Why Are Pagers Still a Thing?

I remember, as a tiny 90s child, briefly wanting a pager. I was at the local high school seeing a basketball game with my dad, and the high school girls loitering outside the gym seemed impossibly tall and unattainably cool. One of them had a pager attached to her belt loop. It was red and glittery, and I was awed. It conveyed an air of importance—this person is reachable at all times.

You know what happened next. Telecommunications exploded, and pagers were buried in the fallout. Now, most of us are reachable at all times, and it has nothing to do with how important we are. (I can't stress this enough. Ten percent of my email inbox is currently coupons for Michael's, the chain craft store.)

Strangely, though, for those of us who really do need to be accessible—for whom being incommunicado can mean putting others' lives in jeopardy—the beeper is still king. Doctors, firefighters, and EMS technicians all still use pagers. (Adorably, so do birdwatchers, for a less vital reason: they subscribe to pages alerting them to rare bird sightings in their area.) This seems absurd at first blush. In 2012, Americans spent $7 million on new pagers, coming to about 10,000 units. By comparison, they spend $64 billion a year on iPhones alone. We have a wealth of messaging apps to choose from: WhatsApp, Kik, Slack. Why do a small number of us cling to a device most everyone else has forgotten?

As it turns out, there are a number of solid reasons. Pagers don't store information, which is a positive when hospitals regularly suffer data breaches, requiring them to pay expensive fines for HIPAA violations. And regular smartphone text messaging is not encrypted.

Pagers don't rely on the same transmitters that cell phones do, and their transmitters are stronger and send signals much further. Additionally, cell phone networks are more vulnerable in the event of a natural disaster. When a tornado hit Joplin, Missouri in 2011, cell phone networks were down for up to four days. Even the teensy earthquake that hit New York the same year hindered cell reception for an hour. And pagers are battery-powered, which is critical in the event of a natural or domestic disaster that knocks out electricity. If the power's out and your smartphone dies, you're screwed. A pager just needs to be fed some new batteries and it's good to go.

And unlike a smartphone, pagers are not distracting. A physician's pager is only used for medical emergencies, so she knows that when it goes off the situation is urgent, and it's the same with emergency response teams. Whereas my Pavlovian response to an iPhone chime forces me to check everything, and it's usually crap.

But maybe most importantly, pagers are just cheap as hell. NYU's Langone Hospital launched a small-scale smartphone program in 2012, and it cost them over $10,000 to pilot only 16 phones. You could fill a bathtub with $10,000 worth of pagers.

This is not to say that there aren't some valid arguments in favor of the smartphone. A smartphone would enable the sender to message a whole team of firefighters, medical staff, or emergency responders at the same time. It would offer access to valuable data like maps and medical info, and it could transmit a GPS signal if a first responder were ever in danger and unable to communicate. Also, the pager system can cause "bottlenecks" in hospitals: as WNYC notes, nurse's stations are frequently slammed by a group of recently-paged doctors all waiting to use the phone, and whatever patients they were tending to are left in the lurch while they wait.

But in order to really make the switch happen, at least in hospitals, any contending messaging app would need to be designed with HIPAA rules and regulations in mind to ensure 100 percent compliance. And It would ideally come with medical vocabulary already loaded into its predictive texting system, so autocorrect couldn't cause potentially fatal mistakes.

One such app, NetSfere, is already working to address these issues with smartphones. Anurag Lal, NetSfere's president and CEO, has tried to make sure NetSfere's encryption algorithm protects messages from data breaches and data mining. "I won't use the word 'impossible,'" Lal says, referring to the likelihood of a breach, "but the data that goes back and forth is secured by an encryption key that is very distinct."

I also asked him about the dangers of autocorrect and predictive texting. "We are counting on the underlying operating system," Lal says. "We typically provide a set of best practices to the hospitals that we go after, and we actually tell them clearly to turn off predictive texting. We counsel against that."

NetSfere has also created its own proprietary tone, so a physician can tell the difference between a message sent via NetSfere and something less important. "We also have the means to send a continual tone," Lal adds, so the alert would recur every 30 or 60 seconds until the message was opened—another feature of the pager that was important for medical staff.

But perhaps the most compelling argument for smartphone use is the collaborative aspect. "There's a need for collaboration amongst doctors. If you speak to doctors or physicians, very quickly they'll confess that from time to time they are faced with an environment where they need other referrals or consultations on cases," Lal says. Using a secure messaging app, doctors would be able to get opinions and recommendations from their colleagues in record time. Collective brainpower protects against confirmation bias and the possibility of an overlooked potential solution.

While pagers may still be in use for another decade or so, it's safe to say that at least among hospital staff they are slowly being phased out. But who knows? Maybe they have a future as ironic accessories.