201612-Arellano-Astrid-Dr-Sept14 1

Doctors need strong ground rules in the relationship with their phone, starting with the off button.

201612-Mobile-Phone-HandcuffsAfter returning from a run, the phone showed three missed calls and half a dozen new email messages. My heart rate, already high, went up a notch.

I wasn’t on call but cursed leaving the phone behind. Absurd given that nothing should be that urgent that an hour of disconnect is a problem, especially on a day off. I listened to the voicemail with the consequent to-do-list of tasks and people to call back.

The anxiety about missed information and guilt for letting colleagues and patients down was hard to push back. Email was equally demanding: school permission slips, banking requirements, clinic referrals to triage, and so on. In an instant the benefit derived from the exercise seemed to vanish. I was back to feeling stressed and annoyed at the interruptions on my day off.

In reality the calls and email had only become a source of stress because I looked at the phone.

Unfortunately much of our lives are driven by stress, pressure and anxiety about the consequences of not doing something rather than the pleasure and satisfaction derived from a job well done. Smartphones are in the pockets of 80% of doctors and therefore schedules can be checked, clinic and theatre lists modified, x-rays and blood tests viewed 24/7 with the consequent required actions.

Each time we read an email or check a blood test we are liable for our actions. Failing to act in a timely manner can lead to litigation. Texting is not confidential or secure, yet patient discussions regularly occur via text.

Smartphones are beneficial for optimising efficiency but require management. They are a curse when trying to live a balanced life.

Doctors are at greater risk of depression and anxiety with higher rates of suicidal ideation than other Australians. Phones cause mental fatigue, they make us disengage with family and friends and they cause constant anxiety. We feel anxious if we can’t get to the phone, anxious of what may be required when answering the phone, we fiddle with them when there is down-time and we are constantly interrupted by calls and notifications. Most of us sleep with the phone by the bedside or under the pillow. Smartphones are more demanding that the worst child anyone has had to look after.

The expectation of being available around the clock needs to change. We need to use ‘absent messages’ more; we need to stop checking the phone 80 times a day and we need to insist on uninterrupted blocks of time because to be effective in our interactions with patients, to digest difficult cases and to perform operations we need to be able to concentrate.

Most importantly, we need time to eat and go to the toilet, to unwind and exercise; and time away from work and phones.

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