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How I Feel About Smartphones in My Exam Room

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These days, people bring their smartphones everywhere--including to the pediatrician's office. As a pediatrician, I definitely have mixed feelings about that.

I had to laugh when I read Russell Saunder's post on The Daily Beast on this topic. "One of these days I am going to lose my $#*% completely, and throw someone's smartphone in the sharps container," he writes. I know that feeling.

I don't totally hate them. I'm actually pretty grateful for their existence when I'm running late; it's much better to walk into an exam room where a child is happily playing a game or watching a video on a phone than into one where everyone is furious with me. It's even better when the parent is happily occupied on a phone too. And smartphones allow parents to take pictures and videos that can be incredibly helpful to me--and show them to me at the visit.

I'm also cool with kids playing with them when I need to get information from their parents. If the kid is distracted and content, then it's often easier for me to ask a whole bunch of questions about something.

Unless it's on really loud. Which it often is. In which case, I'd like it to be turned down. The first time I ask, not the second or third.

That's when I start not to like the smartphone in the room.

There's something about those gosh-darn phones. They have a way of somehow becoming a higher priority than anything else. My friend Dr. Natasha Burgert sent out a tweet the other day saying she had to take a phone out of a child's hands twice that day in order to examine them. Twice is good. I've had days where it's been more than that.

"Look at me," I find myself saying because the child is looking straight down at the phone. "You are here to see me, not that phone." Like Dr. Burgert, I literally have to remove the phone. The kid usually looks downright panicked (maybe he thinks I am going to put it in the sharps box).

Dr. Saunders has a lot of parents who use the phone throughout the visit. I'm luckier than he--most parents are pretty good. They put them down, they don't answer calls or texts that come in while they are with me. However, I've noticed that when two adults are in the room, there's a reasonable chance that one of them will be using a phone during the visit. I guess they figure that the other adult has things covered.

And I figure that if I've got one adult talking to me, I'm good. If I've got at least one person not playing Candy Crush, and the kid turns the volume on the game down the first time I ask, I'm content. Goes to show how low the bar has gotten.

I also really don't like it when parents try to use a phone to calm a child down during a physical exam. It just ends up getting in the way and making things harder. Inevitably I get between the child and the phone--and if I am looking in a toddler's ears, I need the parent to have both hands on the child, not one hand on the child and one on the phone.

Not every situation is solved with a phone. Sometimes it takes other approaches and other skills--and in recent years, it feels like parents aren't learning those approaches or skills.

That's what I hate about the phones in the office. I used to have the full attention of everyone. And it used to be that interactions between parents and children in my exam room were just that: between parents and children.

Now the phone competes with all the interactions. Which means that all of us get less from the visit than we could.

When my kids were little, whenever we went to church or anywhere else the kids might be bored, I grabbed a bag that I kept stocked and near the door. It had picture books (the small and sturdy kind), paper, pencils, crayons, and quiet toys (chosen with the particular little kid in mind). I'd throw in a little bag of pretzels and a water bottle, and we'd be all set. That bag worked wonders.

I wish I saw more of that approach in the doctor's office. I wish I saw more kids drawing, more parents reading to their children (we keep lots of books around for just that purpose), more resourcefulness when it came to both entertaining and calming children. Yes, phones can be helpful. But they aren't the only way to go. And they have some real downsides.

Perhaps the biggest downfall is that they can interfere with our interactions and our relationships.

But only if we let them. So, as Dr. Saunders asks, put down your smartphones when you go to the doctor. Or when you eat dinner. Or when you do anything where the interactions and relationships with the people around you matter.

Because they do matter.

Photo credit: istockphoto

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