Here is an unfortunate, but almost daily not-so-secret occurrence in my practice:
I am in the midst of an intricate follow-up visit with a rather complicated patient with diabetes, high cholesterol, and high blood pressure. I am feeling as though I am a CIA agent in a rather mission impossible assignment: she is here for lab results, is complaining of low back pain, and presents with an elevated blood pressure of 168/90. I have already spent ten minutes with this patient addressing her low back pain, and am starting to review her top-secret lab results with her. I have two patients, aka U.S. government agents, eagerly waiting to meet with me while they pace the lobby.
Me: “Your recent lab test shows that your diabetes is currently not sufficiently controlled with the current regimen. Your hemoglobin A1C, which is a lab test that tells me what your sugar level has been at home for the past three months, is 8.1. We need to add a medication at this point because…”
“Riiinnnggg!!,” a quite startling sound lifts me off my seat, as if signaling a new secret-agent assignment.
Patient: “Oh, Doctor, hold on one minute please.”
Is this a conspiracy? Before I can even respond, she picks up the cell phone and starts talking to this rather shady intruder.
Patient: “Hi, honey. I’m at the doctor’s office. What do you need? …”
I wait about thirty seconds, with what seems like an eternity in the secret agent world, and she is still on the phone with this suspicious invader. At this point, I decide to exit the premises. Many of my fellow CIA colleagues say they do not even wait one second, let alone thirty. They dissipate as soon as the patient picks up that cell phone, with the onset of the betrayal.
On my way to see the next patient, I pass by one of our many subliminal “No Cell Phone” signs in the hallway. How thoroughly it must have brainwashed our traitors, no? It is perhaps time for some newer and bigger signs with more deeply penetrating messages.
I see my next patient and then return to check up on this likely double-agent-of-a-patient. She ends up waiting twenty minutes before I walk back into the room; fortunate for her, it was not any longer (as it often is).
This undercover agent gives me a look of frustration as she exclaims: “Doctor, why did you leave the room? I have another appointment in half an hour!” Does she have a meeting with the enemy camp, I wonder? Hmmm…
What’s the big secret deal, you may ask? Here’s why answering your cell phone in the midst of the office visit is a grand problem of high security:
The cell phone call …
1. Interferes with the flow of the detective work. I spend a good deal of time looking over that chart in detail before I walk into that room to see this patient. I have a secret plan in my mind regarding what needs to be executed, and I’ve already begun discussing this detailed scheme to my patient. This phone call just interrupted my train of thought in a rather complicated patient. That means that when I return, I need to restart from the beginning of my conversation with this patient and re-explain my train of thought to her so that she fully understand why I am initiating a new medication for her diabetes. I cannot just simply pick up from where I left off, because this is an intricate issue of high importance that we are discussing and I have to make sure she understands the details of this intricate plan. Recovering this highly sensitive information is not an easy mission.
2. Intercepts the entire secret agent list. This mission compromises the patient schedule. I have patients pacing the premises, and this phone call is causing an even longer wait for my patients. My patients have jobs of high-importance to return to, child spies to pick up from spy-school, and other top-secret appointments to catch. The cell phone interruption is not just taking time away from the doctor, but it’s imposing on all my secret-agent-patients for the rest of the entire day, as well.
3. Makes a mission really impossible. It interferes with the time I am given with this patient. My appointment slots are fifteen minutes. This patient’s history is already of sensitive and intricate matter. But she’s also expecting me to address her low back pain, and I certainly cannot simply ignore her elevated blood pressure. If we add a cell phone call to the mix, it is really just a huge mission-impossible.
4. Interferes with other CIA gadgets.Most hospitals and clinics ban the use of cell phones in their buildings, just as airplanes do. This is not because we fear that these cellular waves penetrate our brains and take over our thoughts, contrary to popular belief. This is because the cell phone waves may cause interference with other electronic devices. In the case of a patient, it can potentially cause medical harm if, for instance, a patient’s pacemaker starts malfunctioning. No one wants to be responsible for causing such catastrophe that botches the entire mission.
5. Disrupts proper agency etiquette. It is simply inappropriate agent-behavior. I do not carry my cell phone into my exam room with my patients, and in fact, don’t even turn it on during my work hours. I expect this same common courtesy from my patients. Anything otherwise may be considered espionage.
Let’s make this a successful mission, Bond, by working on the same team – let’s all turn off our electronic secret-agent gadgets while at the doctor’s office!
Just don’t forget your bullet-proof vest.
Jill of All Trades is a family physician who blogs at her self-titled site, Jill of All Trades, MD.
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