Menus Subscribe Search

Follow us


Health Care

operating-room

A modern-day operating room. (Photo: MARCELODLT/Shutterstock)

Treat, Don’t Tweet: The Dangerous Rise of Social Media in the Operating Room

• April 16, 2014 • 8:00 AM

A modern-day operating room. (Photo: MARCELODLT/Shutterstock)

Surveys suggest most doctors and nurses understand the significant safety issues associated with the use of cell phones and laptops during surgery. But that’s not stopping them from pulling out the distracting devices.

In one ongoing malpractice case in Texas over the death of a 61-year-old woman following a low-risk cardiac procedure, attorneys for her family discovered that the anesthesiologist charged with administering anesthesia and monitoring the patient’s vital signs had been on his iPad throughout the operation. In his deposition, the surgeon testified that the anesthesiologist didn’t even notice the patient’s dangerously low blood-oxygen levels until “15 or 20 minutes” after she “turned blue.”

The anesthesiologist admitted to texting, accessing websites, and reading ebooks during procedures. He claimed, though, that “even when I’m doing so, I’m always listening to the pulse ox, always checking the blood pressure, always—you know, at least every five minutes.” It seemed lost on him that five minutes is an eternity in medicine: The brain begins to die after just a few minutes without oxygen.

The normalization of social media may have dulled our ability to correctly measure our usage habits. In the United States 73 percent of online adults are active on social media sites—90 percent of those aged 18-29, and 78 percent of adults 30-49. On average, social media users aged 18-34 spend nearly four hours each day on sites like Facebook, Twitter, and LinkedIn; those aged 35-49 spend three hours daily on social media.

On other occasions, the attorneys found, the anesthesiologist had posted about a patient on Facebook—”After enduring the shittiest Friday I’ve had in a while, I just found out my next patient has lice. Freakin lice”—and even published a photo of a patient’s vital signs during surgery, captioned, “Just sittin here watching the tube on Christmas morning. Ho ho ho.” The physician admitted in his deposition he knew he shouldn’t have been doing any of these things.

A medical malpractice attorney in Colorado relayed the case of a neurosurgeon settling with a patient he paralyzed during a surgery after it came out that the surgeon had made no fewer than 10 phone calls while operating.

“Airline pilots don’t allow themselves to be distracted by social media, because they themselves do not want to die,” argued Dr. Peter Papadakos. But the only way to ensure health care providers follow suit, he claimed, would be to say, “If there’s a wrong-site surgery or other error, we will shoot everybody in the OR.” It’s a problem in operating rooms and emergency rooms alike: Nurses, technicians, and physicians glued to smartphones, tablets, and even laptops instead of patients.

Papadakos, an anesthesiologist affiliated with the University of Rochester, is a leading expert on “distracted doctoring,” the deceptively mild term used to describe physician negligence involving electronic devices. While throughout the 1980s, most programs banned residents from so much as studying in operating rooms or on the ward, doctors now routinely do far more distracting things in these same settings, with no possible medical justification—from tweeting to texting to posting on Facebook. How did this happen?

The oft-given defense, that physicians and nurses use electronic devices to keep medical records or look up relevant information, is more limited than most of us might realize. Because SMS doesn’t meet criteria for protecting privacy under HIPAA, for example, it shouldn’t ever be used for communicating with or about patients. Even if the purpose of the use is valid, the decision to use a device for any reason not immediately relevant to the patient is indefensible.

“To adhere to [the Hippocratic] oath, it is critical to be mentally present during all clinical encounters or you may miss a critical, life-impacting piece of information,” an article by a University of Connecticut physician on doctors’ use of smart devices argued. Put simply, physicians should be attentive: If they’re texting, tweeting, or reading, they’re not paying attention.

But at an annual meeting of the American Society of Anesthesiologists in 2011, one presentation claimed survey data showed “nurse anesthetists and residents were distracted by something other than patient care in 54% of cases—even when they knew they were being watched.” Worse, “[m]ost of what took their time were pleasure cruises on the Internet.”

A survey published by a journal for perfusionists, the technicians who operate bypass machines used in heart surgery, found that 56 percent of respondents admitted to using cell phones during procedures. While 78 percent said that cell phone use posed a risk to patients, only 42 percent of respondents agreed that having a cell phone conversation during surgery was always unsafe and just 52 percent said that texting during surgery was not safe. “This survey suggests that the majority of perfusionists believe cell phones raise significant safety issues while operating the heart-lung machine,” the journal drily notes. “However, the majority also have used a cell phone while performing this activity.”

A medical malpractice attorney in Colorado relayed the case of a neurosurgeon settling with a patient he paralyzed during a surgery after it came out that the surgeon had made no fewer than 10 phone calls while operating. An administrative director at an Oregon hospital, meanwhile, admitted to having to discipline a nurse caught checking airfares on a computer in the operating room.

The term “distracted doctoring” doesn’t seem adequate to describe the phenomenon of health care providers who habitually use electronic devices for non-medical purposes during appointments and procedures. These doctors, nurses, and technicians aren’t momentarily distracted: They’re deciding to interact with Facebook friends or Twitter followers instead of the patient in front of them.

Papadakos and others have warned that smart devices and social media have “an addictive element.” He thinks more studies are needed to understand this form of compulsion, to figure out how it can be eliminated. Even if that’s so, there shouldn’t be any confusion about health care providers and institutions’ obligation to protect patients in the meantime. A surgeon addicted to alcohol or an illegal drug wouldn’t be allowed to operate while drunk or drinking—so why are physicians addicted to their iPhones and technicians given to texting still allowed in the operating room?

