Family practice physicians' use and attitudes toward SMS or text messaging and handheld devices in medicine were measured. Our findings showed that handhelds are used mostly for personal information management (PIM) and references on the device. One-third used SMS, mostly for communicating with colleagues, and almost two-thirds were favorable to this modality, including for searching MEDLINE. Findings support continued focus on improving text input interface and information presentation on small screens to reduce misunderstanding.