No cell phone in doctor's exam room? Why?

May 31, 2013 8:32 AM

Just called a friend with a severed tendon to see how his visit to the doctor went and he was still in the exam room. He said he had to get off the phone because there was a sign saying "no cell phones in exam room." I'm wondering why the sign is there. He was alone at the time, waiting for the doctor to return. Is the rule due to an equipment issue, or is it because of doctors being annoyed by rude patients talking on cell phones while the doctor is examining them, or something else?
posted by mediareport to Health & Fitness (24 answers total)

I believe it is to remain in compliance with HIPAA privacy requirements - someone on the other end of the phone call my overhear confidential information.
posted by jquinby at 8:37 AM on May 31, 2013

(it's a Word doc, but here is an example from UNC's medical center policy on cell phones).
posted by jquinby at 8:39 AM on May 31, 2013

Best answer: The offices don't want the noise from people talking and phones ringing. But you know what, who's really going to strictly enforce such a rule? I certainly would make a quiet phone call in an exam room if I needed to without worrying about breaking the rules of a doctor who is finally seeing me 45 minutes past my scheduled appointment time.
posted by Dansaman at 8:42 AM on May 31, 2013 [8 favorites]

Response by poster: Thanks for the responses so far. I should have mentioned that I'm also interested in answers from medical professionals.
posted by mediareport at 8:44 AM on May 31, 2013

If they happen to have an ECG machine, the cell phone can disrupt it, though I don't imagine most GPs do have that kind of equipment onsite.
posted by windykites at 8:45 AM on May 31, 2013 [1 favorite]

Best answer: Sadly, my experience in the emergency department is that most people don't say "she just came in, gotta go." Bizarrely enough, even though they presumably believe they are there for a potential emergency, many people will stay on the phone when I come into the room. I cannot perform an adequate history or physical with someone who is talking on a phone. My approach is that I will wait for a minute, and if they're still chatting away, I leave. In the ED, I have the ability to just come back later when I have time (although it may be half an hour or an hour later, depending on how busy we are). Doctors who see patients on a schedule don't have that luxury.

We call it a "positive cell phone sign". The positive cell phone sign is a prognostic indicator that the person speaking on the phone is less likely to have a serious or life-threatening medical issue.
posted by treehorn+bunny at 8:45 AM on May 31, 2013 [102 favorites]

Cell phones can also interfere with a variety of medical devices, but it does not sound like this appointment was one in which these sorts of monitors or devices would have been used.
posted by treehorn+bunny at 8:48 AM on May 31, 2013

The HIPAA thing is a red herring. Any disclosure that results would be on the patient and not a HIPAA violation. In jquimby's link UNC is prohibiting their own employees from using smart phones because disclosure by staff would be a problem.
posted by Lame_username at 8:49 AM on May 31, 2013 [3 favorites]

Best answer: I have managed dental offices and worked in a variety of medical practices the answer is rude patients. Beyond the rudeness, cell phones make the job harder to do.

The doctor isn't generally running behind schedule keeping you freezing under a paper gown because that is a fun thing for them to imagine. They're moving as fast as they can, trying not to screw up and misdiagnose you. Cell phones are a distraction and prevent you from actually internalizing anything the doctor is saying to you, and slow down the responses you need to give to help the doctor do the job you're paying for. If you're busy thinking about getting your husband to put a casserole in the oven for dinner, it might not occur to you to mention that this problem has been steadily getting worse for 6 months.

In the case of dentistry, you would not believe how many people try to answer a call while the doc is trying to drill, or while the assistant is trying to take an impression for a crown.

There is medical equipment that cell phones legitimately interfere with, so that's the reason universally given. You cannot tell patients, "You're being an asshole and making my job more difficult."
posted by bilabial at 8:54 AM on May 31, 2013 [15 favorites]

Mod note: Constructive helpful answers please.
posted by jessamyn (staff) at 8:54 AM on May 31, 2013

Response by poster: bilabial, jumping off from your answer, wouldn't a sign saying "Please end cell phone calls when the doctor enters the room" or the doctor saying, "Ok, we need to end the cell phone call now to do a proper exam" be just as effective? Are those particularly difficult strategies?
posted by mediareport at 8:59 AM on May 31, 2013 [2 favorites]

Best answer: Actually, the dentist I worked for tried a sign that asked patients to hang up when he entered the room. He also tried a form that every patient had to sign. And the response from patients was an almost universal one finger held up while the patient mouthed the words "one sec, just one sec..." and then half shouted at the person on the other end of the call "I gotta go! The dentist is finally here. Ya. I'm getting a crown. Ya, ya, I'll tell you all about it later. Ya, it's been bothering me for a while. Ya, ya. Ya. Gotta go. Bye. Call you later. Bye."

