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Cellular Conundrum

Cell phones have become such a constant in our lives.  I can hardly remember how I would pass the time without having a small cellular device to obsessively check upon throughout the day. Technology is such a wonderful concept.

When I can pull out this small piece of equipment, I am instantaneously connected with my residents and attending physician. I am able to communicate and coordinate with other students with the tap of a few keys on my touch screen. I can quickly access and review medical materials pertinent to patient cases prior to performing my examination. I am able to fill my mind with facts and expand my knowledge base in order to impress my colleagues and evaluators prior to our morning rounds by reading up on articles within a matter of minutes. I can access applications to help calculate score risks and to review indications for medications  that have adverse interactions with other medications as well as those that may prove life saving during the application of patient care.

Yet, there are drawbacks to this seemingly perfect device. I cringe as some physicians pull out their cell phones while having a conversation with a patient to check in on the phone call or silence the device. A few doctors will even answer the phone and have a brief conversation before ending the call! Should this be acceptable? Does this adversely affect patient care? Do patients feel less important and less valuable even after an apology is given?

If I place myself in the patient’s position, I must admit that I would likely feel frustrated if he or she were to answer a phone call during our already brief and rushed five to eight minute encounter. I trust that if I felt comfortable with my physician and knew that he or she would only answer the call if it was absolutely critical, that this situation would not dampen my confidence surrounding my level of care. However, if I only interacted with this physician a few times before the episode, I would likely feel mistreated and less cared for.

I have already battled this delicate situation myself. When interviewing two family members, I decided to silence my cell phone. Forty-five minutes later, I realized that my resident had probably been trying to reach me! I promptly whipped out the device to see a battery of disapproving text messages asking for my whereabouts and my progress with the history of the patient in question. I tried to answer discreetly but the one family member noticed and abruptly stopped speaking. I was extremely apologetic and I tried to explain to her the situation that I was caught up in, but I could not help but feel as though the tone of the interview had both suddenly but permanently changed.

Perhaps I should have excused myself from the situation immediately and cut the interview short. Some might even say that I should have excused myself for a moment and then returned. Would such a maneuver disrupt the flow of conversation similarly? Even if my device had only vibrated, I would have noticed the vibration and subsequently would have felt distracted knowing that messages were awaiting my reply.

How do we strike a balance? How can we connect with our patients without the interference of text messages and phone calls but still maintain communication with our colleagues?

I can propose this possible solution. Perhaps if medical students were issued pagers within every hospital, this type of situation would mostly be avoided. It is something that clerkship directors should take into consideration. It might create more work behind the scenes and strategic budgeting, but ultimately, I feel that this would eliminate the need to interrupt patient interviews or examinations to check up on text messages from team members.  At the same time, this would eliminate the potential distraction to look at other messages from family members or friends when pulling out the device. Furthermore, it would equip medical students with a sense of responsibility and importance on the team.  Yes, a pager is equally as distracting as a cell phone, but there is at least an association that patients apply to a pager that differs from the one attached to a cell phone. Patients will likely understand that medical professionals exclusively communicate with one another using pagers.  This solution eliminates the possibility that the disruptive message or phone call was just from a friend and creates a more trusting atmosphere for the patient.

One day, I expect that an all-inclusive device will exist within hospitals that will feature message exchange and confidential patient information access and sharing. Until then, medical students might consider pushing for beeper access. If this proves impossible, I urge medical students to consider excusing themselves from any interaction after an appropriate amount of time to check in with team members. I also hope that teammates understand that we may be unable to answer them immediately if we choose to work with our patients free of interruption.

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Cherilyn Cecchini

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