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Curbside Consult with Dr. Jayne 5/14/12

May 14, 2012 Dr. Jayne 3 Comments


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.

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Currently there are "3 comments" on this Article:

  1. Wow, that was very insightful. Thinking about docs being distracted by personal tech is very disturbing.

    I think we all have to think about how we act and how we get our next generation to act in a fairly reasonable way. I’ve been in our business on the vendor side since ’84 and have generally been very well connected, using email in college before that and getting my department in on it when I started. My son, who is about to graduate high school, got a cell phone at 13 (a pay as you go/no texting). Later we went to the real texting phone and very recently, a smart phone (with minimum plan). My daughter has just turned 13, and unlike most all of the “other kids” does not yet have a phone. We will get one, but it will be a basic one. When we have dinner, the phone is away. And I make it a point (as the chef) that we do have dinner together, even quickly). If we go out, tech is understood to be away (unless we end up eating at “fawlty towers” and are waiting for hours). Or need to figure out where to go next.

    I’ve been out with some of my peers/friends that I rarely see, and when they start tapping on their phone for no special reason for more than a minute or 2, I find it very unnerving. If you are out with friends, be discreet, please. Guess I’m just getting old.

  2. I have a simple rule of etiquette: When someone is doing something other than focusing on me during a personal exchange, they are saying, “This is more important than you right at this moment.” So it had better be. If it’s not, they are being rude.

    The fact that cell phones are so ubiquitous means they are meeting a fundamental need to be attached within a social structure. I think that’s a good thing, and part of our nature. Unfortunately, cell phones extend the opportunity for an unlimited number of simultaneous exchanges, and our paradigms for interaction do not include a natural mechanism for ranking those exchanges. The possibility of simultaneous interaction with the whole world has never existed before.

    I might add that it’s highly unlikely “etiquette” will be a powerful motivator to alter behavior. We are coarsening our standards of interaction for a variety of reasons beyond the scope of a post here. While the personal cell phone enables rude behavior, it is not the cause of it.

  3. Etiquette around using a given piece of technology always lags behind actual use of that technology. I’m sure the etiquette with using the original “hard line” telephone was atrocious before the protocol of saying “hello” and “goodbye”. Sadly technology is probably advancing so fast that etiquette doesn’t get a chance to “settle in”.

    Concerning parents giving technology to children without defining boundaries I highly recommend…

    Cybertraps for the Young

    …a book written for parents and educators. Many parents don’t understand the ethical, and moreover, the legal quagmire a child can get into when items like cell phones are used inappropriately.

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