And then they hang up and look at the dentist and say with a shrug, "sorry about that. You know, moms." So he instituted a no cell phones in the whole office policy.

It was even worse for the assistant who doesn't get the level of respect that doctors and dentists do. Nearly all of my nurse friends report that patients hang up more quickly for doctors, and some patients never get off the phone for nurses, despite being asked. And I mean for stuff like blood pressure checks. They've started leaving the room, explaining that they need the patient to be sitting still, not talking, not holding anything in order to get a good reading. They'll be back when the conversation is over. Patients get pissy about that, because having to wait will kill them or something.
posted by bilabial at 9:08 AM on May 31, 2013 [32 favorites]

Here's a possibility: Cell phones have cameras, and doctors may feel compromised if a patient were to video record an examination.
posted by weapons-grade pandemonium at 9:12 AM on May 31, 2013

Just as another data point: my son's pediatrician has signs in all the exam rooms that simply say, "Please silence your cell phones during exams." This is fresh in my mind because we recently sat in a exam room for 45 minutes waiting for her.

I routinely wait 15-30 minutes after the MA/nurse before my GYN enters for my exams as well. And FUCK if I'm not texting/talking/playing Angry Birds while I wait.
posted by peep at 9:29 AM on May 31, 2013 [1 favorite]

At the ER where my mom is a nurse, people have tried to take pictures during treatment, like wanting to show all their friends their kid's first stitches on Facebook. This interferes with treatment. There are also privacy concerns for the employees-- they recently went to a name badges that just say firstname, RN for that reason. It's difficult to apply a rule like "no cell phones unless absolutely necessary" or "no cell phones when the doctor/nurse/medical assistant is in the room" because everyone thinks they should get an exception. It's much easier to just apply a blanket rule.
posted by bbq_ribs at 9:33 AM on May 31, 2013 [1 favorite]

In terms of restricting calls to just when a medical health professional is not in the room, some people talk REALLY LOUDLY on phones, to where it can disturb people in other rooms. It's kind of one thing if you're hard of hearing and don't want to wear your hearing aids to the doctor and so end up broadcasting your own appointment to the entire office because you're shouting and requiring the doctor to shout; it's another if you're disturbing the doctor's other appointments.
posted by jaguar at 9:37 AM on May 31, 2013 [1 favorite]

I expect that a patient would be seriously annoyed if a physician took a personal phone call while in the room with them. Most patients get annoyed even if a physician takes a medical phone call while in the room with them, although reasonable patients may be willing to forgive this rudeness if the phone call is perceived to be urgent or emergent. I always excuse myself and apologize prior to taking any call (even an emergent one), and apologize immediately upon return as well, because the expectation is that a physician-patient conversation is intimate and interruptions spoil that intimacy.

The patient is unlikely to interrupt while the physician is on the phone and say "hey, this is a doctor's appointment - we need to end the personal phone call now." Despite doing this as a response to rude behavior, that would be an awkward situation to put a person into, because there is an understanding that interrupting someone on the phone is also rude. I'm sure if the patient shouted loudly enough or perhaps if they reached over and were able to hit the hang up button, it could be quite effective in ending the phone call. But none of these solutions would be as easy as the phone call not being made in the first place, right?
posted by treehorn+bunny at 9:38 AM on May 31, 2013 [2 favorites]

Best answer: I work in a hospital, specifically in the OR where there is more electronic gadgetry than you can imagine, and we use cell phones as our preferred method of communication. So interference with medical equipment is not the answer; it was a theoretical concern years ago but not currently. Likewise HIPAA violations are unlikely to be an issue, although the law continues to be misunderstood and over-reactions to it are common, so it is sometimes used inappropriately to limit otherwise acceptable behavior. As others have mentioned, the real reason is patients who talk on the cell phone rather than pay attention to the other person in the room. We don't have such a policy at work and it is incredibly common for me to go into the holding area to talk to parents about their child's upcoming anesthetic and have to wait while they get off the phone. Some never get off the phone and try to carry on two conversations at once. Given the pressure placed on health care organizations to move patients through the system as quickly as possible, the delays introduced when patients are on the phone can really slow things down enough to hurt the bottom line. Think of the last time you were behind someone checking out at the supermarket who can't get off the phone long enough to pay for their groceries. They have no clue how much they are slowing things down, but everyone in line behind them is acutely aware of how talking on the phone interferes with the task at hand.
posted by TedW at 10:05 AM on May 31, 2013 [8 favorites]

Best answer: wouldn't a sign saying "Please end cell phone calls when the doctor enters the room" or the doctor saying, "Ok, we need to end the cell phone call now to do a proper exam" be just as effective?

