Doctors should ask patients about texting-while-driving

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Doctors should talk to patients about the risks of distracted driving, just as they discuss the dangers of smoking and unprotected sex, writes Dr. Amy N. Ship, an internist at Beth Israel Deaconess Medical Center, in the June 10 issue of the New England Journal of Medicine. As more states pass laws banning talking on a cell phone or texting while driving — Washington state’s cell phone ban while driving went into effect today — and more studies highlight the deadly dangers of distracted driving, Ship argues that physicians too should broach the topic in preventive care discussions with patients.

Ship begins the editorial by describing the horrifying scene depicted in a U.K. public service announcement (video below), in which three young girls are happily moving along the road — until the driver takes out her phone to send a text. What happens next irrevocably changes her life, and serves as a terrifying and heartrending reminder of what’s at stake when the urge to tap into the broader world available through technology overwhelms good sense.

Ship argues that doctors have a unique opportunity to present the dangers of distracted driving to their patients in a way that at once implies the gravity of the risks, and puts them in the context of other serious health dangers. She writes:

“When a doctor raises and issue while providing overall preventive care, the message is different from that conveyed by a public service announcement nestled between ads for chips and beer or a printed warning on a product box.”

Finding a way to clarify to patients just what is at stake when they drive distracted could be as critical as deterring them from smoking or other dangerous behaviors. And if the impact is anything like that of conversations about smoking — Ship points out that a mere 3 minutes’ discussion about the health benefits of quitting smoking increases the odds that patients will try to quit — it could have serious benefits, not only for those individual patients, but for the public at large. As she points out, the latest data from the National Safety Council suggests more than one quarter (28%) of all road collisions in the U.S. are caused by a driver talking or texting. Ship adds:

“Although I can share published data and often recommend that patients view the video… 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.”

And if patients confess that the desire to respond to messages, check email or carry on phone conversations overwhelms their better judgment, Ship suggests strategies for limiting the temptation:

“I tell them about a driver who killed a woman while talking on his phone but couldn’t restrain himself even after that horror. He now puts his phone in the trunk of his care before he gets behind the wheel. I talk about creating such a system for eliminating the risk.”

Ship is also careful to point out that it isn’t just texting-while-driving that increases the risk of a deadly crash. She says that other types of distraction — from putting on makeup to shaving — can also increase the likelihood of a collision, but that the prevalence of cell phones means they are a much more significant cause. And talking alone, hands-free or not, undermines safety. Ship points to ample research showing that having a telephone conversation while driving is significantly more distracting than talking to a passenger. When her patients don’t buy it, she tries to frame the issue in a way that clarifies how difficult it is to concentrate fully on the the current task if you’re also carrying on a phone conversation:

“How would you feel if the surgeon removing your appendix talked on the phone — hands free, of course — while operating?”