Distractions are nothing new for physicians. Managing the day to day activities of a medical practice or the rigors of a hospital are something that doctors learn to deal with.
However, the era of the smartphone is also presenting new challenges for doctors, who are increasingly becoming distracted by the devices.
While there are not a wealth of studies that have looked at this particular issue, a study in the Journal of Medical Internet Research from August 29, 2011 asserts that doctors are interrupted nearly five times an hour by phone calls, emails, and face-to-face interactions.
According to the AMA, a 2010 survey of more than 400 perfusionists (operate heart-lung machines during cardiac surgery) found that a majority of them used their cellphones during cardiopulmonary bypasses, with 21% of smartphone users checking their email, 15% using the Internet and 3% posting to social networking sites.
In fact, the popularity of smartphones are so apparent, that we recently reported mHealth apps are forecasted to reach 44 million by the end of 2012 and 142 million downloads globally by 2016. Smartphones are a staple of modern life and thus have very practical purposes. The challenge though is distinguishing between important messages and superfluous ones.
“This combination of the personal device and the professional mission makes it easier for nonclinical messages to interrupt, said Peter J. Papadakos, MD, a professor of anesthesiology at the University of Rochester (N.Y.) School of Medicine and Dentistry. ‘Let’s say your office is going to text or email you with information about your patient, Mr. Jones,’ Dr. Papadakos said. ‘What happens is you don’t know what that message buzzing is — you can’t discriminate. The unpredictability makes it incredibly irresistible to keep checking your device.'”
Additionally, the AMA discusses how the smartphone generation–those that are technology natives, may have a greater challenge withstanding the “urge to scratch the smartphone itch.”
“A case described in the December 2011 issue of the online patient safety journal AHRQ WebM&M highlights the concern. While rounding on a 56-year-old man hospitalized to have his percutaneous endoscopic gastrostomy tube replaced, the attending physician at an unidentified academic medical center said the patient’s Warfarin should be stopped. A resident rounding with the attending physician started entering the drug stop order using her smartphone, which could access the hospital’s computerized physician order entry system. She was interrupted by an incoming text message from a friend asking about an upcoming party.
The resident answered the text message — yes, she would attend the party — but forgot to complete the stop order. The patient continued receiving Warfarin and two days later developed shortness of breath, a rapid heart rate and low blood pressure. He ultimately required open-heart surgery to remove blood that was filling the sac around his heart. The spontaneous bleeding, the medical team believed, was due to the extra doses of Warfarin the patient got because the drug order was not stopped.”
There are various ways that mobile experts recommend helping with the problem. Customizing smartphone notification settings to prioritize clinical matters, or even turning off notifications from personal email accounts as well as social media sites such as Facebook are good first steps. Ultimately, though, it is up to the physician to manage the distractions of a smartphone just like the plethora of distractions they encounter on a daily basis.