I'm a nurse in a hospital, and it can be nearly impossible to get someone's attention enough to even ask them to end their phone call. When someone won't make eye contact with you, and is talking nonstop at the person on the other end of the line, it feels incredibly rude to interrupt them. Or when someone does glance up and acknowledge that you've entered the room, it's easy to stand there for 20-30 seconds thinking, "OK they've seen me, they're about to hang up any second now. Any... Second... Now..." If they stop talking long enough to listen to the person on the other end of the line, I will usually just speak up and ask if I can interrupt them for a minute. But to talk over someone who is in midsentence in front of you feels amazingly uncomfortable, especially when you still think that maybe they were about to hang up anyway. The time we spend trying to figure out whether we need to rudely interrupt is wasted time, and in healthcare we already don't have enough time as it is.
posted by vytae at 10:26 AM on May 31, 2013 [2 favorites]

Best answer: I'm in primary care and although we would never put anything up in the practice banning them, the phenomenon of patients not getting off the damn phone to talk to you, the medical professional in front of them, is real.

My patients don't even wait in the exam room (I bring them back from the waiting room personally) and some of them still take calls with me in front of them. Mostly people are pretty good about getting off the phone, but the signoff usually takes a while. "Gotta go, I'm with the doctor!.... Oh, about half an hour, I guess.... Yeah, takeout sounds fine....yeah, meet you out front....no, on the other side, the one with the fountain...Bye! Love you too! Bye!" There are many people who get calls while in the exam room and try to let them go to voicemail but whoever is on the other end just keeps calling back over and over until they answer and then they have the aforementioned conversation.

Rounding in the hospital is also frequently bizarre, with a team of 5-8 doctors standing around a hospital bed waiting to speak with a patient who is happily talking away and showing no signs of slowing down. I usually ask if we should just come back later.

I'm sympathetic to people having to wait, so I don't make a big deal out of it, the same way that I just started keeping crayons in my office for all the kids my patients bring with them, but it's one of those things that is substantially more irritating than it seems like it should be, and I can totally see that in practices that depend on high volume and efficiency, for providers with a certain kind of personality, the impulse to ban cell phones in the rooms could be strong.
posted by The Elusive Architeuthis at 10:35 AM on May 31, 2013 [1 favorite]

I actually just talked to my dentist about this when I was in for a cleaning and in his case the problem is not so much that you, individually, are talking on your phone. The problem is that all those minutes he and his staff stood around waiting for everyone else to finish talking on their phone (assume even 1 minute each per patient across a busy practice and you're 15 minutes+ behind by lunchtime and 30 minutes+ behind as the day wraps up) can really screw up a tightly slotted schedule on a busy day. And it's much easier to put the sign up and make serious doctor noises than to try and force people to stop being assholes on an individual basis day after day because that's a losing battle.
posted by Ghostride The Whip at 10:42 AM on May 31, 2013 [6 favorites]

"Please end cell phone calls when the doctor enters the room" or the doctor saying, "Ok, we need to end the cell phone call now to do a proper exam" be just as effective?

Realistically, almost no one is going to end a phone call immediately, despite the best intentions, so the most effective strategy is to avoid the problem. It is different if both people are in the same room talking, because then both have a similar understanding of the context and are both exposed to the same information at the same time.
posted by Good Brain at 5:48 PM on May 31, 2013

Response by poster: Thanks everyone; this was informative. I can now better imagine how absurdly stupid and wasteful it is for a medical professional to be in an exam room while the patient is talking on the phone, even for half a minute. I suppose I shouldn't be surprised folks really pull that kind of idiotic rudeness (maybe they think they're getting back at the doctor for making them wait or something?) but I also am now more comfortable with the conclusion that non-rude people can quietly talk with friends or loved ones on a cell phone while waiting alone in an exam room, even if there's a sign saying don't.
posted by mediareport at 7:08 PM on May 31, 2013

My doctor's office has a sign requesting that calls be taken outside - I always thought it was a courtesy to the other patients.
posted by bunderful at 7:35 PM on May 31, 2013