Sometimes you wish the evidence was wrong.

cellphonegraph
I hate my cell phone.

It’s not because it’s a bad phone. It works fine. The plan I have isn’t too terrible. And, I will admit that it is a valuable tool for my work.

I just hate having to have it.

It’s not unlike the relationship that I have with my pager. I remember the day that I first got a pager – late in my 2nd year of medical school. We were required to rent our own pagers for the start of our 3rd year medical school clerkships. I remember thinking, “How cool. I’ve reached a point in my life where it was important that other people be able to get in touch with me any time of day.” It didn’t take me too long to realize the flaw in my thinking. People higher up the food chain were did not pay for their own electronic leashes. In fact, people at the top of the food chain often didn’t have electronic leashes. They had the privilege of not being accessible 24/7.

I feel the same about my cell phone.

And to think – I was contemplating Blackberry or Treo. I’m glad that I didn’t. Especially after reading Paul Levy’s revelation that he was giving his up. If someone of Paul’s position could do without one, then I can certainly do without.

The one place that I found my cellphone to be helpful was in the hospital. Being tethered to a wall or desk telephone to return a page or call the lab is difficult for an intern, resident or fellow. Housestaff often need to work while walking from ward to ward, or building to building. Especially since the implementation of the 80 hour per week rule – there is a limited amount of time in which to accomplish one’s work. Efficiency is essential, and cell phones help.

However, many hospitals, for many years, have had bans on cell phones in patient care areas. The hospital where I trained for my residency was positively draconian about their rules. You couldn’t use cellphone anywhere in the hospital. In the NICU we had wireless, non-cellular phones. But for the most part you had to use regular wired phones. The rationale for this was that cell phones could interfere with monitoring equipment or other medical equipment. I found this to be incredibly annoying from a housestaff point-of-view, especially because there was no evidence to support this policy. On the flip side, I truly appreciated working in a hospital where every other person didn’t have a phone held to his or her head. While some people (Mrs. Blog, MD, for example) have stellar cellphone manners, many people don’t. I find hospitals to be sonically displeasing environments at baseline – pagers, monitors, alarms, overhead paging, and too many people – and so adding cellphone chatter is throwing gas on the fire. At my previous hospital I took the same joy in telling people that they couldn’t talk on their cell phones that I do in telling people that they couldn’t smoke cigarettes on hospital grounds. Being able to extinguish cell phone conversations somewhat mitigated the fact that I couldn’t tell smokers to stop smoking in the blunt and forthright way that I felt was appropriate for someone smoking outside the door of a children’s hospital.

Yesterday, a report was published in the Mayo Clinic Proceedings clearly showing no interference or interactions between cell phones and medical devices (full text available here). The authors tests 192 medical devices with two different cellular phones (Nokia’s, in case your were curious) and two different phone protocols (one was CDMA and one was GSM). Fortunately they didn’t indicate which cell service they used, so we won’t be seeing annoying Cingular or Verizon ads trumpeting their “hospital safeness”.

The authors concluded:

This study determined that the cellular telephones tested, when used in a normal way, did not cause any interference with the various medical devices present in the patient care areas studied. For institutions that have restricted cellular telephone use, these studies support revision or abolition of the existing policy.

Truth be told – I’m actually a little sad about this, because it means that one of the few cellphone free zones left in the world may be opened to the noise pollution that accompanies unrestricted cell phone use. And I can tell you that there is nothing more frustrating that the collision of a busy medical team and poor cell phone manners. The times I’ve moonlight and walked into rooms to see patients only to have them give me the “just a minute I’m on the phone” hand sign, I’ve walked right out and put their chart at the bottom of the pile. I hate to say it, but if your phone call is more important that discussing your child with a doctor, then your child is probably not that ill.

The authors of the current study recognize this:

If not clinically important adverse effects occur as a result of using cellular telephones in the hospital, then it seems that the advantages this technology brings to institution and patients would be well received. These advantages may be tempered by etiquette and lack of common courtesy by some individuals when using cellular telephones (cellular telephone users talking loudly and obnoxiously, bother other patients and visitors).

I suspect that before too long, hospitals will be like many other places, where cellphone conversations and the bad behavior the accompanies them, is commonplace, and where people are only half-focused on what is going on around them. The potential for cellphone use on airplanes makes me wish that this study had never occurred, and that the evidence-free policy persisted.