Rebecca Buckwalter-Poza
Rebecca Buckwalter-Poza attended Harvard College and Yale Law School. She has written on law and politics for the Nation, the Atlantic, Politico, the Daily Beast, and CNN, and co-authored James Carville’s 40 More Years. Follow her on Twitter @rpbp.

More From Rebecca Buckwalter-Poza

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

October 24 • 4:00 PM

We Need to Normalize Drug Use in Our Society

After the disastrous misconceptions of the 20th century, we’re returning to the idea that drugs are an ordinary part of life experience and no more cause addiction than do other behaviors. This is rational and welcome.


October 24 • 2:00 PM

A Letter to the Next Attorney General: Fix Presidential Pardons

More than two years ago, a series showed that white applicants were far more likely to receive clemency than comparable applicants who were black. Since then, the government has spent hundreds of thousands of dollars on a study, but the pardons system remains unchanged.


October 24 • 12:00 PM

What Makes You So Smart, Middle School Math Teacher?

Noah Davis talks to Vern Williams about what makes middle school—yes, middle school—so great.


October 24 • 10:00 AM

Why DNA Is One of Humanity’s Greatest Inventions

How we’ve co-opted our genetic material to change our world.


October 24 • 8:00 AM

What Do Clowns Think of Clowns?

Three major players weigh in on the current state of the clown.


October 24 • 7:13 AM

There Is No Surge in Illegal Immigration

The overall rate of illegal immigration has actually decreased significantly in the last 10 years. The time is ripe for immigration reform.


October 24 • 6:15 AM

Politicians Really Aren’t Better Decision Makers

Politicians took part in a classic choice experiment but failed to do better than the rest of us.


October 24 • 5:00 AM

Why We Gossip: It’s Really All About Ourselves

New research from the Netherlands finds stories we hear about others help us determine how we’re doing.


October 24 • 2:00 AM

Congratulations, Your City Is Dying!

Don’t take population numbers at face value.


October 23 • 4:00 PM

Of Course Marijuana Addiction Exists

The polarized legalization debate leads to exaggerated claims and denials about pot’s potential harms. The truth lies somewhere in between.


October 23 • 2:00 PM

American Companies Are Getting Way Too Cozy With the National Security Agency

Newly released documents describe “contractual relationships” between the NSA and U.S. companies, as well as undercover operatives.


October 23 • 12:00 PM

The Man Who’s Quantifying New York City

Noah Davis talks to the proprietor of I Quant NY. His methodology: a little something called “addition.”


October 23 • 11:02 AM

Earliest High-Altitude Settlements Found in Peru

Discovery suggests humans adapted to high altitude faster than previously thought.


October 23 • 10:00 AM

The Psychology of Bribery and Corruption

An FBI agent offered up confidential information about a political operative’s enemy in exchange for cash—and they both got caught. What were they thinking?


October 23 • 8:00 AM

Ebola News Gives Me a Guilty Thrill. Am I Crazy?

What it means to feel a little excited about the prospect of a horrific event.


October 23 • 7:04 AM

Why Don’t Men Read Romance Novels?

A lot of men just don’t read fiction, and if they do, structural misogyny drives them away from the genre.


October 23 • 6:00 AM

Why Do Americans Pray?

It depends on how you ask.


October 23 • 4:00 AM

Musicians Are Better Multitaskers

New research from Canada finds trained musicians more efficiently switch from one mental task to another.


October 22 • 4:00 PM

The Last Thing the Women’s Movement Needs Is a Heroic Male Takeover

Is the United Nations’ #HeForShe campaign helping feminism?


October 22 • 2:00 PM

Turning Public Education Into Private Profits

Baker Mitchell is a politically connected North Carolina businessman who celebrates the power of the free market. Every year, millions of public education dollars flow through Mitchell’s chain of four non-profit charter schools to for-profit companies he controls.


October 22 • 12:00 PM

Will the End of a Tax Loophole Kill Off Irish Business and Force Google and Apple to Pay Up?

U.S. technology giants have constructed international offices in Dublin in order to take advantage of favorable tax policies that are now changing. But Ireland might have enough other draws to keep them there even when costs climb.


October 22 • 10:00 AM

Veterans in the Ivory Tower

Why there aren’t enough veterans at America’s top schools—and what some people are trying to do to change that.


October 22 • 8:00 AM

Our Language Prejudices Don’t Make No Sense

We should embrace the fact that there’s no single recipe for English. Making fun of people for replacing “ask” with “aks,” or for frequently using double negatives just makes you look like the unsophisticated one.


October 22 • 7:04 AM

My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.


October 22 • 6:00 AM

How We Form Our Routines

Whether it’s a morning cup of coffee or a glass of warm milk before bed, we all have our habitual processions. The way they become engrained, though, varies from person to person.


Follow us


Politicians Really Aren’t Better Decision Makers

Politicians took part in a classic choice experiment but failed to do better than the rest of us.

Earliest High-Altitude Settlements Found in Peru

Discovery suggests humans adapted to high altitude faster than previously thought.

My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.

That Cigarette Would Make a Great Water Filter

Clean out the ashtray, add some aluminum oxide, and you've (almost) got yourself a low-cost way to remove arsenic from drinking water.

Love and Hate in Israel and Palestine

Psychologists find that parties to a conflict think they're motivated by love while their enemies are motivated by hate.

The Big One

One company, Amazon, controls 67 percent of the e-book market in the United States—down from 90 percent five years ago. September/October 2014 new-big-one-5

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.