My BIDMC doctor, Amy Ship, offers a Perspective article in the New England Journal of Medicine entitled, "The Most Primary of Care — Talking about Driving and Distraction." (The free full text is available here.)
At the medical school and academic practice where I teach, students and residents routinely query patients about habits associated with harm, asking about the use of helmets, seat belts, condoms,cigarettes, alcohol, and drugs. There is little solid evidence that asking these screening questions has any benefit. But we continue to ask them — as I believe we should. And as technology evolves, our questions must be updated in keeping with the risks: it's time for us to ask patients about driving and distraction.
... Recently, I have added a question about driving and distraction to my annual patient review of health and safety. I begin with the customary seat-belt question. Then I ask, "Do you text while you drive?" Although I'm concerned about both texting and talking, most people are aware of the risks associated with texting, and many judge it more harshly. If a patient admits to texting while driving, I share my knowledge and concerns. Many patients who do not text while driving voice opinions about its dangers, giving me an opening to note that talking on the phone while driving actually causes more accidents than texting. Although I can share published data . . . , I find it more powerful simply to say that driving while distracted is roughly equivalent to driving drunk — a statement that captures both the inherent risks and the implied immorality.
Amy did this with me during my most recent physical exam, ending the discussion with, "How will you feel if you injure someone because you were answering a phone call?" That was pretty powerful.
Now, the truth. Even though I know this to be the case and have written about it before, I find that it is all to easy to be a recidivist, to rationalize answering that phone because "it is something important" or "it will just take a few seconds." Well, at 30 miles per hour, you go 44 feet per second. That's more than enough distance to destroy someone's life before you focus back on the road.
My new approach is to turn off the phone when I am on the road. That's the only sure way to comply with my doctor's orders.
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