Today in civilizational inadequacy: traditionally, doctors wrote prescriptions on small pieces of paper. Faxes were supposed to replicate that, and so they had a character limit. E-prescription programs replicate faxes, so they also have a character limit.

Sometimes pharmacists are unhappy about a prescription, because they think there’s a drug interaction or something. Then they have to send a message back to the doctor explaining that. That message has a certain max number of characters (on my program it’s 210, so a little shorter than a tweet).

Sometimes the doctor disagrees with the pharmacist, maybe because they think the interaction between those drugs doesn’t replicate, or isn’t an issue in this particular situation. Then the doctor has to communicate that through the same program.

So you’ll have these two educated professionals trying to compare notes on the latest research about cytochrome enzyme systems, using 210 characters per message (of course, the e-prescribing program doesn’t tell you how many characters you’ve already used, because that would be too easy, so you just try to keep it really short and fill it with abbreviations and hope it goes through).

True, at any time the doctor could call the pharmacist, or vice versa. But this would require getting through a ten-minute phone tree and then sitting on hold for ten minutes and then getting told the doctor/pharmacist was busy with a patient right now and will call you back later, which inevitably ends in a weeks-long game of miserable phone tag.