Patients should silence their phones in the exam room

I wrote a column recently about the role computers play in the doctor patient relationship, and my concern that screens shift physicians’ focus away from their patients. This column is part of a large conversation going on nationally and beyond about what I’d call “distracted doctoring.”

A Wall Street Journal opinion piece by my colleague Dr. Victoria McEvoy addresses the issue of whether all the digital box checking now required of doctors as part of “quality assurance” is helpful. She asks, “Would you rather your doctor won the ‘quality’ contest by doing good list management and robust box checking or spent that time listening to you?”

But amid all this talk about distracted doctoring, I’ve heard less about “distracted patient-ing.” An experience I had this other day got me thinking about whether smart phone screens (and sounds) interfere with patients’ (and doctors’) attentiveness in the exam room.

A patient and I were discussing a symptom that was very frightening to her — she’d passed out — and potentially indicative of a serious medical problem. Every few seconds a sound emitted from her handbag: ping! ping! And every time her purse pinged, the woman turned her head to peek over at her phone, which lay in the open bag. I found it hard to focus, and I can’t imagine she found it any easier.

Still, I was a little reluctant to ask the woman to silence her phone — and I’ve been reluctant to ask many other patients to do the same.

Why?

For one thing, I was trying to be mindful of that fact that this was her time and should be conducted as much on her terms as possible. I have an elderly patient who does not have a smart phone but who flips through a magazine during her visits with me. I used to find this annoying, but I came to see it as her way of maintaining a bit of control over a situation in which she feels out of control (it’s hard to feel in control when you’re in a flimsy gown and the other person in the room is wearing a suit). Maybe my patient kept her phone on during our visit to tell me: my ping, my choice.

Also, it’s hard to begrudge a patient their phone when I’ve got this huge computer monitor on my desk (and a beeper on my belt and a phone on my wall).

Plus, I know well how hard it is to turn off a phone, even for a little while, when you never know when your kid (your plumber, the school nurse …) is trying to reach you urgently.

But the pinging distracted both of us nonetheless.

So I’ll say here what I didn’t say then: please show me those baby, prom, and wedding pictures, consult the list of questions you’ve listed digitally, then silence your phone and put it away. I’ll put mine away, too. At least there will be two fewer sources of distraction in what’s become an increasingly distracting medical office.

Suzanne Koven is an internal medicine physician and a Boston Globe columnist.  She blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50.

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  • Lisa

    I would never leave my cell phone on during a doctor’s appointment. And I would be horrified if my doctor answered a cell call during an appointment. The time allocated for an appointment is short enough as it is.

    • querywoman

      I had one doctor answer a cell phone during an appointment. He’s normally very courteous. Looking back, it had may have been the time when his office had a fire. They crowded into another doc’s office. I think he managed to see me 24 hours after the original appointment and came in apologizing to me for being late!
      Perhaps it was a fire-related call.
      I thought he did pretty good on getting his act together!

      • Lisa

        Your doctor probably can be forgiven.

        I’ve never had a doctor answer a cell phone call during an appointment. My pcp has looked up information about medication on a smart phone while I was with him, but that is because I am the ‘queen’ of unusual side effects.

        • querywoman

          Yeah, he apologized to me for running late when he got his act, stuff, and staff together and crammed into another doc’s office.
          They never did go back to the office with the fire. I think it had something to do with icy weather – don’t know how that started fire.
          More docs in the “fire” office now.

        • rbthe4th2

          I’ve had them answer the cell phone. Last time I went.

          • Lisa

            Ugh. I think I’d start looking for another doctor.

  • Kristy Sokoloski

    I always have my phone on silent when I am at the doctor’s office. Some of the doctor’s offices in my area also have signs asking that the patients please put their phone on silent.

    • querywoman

      They have those signs around here too.

    • James_04

      They have them at my doctor’s office too, and I’m glad they do. At the sign in desk it says “please sign in, and remember to turn your phone to silent mode”. Honestly, it’s something that’s easy to forget to do, a friendly reminder is welcome.

  • SherryH

    Considering the fact that an appointment lasts 2-15 minutes, I see no reason why that cell phone should be on. Not just for common sense reasons, but also out of common courtesy.

  • querywoman

    One of the most awful cell phone stories I ever read was from a eye surgeon. He was doing eye surgery on a patient when the patient’s cell phone rang and the patient answered it!

    • Lisa

      I seriously doubt that story.

      I’ve cataract surgery for both eyes. The procedure is they give you a sedative, then wrap you up like a burrito, so you can’t move you arms. At the time I thought it was so I wouldn’t wack the doctor when he started the surgery. But maybe it was so I wouldn’t answer my ringing cell phone. ;-)

      • querywoman

        I don’t doubt that it happened. Why would anyone make it up?
        It’s possible this has happened to more than one eye surgery patient, heh, and they have now developed a technique to protect idiots from themselves: answering thier cell phones.

        Yes, Lisa, I believe there are people dumb enough to do this while having delicate eye surgery!
        I hate abusive cell phone use, but pride cometh before a fall.
        Last Sunday, at church I had a cell phone with me that should have never left my home. I put in a pocket and thought I had turned it off.
        I like to sit cross-legged with the children during their sermon. I did, and my cell went off toward the end of the children’s sermon. My minister said, “It must be God calling.”
        He doesn’t carry the title, “father,” but it was a, “Forgive me, father, for I have sinned,” instance. It taught me some humility.

        • Lisa

          I believe there are people who would be dumb enough to answer a cell phone during eye surgery, but I just doubt if they would get a chance. It does make a good story. . .

          • querywoman

            Perhaps docs doing sensitive office surgery should state, “I have had a patient answer a cell phone call during this surgery. Please turn yours off for your own safety.”
            People like to take risks, but some are really foolish.
            I take an art class, a sculpture class, which includes firing clay and all kinds of machines like band saws. Last week some of the younger students were horsing around and chasing each other in class.
            Someone did tell them to quit.
            That class is no playground. For example, when we clean out the mats we pound clay on, we can’t get them dry before moving them to where we keep them, and water drips!

  • querywoman

    I am surprised at your reluctance to ask her to TURN IT OFF!

  • southerndoc1

    If doctors use time that the patient is paying for to do secretarial work in order to get a few measly MU pennies, they have no moral authority to lecture patients about cell phone use.

  • guest

    Sorry, but as a patient and a doctor I disagree. The doctor spends some of the time he is with me looking a computer screen and checking off things that do not benefit me in any tangible way, also lecturing me about the amount of exercise I get so that he can check off “wellness counseling,” which I also did not ask for. Additionally, it is not unusual for me to spend up to 45 minutes in the exam room waiting for the doctor to appear. If I want to have my phone on so that my childrens’ schools can call about emergencies, I see no reason why that should be a problem. My phone should not distract the doctor any more than the doctor’s computer distracts him or her.

    • SherryH

      Sounds to me like you are the jerk in the movie theater who leaves his ringer on.

  • SherryH

    In your circumstance I can understand why you may need to leave it on, but in many situations this is not the case. Some people see every call as an “emergency”, when in most cases it is not.

  • querywoman

    People used to wait 20 minutes, an hour or more, before finding out emergencies. Most calls are not emergencies.
    My own priority is the person in front of me, not a caller. A doctor-patient interaction is face-to-face and a limited time encounter for both!

  • querywoman

    You Xplained the circumstance, which made the difference. That’s a courtesy the rude cell phone users don’t give.