Wednesday, June 09, 2010

Driving and distraction

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.)

Amy notes:

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.

Please leave a message . . . .


Anonymous said...

How coincidental; e-patient Dave and I just had that very conversation when he called me yesterday while he was driving..... I'm glad to know I gave him sound medical advice.
(sorry to "out" you, Dave, but you know about evidence-based medicine!)

nonlocal MD

e-Patient Dave said...

You're not outing me, nonlocal - I'm "out" about my practices, which is why I discussed it with you!

In fact I dropped in here to say that my own practices DID change after the discussion here about texting while driving - except that term sounds crazier than the actual seductive practice of *glancing* at an incoming text, or email, which is much less insane than trying to *type* a message while driving.

I came here to say that after discussing this slippery slope, I actually have completely stopped looking at my phone while the car is moving. I will, if I'm stuck in traffic. And as you know, I'll talk when I'm in low volume easy driving. But the moment it's anything other than easy cruising, I stop.

I'm not asserting the wonderful Dr. Ship is wrong - far from it. I'm just being open (transparent??) about my own practice, and saying that discussion here has modified my behavior. Not claiming I'm right and anyone else is wrong.

(Hm, I have a visit with my primary tomorrow - I should probably include this.)

the man from Utz said...

On June seventh there was an article in the New York Times about a study of how the constant input of stimuli erodes the brains ability to focus- it included a neat little test of ones ability to hold information in very short term memory. The constant distraction of phones, computers, and other gadgets changes the way our brain works, the study concluded. so turning off the phone is a very good thing to do, on many levels!

rlbates said...

Good for you Paul. Mostly, I don't answer the phone when I drive. I'm working on the it being "never."

AC said...

Additionally, drowsy driving is also roughly equivalent to driving drunk. I hope that Dr. Ship will also ask her patients whether they have driven while drowsy.

The National Highway Traffic Safety Administration (NHTSA - reports that drowsy driving causes more than 100,000 crashes a year, resulting in 40,000injuries and 1,550 deaths. Drowsy driving is another form of distracted driving, and should be addressed with patinets during annual reviews of health and safety.

It was my primary care physician who listened to my accounts of drowsy driving, and sent me for additional medical evaluation. I credit her with changing my drowsy driving habits, and helping me prevent an accident while driving.

Michael Pahre said...

For turning off the phone when you're on the road: Bravo!

Anonymous said...

My brother's wife was driving to work one morning and was killed when she was rear-ended by another car. The other driver's cell phone records indicated that she had placed a call just seconds before the accident.

My nephew was three years old at the time and my niece had just turned one. My sister-in-law was 30 years old.

JS said...

I loved this article. I have taken to an even more offensive driving approach in that I look in the rear view mirror frequently and IF I see someone texting or talking behind me, I move to another lane to get out of their line of distracted driving. If only one lane I will also make the effort to turn off if the person looks really distracted!

Recently on route 9, a young man was texting and I did just that -- moved lanes -- and one mile up the road there was the accident I knew would happen! Thank goodness for those rearview mirrors and our heightened safety awareness!