks” with your clients is to present it in multiple places (i.e. e-mail, website, etc.) and to structure your message so that important information resides at or near the start of your message. Information near the start of a message is less likely to be skimmed over and more likely to be read and retained. Further, you can keep important details from getting lost simply by keeping your message concise. A well-crafted message should be brief enough that it leaves no place for the important details to get lost.

As you can see, both text messages and e-mail messages have delivery challenges and are subject to spam filtering. However, when used properly, they each have their place and can work well together to ensure the delivery of critical information to your clients. While text messages tend to find people wherever they are, messages opened when someone is out and about could be lost or forgotten. People checking their e-mail do so when they have a little time to sit down and ingest more information, and also gives you more room to include additional details that might not fit inside a text message. While each method has its own technical pitfalls, using both together, you will maximize the chances of your message being received, read, and remembered.

Until next time… Be well and stay safe!

mindZplay Solutions Inc. a provider of massage therapy websites and practice management solutions. To learn more, visit

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