What Is a Good Text Message Open Rate for a Medical Practice?

A dental office manager asked us a fair question last month. She had just switched on patient texting and her dashboard proudly showed a 98 percent open rate. Her email newsletter, meanwhile, was stuck around 20 percent. She wanted to know if the texting number was real, and whether it meant she could stop emailing entirely.

The short answer: the number is basically real, and no, do not stop emailing. But that 98 percent is also the most misunderstood stat in patient communication. It sounds like the whole game is won when you turn texting on. It is not. Once you understand what the number actually measures, you stop staring at the open rate and start watching the metric that decides whether all this texting turns into booked chairs.

The benchmark, plainly

Let us put the real numbers on the table so you have something to compare your own practice against. These are the figures from across the messaging industry heading into 2026, with the healthcare specific ones where they exist.

• Open rate: around 98 percent for SMS, with roughly 97 percent of messages read within about 15 minutes, according to SendHub's 2026 SMS statistics. Email opens sit near 22 percent.
• Response rate: about 45 percent for SMS overall, versus roughly 6 percent for email, per Infobip. In healthcare specifically, TextUs benchmarks put the average patient response rate closer to 53 percent.
• Confirmation rate: for two way appointment confirmations, practices commonly see more than 75 percent of patients reply or confirm.
• Opt out rate: around 0.28 percent in healthcare, which is tiny. Patients rarely unsubscribe from texts they agreed to get.

So what counts as a good result for your practice? If your appointment and recall texts are pulling replies above roughly 40 percent, and your two way confirmations land above 70 percent, you are in a healthy range. If they are far below that, the problem is almost never patient interest. It is delivery or the message itself, and both are fixable.

Why the 98 percent is a little bit of a magic trick

Here is the part the software vendors gloss over. Email open rates are measured by a tiny tracking pixel that fires when someone actually opens the message. SMS has no such pixel. As MessageIQ points out, the famous 98 percent open figure is largely inferred from delivery reports and how fast people reply, not from a direct measurement that a human eye landed on the screen.

That is not a reason to distrust texting. Texts genuinely do get read at rates email can only dream of. But it does move your attention to the number that is measurable and that actually matters: delivery. A text that never arrives cannot be part of that 98 percent. And plenty of texts never arrive, for boring reasons:

• Wrong or outdated phone numbers sitting in your patient records.
• Landlines saved in the mobile field, so the text quietly bounces.
• Patients who never actually opted in, so you cannot send at all.
• An unregistered business sending number that carriers filter as spam.

This is why two practices with the identical 98 percent open rate on paper can get completely different results. One has a clean, consented list where 95 percent of texts truly land on a phone. The other has a messy list where a third of numbers are dead, so the real reach is far lower even though the dashboard looks flawless. The headline stat is the same. The booked appointments are not.

What texting is actually good at

The open rate matters because of what it lets you do. When you know a message will be seen in minutes, you can use texting for the moments where speed changes the outcome. This is where texting earns its keep for a practice:

• Appointment reminders and confirmations. The bread and butter. Text reminders reliably cut no shows, and a two way confirmation lets a patient reschedule instead of ghosting. We dug into the details in text versus email appointment reminders.
• Catching missed callers. When someone calls and you cannot pick up, an instant text back saves the booking before they dial the next practice. It is one of the highest return uses of texting, which is why we wrote a whole piece on texting back your missed calls.
• Waitlist and last minute openings. A cancellation at 9am can be filled by 9:15 with one text blast to your waitlist, because people actually see it in time to say yes.
• Reactivating quiet patients. The cheapest new patient is one you already had. A short recall text to people overdue for a visit routinely outperforms any ad you could run for them.

Notice what these have in common: they are short, timely, and ask for one clear action. That is the lane where a 98 percent open rate becomes real money. Where texting goes wrong is when a practice treats it like a megaphone and blasts long, salesy messages three times a week. That is how you turn a 0.28 percent opt out rate into a much uglier one. We covered that line in are you texting patients too much.

So should you drop email? No.

Back to the office manager's question. Texting wins on speed and reach, but that does not make email dead weight. The two channels do different jobs. Text is a tap on the shoulder. Email is a room to explain something. A pre visit prep sheet, a new patient welcome sequence, a monthly note about a new service or provider, all of that reads better in an inbox than in a cramped text thread. For what a healthy email benchmark looks like, we broke it down in what is a good email open rate for medical practices.

The strong practices we work with do not pick a side. They text the urgent, time sensitive things and email the longer, educational things, and they keep both lists clean. The channel matches the job.

One rule before you send a single text: consent

Texting patients is legal and normal, but it is not a free for all. Under the TCPA you need a patient to opt in before you text them, and every message should make it easy to opt out. On the health side, appointment reminders and similar notices are generally fine under HIPAA, but you should keep sensitive clinical detail out of a plain text and use a proper compliant platform, not a staff member's personal cell phone.

The clean way to handle it: collect a mobile number and a simple texting consent at intake, log that consent, and honor every opt out the moment it comes in. Do that and you get all the reach with none of the risk. Skip it and one complaint can cost you far more than texting ever earned.

Our take

The 98 percent open rate is real, and it is genuinely one of the best things going for a small practice. Where owners go wrong is treating the number as the finish line. It is the starting line. Almost every delivered text gets read. The whole job is making sure the text gets delivered, says one clear thing, and asks for one clear action, to a patient who agreed to hear from you.

Get that right and texting quietly becomes one of the highest return tools in your front office: fewer no shows, more filled cancellations, more missed callers saved, more quiet patients brought back. None of it shows up as a fancier open rate on a dashboard. It shows up as a fuller schedule. That is the number worth chasing, and it is exactly the kind of connected front office we build inside our patient acquisition system, where texting, missed call recovery, and our AI receptionist work together instead of as scattered gadgets.