Signs, policies don't deter cell phone users

It never seems to fail. You've worked for the last hour to get back on schedule, and with one more efficient office visit, you may actually have five minutes to spare for a break.

But then you walk into the next exam room, and you find your patient chatting away on a cell phone. You get a glance, a nod, an index finger in the universal "one moment" gesture, and you spend the next few minutes waiting while the patient finishes the discussion and ends the call.

Or, even more disruptive, you're in the middle of an exam, and the patient's cell phone rings. And instead of ignoring it, the patient answers it.

Whether they temporarily break the rhythm of an appointment or add time to your day, patients busy on cell phones can certainly be a disturbing force to your practice. Cell phone delays are near-daily occurrences in most offices, despite physicians' best efforts to eliminate them.

"They always have some excuse," said Tim Gorski, MD, an ob-gyn in Arlington, Texas. "When you have a business meeting, you'll hold your calls, but when it comes to a cell phone, it doesn't seem to matter."

Policies hardly force 100% compliance in other settings, either. Hospitals generally tell visitors to turn off their cell phones, yet you can hear them ringing down corridors all the time. Movie theater patrons are reminded several times to shut off their ringers before a film starts, but interruptions still occur.

Virgilio Licona, MD, a family physician in Fort Lupton, Colo., said despite signs in every exam room, he encounters patients on their phones daily. He has to deal with family members who are in the room and answer their phones during an exam as well.

"Cell phones become yell phones," said Dr. Licona, who works at SALUD Family Health Centers, a network of nine clinics and about 35 physicians outside of Denver. "It affects my ability to communicate."

Dr. Licona said if he finds a patient on the phone when he walks in the exam room, he usually will leave and move on to the next exam room "not in a punitive sense, but because I have to go on."

There are other reasons besides practical ones to limit cell phone conversations, said Lovette Kaufman Lindon, PhD, senior health care consultant for MLA Healthcare Management Consultants in Marietta, Ga. A third party who can hear conversations in an exam room brings up concerns under the Health Insurance Portability and Accountability Act, she said.

Dr. Licona said he never starts or continues an exam when a patient is on the phone, and he tries to put it delicately to them that phone use in the office is inappropriate.

Joseph Perkinson, MD, a family physician in solo practice in Victoria, Texas, also said he does not carry on an exam with patients who are on their phones, but he also does not try to dissuade patients from using their phones. If he enters an exam room to find a patient on the phone, he waits patiently for that person to end the call. If the patient ignores his arrival and crosses "that invisible divide that is rudeness and insensitivity," Dr. Perkinson indicates he'll be back after seeing another patient.

"Every one of those patients, who has already been waiting for some time, has called out, 'No, no, hold on, I'm through,' and ended their call promptly," Dr. Perkinson said.

Going to another room, however, still adds time to your day and keeps a room occupied for that much longer, Dr. Gorski said. The number of delays from patients on cell phones have decreased since signs were posted in his office and staff members started to regularly remind patients to turn their phones off. But it seems there may always be a few disruptions.

"We've even tried signs that say cell phone use will disrupt the functioning of equipment, but that doesn't always stop people," Dr. Gorski said. "It's like people smoking in front of a 'No smoking' sign. People are just addicted to their little gizmo. It becomes a part of their life."