Contxt: What Pediatricians Think of Cellphones

Over the last five years, I have seen a sea change in how cell phones and texting devices are used by their owners, during an encounter with their child or with their doctors.

Personal technology isn’t all evil all the time. But it has its downsides. Oh, yes. Recall, the recent message from the physician director of the Cancer Institute at the University of Pittsburgh emailed some 3000 of his staff suggesting preliminary data linked brain tumors to cell phone use. I’ve got my headset, how about you?

Research demonstrates irrefutably what many of us already see daily. Cell phones change our behavior, and tend to make us oblivious to our surroundings, blunting our awareness and our tendency to live in the moment. Driving while texting is as bad as driving drunk, as innumerable reports, studies, and stories attest. We’d never do that . . . would we?

To muddy the water a bit, we hear news to the contrary. Recent articles suggest smartphone use may create smartkids. Is the path to ideal childrearing becoming, then, a matter of having the right app? Mayhap. Other stories suggest that physician use of cellphones may reduce medical errors by speeding communication about patient care in hospital. Another day, we’ll discuss the pitfalls and benefits of emailing one’s doc about one’s kids.

Cellphone offers us that lifestyle flexibility the ads tell us about, but at a cost. Yet, these same devices blur boundaries, blunt common sense and render the user preoccupied (“Um, mommy?” “Er, ma’am?”). It is pervasive: our parents offend as often as our adolescent patients. Almost daily now, I have parents taking calls while I am speaking to them, or while examining their child. Some even step away for a chatty interlude (on a recent occasion, even as we gave her child shots!), my slack-jawed expression having little or no impact. During explanations or interviews, I have had parents or children slip out their Sidekicks—mid-discussion—and start texting their friends. Hey, some of them are quite good, and I feel like I am in court and they are my stenographer. Signs on our doors and walls with big red slasheds through a silhouetted cellular phone appear to make little impression.

To be fair, doctors may have asymmetric expectations. We may get called during a patient encounter, causing our beepers to squawk, or our cellphones to chitter. We—who asked you to come early but probably kept you waiting—are allowed to get ‘called out.’ Pages and calls can be particularly difficult during the discussion of a delicate subject (bedwetting in a 7-year-old, for example, or a child’s not doing well at school). The intimacy or the intensity of the moment shatters, and we struggle to bookmark where we left off, and to resummon the idea and the space to share it on our return. If we’re lucky, the moment isn’t lost. When possible, a judicious doc will phone a less pressing caller back later. It isn’t easy, and nobody likes to get such calls at such times. No one I know anyway.

There is already a huge battle for our attentions in the exam room. Time is fleeting; a typical child may have but a 15 to 20 minute window to cover the entirety of his health, development, growth, medication and vaccine needs. Add in parents doing the Blackberry Nod, the iPhone Sweep and Scan, or the furtive Text Peep ‘n’ Check, and we all lose the primacy of the moment, and the connectedness that lends itself to relating, learning, and collaborating. We are all already multitasking; and the distraction and disconnection from a Taylor Swift or Hannah Montana ringtone robs us of an opportunity to share our thoughts, and to build our therapeutic alliance.

Be Here Now, is a sign my father has above his desk. This is a motto that I myself—in our connected world—have uttered to my patients, their faces bluelit by a 2×2 screen. And, other times, when my own electronic leash is pulling me from something pressing or important, perchance playing with own kids, it is something I have to say to myself. So, may we all follow my dad’s motto when working together in clinic, letting those calls, and voicemails, and text messages wait just a little bit longer.

Photo by blog.discovery.com