Do you avoid using your iPhone’s medical apps in the hospital for social reasons?

The other day a physician peer of mine looking frantically through the Harriet Lane handbook to look up the dosing of a common antibiotic for a pediatric patient. I showed them a relatively simple app we have reviewed at iMedicalApps, and told them it helps save me time when writing prescriptions for patients.

The response I received from my physician friend was interesting — “Even though I have an iPhone, I don’t like to pull it out in the Hospital because I’m worried my patients or staff will think I’m playing games or using it for social reasons. When I have a book or manual in my hand, at least people can see what I’m doing”

At first I thought this was an overly cautious concern until I talked to my other peers. Most of them stated this was a legitimate concern, and although it does not prevent most of them from using their smartphone in the medical setting, the thought of giving the wrong impression does cross their mind.

One of my peers went as far to state they make sure they “look very keenly at their phone, hoping to convey deep thought, so others know they aren’t playing Angry Birds”. This was also the most humorous response I received. But their response also provided the crux of the issue — when you’re behind your glass screen, only you know what you are doing.

I’m not certain I know how to avoid giving the wrong impression when using a smartphone in the medical setting.

Obviously, if you are furiously typing on the phone it gives the impression you are texting — but what about the physician or resident who is making a note in their Evernote app about a medical case they just saw. In the business world there are many companies who now give their employees a dedicated business phone secondary to their personal phone.

I don’t think we’ve come to that point in medicine, but it does beg to offer the following two questions:

Do you avoid using your iPhone in the hospital as a reference tool for fear of giving the wrong impression? Is there any way you can make sure you’re not giving the wrong impression?

Author:

Iltifat Husain, MD

Founder, Editor-in-Chief of iMedicalApps.com. Emergency Medicine Faculty and Director of Mobile App curriculum at Wake Forest School of Medicine.

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11 Responses to Do you avoid using your iPhone’s medical apps in the hospital for social reasons?

  1. Antibiotic Pharmacist June 5, 2012 at 1:57 pm #

    It’s a concern at mine both by practitioners and those around them that use of a phone might be misconstrued as being not-that-bothered/less professional/less focused on the job at hand. I read my (clinical) RSS feeds whilst on the 5 minute walk between wards, and I’m aware that it might be construed as me texting friends. I know a pharmacist who was given a massive dressing down for ‘looking unprofessional’ when he was accessing a key pharmacy resource in 1/4 of the time it would have taken to look in the paper version. I know nurses concerned that patients lack confidence in doctors that pull out a phone during a consultation.

    In front of patients, i would tend to make some joke to explain what I’m doing – mostly that would be using a clinical calculator, as i tend to use desktop web apps for reference sources.

    Smartphone use is certainly stigmatised in the UK, whether it’s because legitimate clinical use is new I can’t say but one certainly hopes so.

    (PS iPhones are not the only smart phone – Android FTW!)

    • Iltifat Husain, MD June 5, 2012 at 2:13 pm #

      Great point — I think you make a key point about how much faster it is to use a smartphone for clinical reference than many of the desktop computers that are available. So many of the desktop computers have old windows legacy software that makes looking up medical references significantly slower.

      Another key point is making sure patients know what you are looking up as well. (BTW, as a pharmacist, what is your go-to prescription drug app?)

  2. HardRoc June 5, 2012 at 3:43 pm #

    I’ve gotten in a lot of trouble during several of my clerkships for looking up an unfamiliar term or to practice a calculation during noon conferences. Even when I explain to my preceptor what I am doing and show them, they still believe I am “doing the facebooks” or “playing Angry Birds.” Very frustrating to live in a world with such Luddites!

    • Iltifat Husain, MD June 5, 2012 at 6:28 pm #

      Wow, and I think thats another thing to consider as well. There is a huge generational component associated with this. I’m definitely more inclined to see younger attendings use their phones than older ones. And maybe that extends to patients as well? Younger patients are potentially more welcoming of physicians using a smartphone to look up reference data than older patients. Do you have an iPad? It’s so much more socially acceptable to take notes on an iPad verse iPhone. I can’t imagine the looks people would get if they were at conference and they had their iPhone out and were furiously taking notes on it within a note taking app.

  3. Hardy June 5, 2012 at 5:10 pm #

    In Australia there is an increasing focus on the use medical apps and the risks it poses. I’d be very careful using software to calculate drug doses- it’s really serious stuff and the outcomes of errors can be disastrous. You place a lot of trust in the developer that they have good QA processes in place- and good source material too.

    https://www.mja.com.au/journal/2012/196/7/clinical-software-personal-mobile-devices-needs-regulation

    • Iltifat Husain, MD June 5, 2012 at 6:31 pm #

      Good point, but there is a huge chance for error when having to make multiple conversions and calculations on the fly by yourself as well. We actually have great pharmacy support in our ER where they will look over every script that goes to our pediatrician population to make sure it’s correct.

  4. Carlos June 5, 2012 at 10:10 pm #

    This is me everyday…sad but true. I live in a third world cuuntry and theres a lot of poor people, patients and Doctors. I certainly think rwice when pulling my iPad/iPhone out because it gathers too much attention, people unsually thing im just showing off and most patients thing im playing games and not paying them attention. So.. Its difficult.

    • Iltifat Husain, MD June 6, 2012 at 10:16 am #

      Thats a perspective I didn’t even think about. Thanks for sharing this. I wonder if NGOs face issues such as this as well.

  5. Dr. Kamen June 7, 2012 at 6:20 am #

    I have worked in the scenarios of coworkers being so ignorant that they actually thought I would be texting when using Epocrates to verify dosing. I usually use my smartphone strictly for medication reference, but that’s because research requires substantially more time and is not necessary in front of patients. Health care workers should assume you are using these devices for work…unfortunately, the older providers do not seem keen on using technology to enhance their knowledge base…even my wifemismopposd to ebook training our children instead of using physical books. But clearly, an electronic folder and note taking method is superior to the old days, as notes from years back will be available without significant effort…and the library at home can now be an open space or a new window in the living room!

  6. drrjv June 8, 2012 at 9:56 pm #

    I use my iPad and iPhone in the hospital all the time and have no problems with staff for patients. In fact, patients seem to love it, especially when they realize I’m looking up something to improve their care.

  7. jkawata June 18, 2012 at 12:19 pm #

    It’s all about timing. Clearly, it looks bad to do it on rounds or in front of the patient….unless you preface your actions with the reason you are doing it. I often say “I’m just going to reference those drugs to make sure there are no interactions”….something like that. I think it is more accepted as medical apps are more commonplace.
    -JK

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