A busy dermatologist recently walked into a treatment room to find her patient talking on a cellphone. The patient put her finger up, indicating the physician should wait until she was through with her conversation.

“We realized that with the vast majority of Americans now owning a cellphone, this probably wasn’t an uncommon scenario,” says Madeline DeWane, a student at the University of Connecticut and co-author of a recent paper on this topic.1

This is especially true for busy practices with long wait times. “Beyond the etiquette question of how best to react in the moment, we felt the situation raised some interesting ethical questions,” says DeWane.

Ethical issues related to patient cellphone use center around the physician-patient relationship. At issue: How to balance the value of both physicians’ and patients’ time.

“In some cases, cellphone use may be appropriate and helpful,” notes DeWane. Patients may want to be distracted during an uncomfortable procedure. It also is an easy way to include family or loved ones during decision-making. Additionally, cellphones distract patients during long waits.

“However, when cellphone use disrupts a clinical encounter it can make communication challenging,” says DeWane.

Cellphone use can interfere with the establishment of trust and rapport. “This has the potential to stress the physician-patient relationship and interferes with the process of shared decision-making,” says DeWane. A patient immersed in a phone conversation forces the physician to choose between treating the patient at hand and their duty to other waiting patients.

The potential privacy implications of cellphone use in the clinical setting are another ethical challenge. “This is especially complex because what’s legal is not always ethical,” says DeWane.

Most U.S. states require only single-party consent to legally record a conversation. However, many people would agree it is unethical to record someone without their knowledge. “In a clinical setting, there is an expectation by both patients and physicians that conversations are private,” says DeWane.

Similarly, individual patients are not bound by patient privacy regulations. Thus, they are legally allowed to take photos or videos in close proximity to other patients. “But these actions could be considered unethical if they violate another patient’s privacy,” notes DeWane.

REFERENCE

1. DeWane M, Grant-Kels JM. Cell phone use in the clinic: “Please hang up now, the doctor is ready to see you!” Int J Womens Dermatol 2018; 4:238-239.