The wired doctor: hi-tech or hi-text?

Robin Wulffson MD's picture
medical technology, distracted doctoring, smart phone, texting, medical data

Texting while driving has been coming under increased criticism because the distraction has resulted in a number of traffic fatalities. Recently, another worrisome practice has arisen: “distracted doctoring.” Computer technology, ranging from sophisticated medical computers, laptops, tablet computers, and smartphones, are widespread throughout hospitals and physicians’ offices. Medical computers monitor medical information in operating rooms, intensive care units, and hospital beds. In a doctor’s office, a physician can enter and receive medical information on hand held devices. He or she can look up a patient’s medical history, enter his medical services, and write prescriptions. The information entered is wirelessly transferred to the front desk where the patient can receive a hard copy of prescriptions and other material.

There is a downside to all this new technology, however. Healthcare professionals can become so involved in computer data that they lose focus on the patient. This problem had its origin several decades ago. I can cite an example that occurred during my specialty training in obstetrics and gynecology in the early 1970s. Fetal monitoring during labor was just coming into vogue. Several doctors and nurses were intently watching the monitor strip when rapid fluctuations in the heart rate appeared on the trip. Several theories were advanced regarding what had caused the fluctuations. They heard crying: the baby had delivered!

Current technology is a far cry from that in existence during my training. As the technology has advanced, so has distracted doctoring. Surgeons, nurses, and technicians in the operating room can send and receive personal phone calls and/or text messages in the operating room. Obviously, this problem is much more prevalent among healthcare personnel who are not “scrubbed in” (i.e., a cardiac bypass technician or a circulating nurse).


Distracted doctoring is currently subject of much discussion at hospitals and medical schools. As a result, some medical centers have begun limiting the use of devices in critical settings in the face of an ever-increasing number of hi-tech devices. Virtually all of the current crop of medical students possess smartphones and other handheld devices. Their instructors now constantly remind them to focus on the patient rather than either their personal devices or hospital monitors.

Research on the distracted doctoring is emerging. A peer-reviewed survey of 439 medical technicians, which was published in the journal Perfusion, reported that 55% of technicians who monitor cardiac bypass equipment acknowledged that they had talked on cellphones during heart surgery. In addition, about 50% noted that they had texted while in the operating room. Approximately 40% admitted that they believed talking on the phone during surgery to be “always an unsafe practice,” and approximately 50% had the same opinion of texting. The investigators concluded: “Such distractions have the potential to be disastrous.”

Since cell phones and pagers first appeared several decades ago, healthcare professionals have been interrupted by them. For example, prior to the emergence of cell phones, surgeons would clip their pager to their scrub suit to maintain contact with others who might need their services. In those days, the surgeon would ask the circulating nurse to place the call and establish communication. On occasion, the pager would fire off at a critical period during the surgery; thus, providing at least a momentary distraction. As the proliferation of evermore sophisticated devices has progressed so has the pressure for healthcare personnel to interact with their devices.

The ever-increasing extent of doctor distraction stems from the current medical concept that patient care must be “data driven,” and that healthcare professionals must be privy to the latest, instantly accessible data. Annual investment in hi-tech devices by physicians and hospitals has skyrocketed into the billions of dollars.

One area of the rapidly-evolving medical technology is not involved in doctor distraction: medical data. Computerized medical records can be retrieved from remote locations, providing that data access is available. Graphic data such as X-rays and CT scans can be transmitted from, for example, a small rural hospital to an urban medical center for expert review. Hampering computerized medical records is fear that personal health information could be “hacked” and fall into the wrong hands.


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