Doctors should ask patients whether they text and drive

It’s time to ask patients whether they text and drive.

An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams.

The data surrounding texting and driving is grim:

Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. Talking on the phone causes many more accidents than texting, simply because millions more drivers talk than text; moreover, using a hands-free device does not make talking on the phone any safer.

The author of the piece, Amy Ship from Boston’s Beth Israel Deaconess Hospital, says that doctors should update traditional preventive questions to keep up with the times.  The simple question, “Do you text while you drive?”, is a way to start this important conversation.

But how can we deal with skeptical patients? Dr. Ship provides good advice when responding to patients who downplay the risk:

[Patients] ask why talking on the phone, even with a hands-free device, is more dangerous than talking to a passenger in their car. There are several reasons: first is the obvious risk associated with trying to maneuver a phone, but cognitive studies have also shown that we are unable to multitask and that neurons are diverted differently depending on whether we are talking on the phone or talking to a passenger.

When patients aren’t convinced, I ask them, “How would you feel if the surgeon removing your appendix talked on the phone — hands free, of course — while operating?” This hypothetical captures the essence of the problem — the challenge of concentrating fully on the task at hand while engaged in a phone conversation.

I’ve started to incorporate this question during my routine health exams, and it’s something all primary care doctors should consider as well.

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  • Vox Rusticus

    You must be joking. While texting while driving is surely hazardous, so is driving with a carful of screaming children, or without sunglasses in bright sunlight. For that matter, having a cellphone conversation while driving, even hands-free, is a distraction. Yes, texting is bad behind the wheel; it interrupts a proper visual scan pattern needed for safe driving. So do bees in the car.

    Reminding people not to do these things is not the job of the doctor. And these issues are not personal health issues. And quizzing patients when they are getting a visit already under considerable time pressure with history that is not directly relevant to health is just poor use of time. Doctors are not traffic safety officers. We are not policemen.

    Doing things that are distracting while driving is a bad idea. But claiming that a doctor’s job is to ask patients if they text while driving does not necessarily follow. Keeping poisonous substances in the home is not always wise. Neither is speeding or driving after drinking, or boating during storms. Are we supposed to ask about these things too?

    There is a small but vocal group of doctors who like to assume that every doctor has to be the point man for every public health and safety issue they can think of and that the patient encounter is supposed to be the place for those issues to be presented. Well, they aren’t and it isn’t.

    If you are a doctor and you missed your true calling as a traffic safety researcher or advocate, that is unfortunate. But pet issues for such people should not become “medical” issues just on their say-so. All that really is is a distraction, one that keeps you from more important things, like medicine, or driving.

    • Max

      Well said, Vox. I agree completely. Someone comes up with a pet project and all of a sudden it’s a ‘good idea’ for everyone. Why is it someone else’s good idea always adds work for *me*. You like it, you ask it. Done and done. As if PCP’s don’t have enough to do in their 15 minutes. Each new question adds time that isn’t there.

    • Dr. J

      The list of safety concerns pcps are supposed to address with patients borders on the insane. If someone crashes while texting and their doctor did not tell them not to do this, do they have a legitimate med-mal suit?
      Doctors are not responsible for the every move of their patient, nor for good sense. This is a personal responsibility issue and in some places a legal issue. It is not a medical issue…

  • http://www.ohiosurgery.blogspot.com buckeye surgeon

    Other things doctors need to be asking patients during their 15 minute appointment slots:

    -Do you run with scissors?
    -Are you sticking your fingers in electrical outlets?
    -Do you like to drink a six pack and then wander around dangerous cliffs?
    -Have you considered sneaking into a small airplane and flying it over Niagara Falls, even though you don;t know how to fly?
    -When you bathe, do you precariously balance your television on the edge of the tub?
    -Do you sometimes store deadly poisons in old ketchup bottles and then store them in the refrigerator next to your children’s juice?

    • anonymous

      I love you list! This was my sentiment exactly when I first saw the headline.

  • ninguem

    You get so sick and tired of this. Everybody wants their pet peeve covered in the 15 minute visit. Maybe they can pay us to run their “commercial”, while I’m trying to take care of blood pressure and sugar.

  • Bious

    What an absolute joke

    If someone asked me this at a doctors office, I would laugh in their face and go to another doctor

    Ridiculous

  • guest

    Doctors are liable for everything wrong that ever occurs in the world and must broach every subject with patients.

  • David Allen

    Everyone above is right on. This is so beyond the proper role of a physician!

  • AA

    I totally agree with all the comments.

    Meanwhile, the drug side effect that I have a concern about which is the role of my PCP to discuss will get glossed over because he/she is too busy playing traffic cop and not a healthcare professional.

  • Kat

    A good way to make sure people lie even more to their doctors about what really goes on. I know I always think what is going in my medical record that an insurance company will get their hands on and use against me. Don’t people get tired of being busy bodies?

  • Bhavit

    What is wrong with this question? Just as they ask do you smoke, this is more dangerous and should be a question that must be asked. Just like smoking the effect of texting and driving not only impact the person who is driving but the people around them.

    I think people texting or talking and driving should be fined heavily, yet we don’t do anything about it.

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