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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