Curbside Consult with Dr. Jayne 5/14/12

Over the last several months, there have been quite a few articles and studies about the growing phenomenon of mobile device distraction. Smart phones, tablets, and other devices have become ubiquitous. It’s almost unusual to see a group dining in a restaurant without devices littering the table. I don’t need to mention the danger of distraction while driving or otherwise being on the street and using a mobile device.

I wasn’t surprised then to see four Tweets in the last 24 hours that addressed the issue. There’s quite a buzz around psychologist Larry Rosen’s book iDisorder: Understanding Our Obsession with Technology and Overcoming Its Hold On Us. Some of his ideas are pretty common sense, such as the recommendation that families should have dinners where technology is not allowed at the table. I do agree with his point that technology might be making us dumber – the “Google effect” may make us less able to remember facts when we know that they are at our fingertips through search engines. His acronym for wireless mobile device (WMD) is accurate when you consider its other meaning: weapon of mass destruction.

Maybe having been required to be accessible 24×7 during my medical school and residency years jaded me, but until the last year or two, I had never been one of those people to compulsively carry my cell phone. Even now I don’t always answer it. Definitely not during a meal or a social event unless I’m on call or waiting for a specific return call.

The advent of the smart phone has made it easier to be in touch, though. I find texting or e-mailing to be less disruptive than taking a phone call as long as it’s self limited. However, when you open your e-mail to send a quick note to your staff or a colleague, it’s awfully tempting to troll through your account(s) to see what else is in there, and down the rabbit hole you go.

Like any other dependency, some have an easier time returning to real-time socialization than others. Some also have a hard time switching from texting-based communication to the traditional written word. This becomes apparent when I work with young people who can barely write grammatically correct sentences, but can text like crazy. In addition, despite having vast social networks, many are isolated when it comes to the skill of face-to-face communication.

An opinion piece in The Wall Street Journal proposes that, “We ought to group these machines with alcohol and adult movies.” I’m not sure I disagree. I’ve had to conduct interventions with parents who can’t seem to understand that their 11-year-old children shouldn’t be playing with an iPhone while I’m trying to take the child’s history and perform a physical exam.

Often, the phone belongs to the child, not the parents. That still baffles me given the cost of a data plan. I’ve had to explain more than once that when parents complain that children are spending too much time on the phone or with video games, it’s the parents’ job to put limits on those items.

What do you do, though, when the offenders are adults? It doesn’t seem like we have collectively developed the skills to police ourselves. I can’t imagine using a Bluetooth phone to make personal calls while performing surgery or surfing the Internet while administering anesthesia. We know it happens, however. I’ve had physicians complain that the EHR makes it to difficult to complete their documentation, one of them as she sat doing holiday shopping on her phone.

Do we need to put device behavior clauses in our medical staff bylaws along with rules about documentation deadlines and appropriate interpersonal behavior? Should facilities create WMD-Free Zones to allow us to decompress? Or do we just throw up our hands in defeat?

Have a suggestion on the wide-open field of WMD etiquette? E-mail me. I’ll try to read it in between surfing the net for animal-print crystal phone cases and signing charts.

E-mail Dr. Jayne.