Monthly Archives: January 2016

Are physicians being distracted from patient care by electronic devices?

With the ubiquitous nature of the electronic devices on our person (phones, smartwatches, tablets, computers), a physician’s attention is being pulled in various directions during a normal working day. This is more of an issue for radiologists who perform most of their work on a screen which has access to as many notifications as one would allow to come through. The constant stream of information from scanners with technologists updating patient status on dashboards, schedulers sending patient orders for protocols and clinicians asking for explanation of what is already on a report during a active reporting session is very distracting.

These updates and the requirement to answer each of these requests and notifications instantaneously in the name of “improving workflow” makes me switch my attention from my primary focus i.e. creating a good quality report and helping the clinician manage the patient’s illness.

I believe asking a physician to multitask during a patient care session is equivalent to asking a driver to take a phone call during a busy commute-prone to disaster when the unexpected comes up from the blind spot.

This problem is more acute when the physician is with a patient. My fellows are constantly paged to check a MRI when they are performing an ultrasound scan and my clinical colleagues complain about having to answer”status check” pages when they are examining a patient. The distraction of having to constantly answer a hospital issued phone within a few seconds of having received the notification while dealing with a patient can become extremely frustrating for both the physician and the patient.

In addition to the interruption to the chain of thought while formulating a report or examining a patient, there is a danger of “attention residue”, a term used by psychologists studying multitasking to describe how it is difficult for people to transition their attention away from an unfinished task, thereby adversely affecting their subsequent task performance.

My experience is that the many managers making these rules are either non-clinicians or clinicians who have moved on managerial posts and are no longer involved taking care of patients. Their focus is on metrics like time saved, increased throughput of cases and financial gain, and not about quality and patient safety, which should be the priority of all health care institutions.

I have consciously decided to switch my phone off and not look at emails during the workday in the reading room. I also read through and answer my emails in not more than three batches during the day. Also, I now refuse to answer pages when I am not on service and when the person paging you is asking for a non-urgent opinion about a case that I am not actively involved in. I do not have email or application alerts on my phone and have deleted all social media applications from my phone that I use in the hospital. I also batch up complex reports to revisit during a quiet period after my time in the reading room when I can switch off every single notification device on my person.

I would be interested in seeing if others have come up with solutions for the electronic/technology distraction problem.