iPhone Attribution Error

December 23, 2010

This post from nurse blogger SaraBethRN is important.  She recounts an experience where she referenced her iPhone for a lab value and was accused of texting on the job.  This has happened to me on a couple of occasions.

It’s the iPhone attribution error:  If you’re looking at your iPhone, you must be goofing off.

We sometimes associate phone use with those who are self-absorbed and obsessed with their personal business.  While we all know a few of those, the fact remains that the iPhone is an indispensable tool for health providers.

Our stereotyping of technology crosses over to other applications as well.  It’s assumed that Facebook is a place to clown around.  While this may be true, it’s also a serious platform for communication.  A colleague once confronted me for using Twitter during clinic hours.  He assumed that Twitter’s raison d’etre is to tell the world when you’re eating an egg sandwich.  So I gently took the fellow to school.

For health providers using these new tools expect the old guard to believe you’re up to no good.

I recently referenced Epocrates during a patient visit and was called out (tongue-in-cheek) by the patient’s mother for peeking at my phone during the interview.  When I disclosed that I was referencing the Epocrates Pill ID feature she became curious and together we looked for the shape, size and color of pill that she was trying to recall.  She learned that a doctor referencing a smart phone does not necessarily indicate a rude, distracted provider.

This does raise the question of how to appropriately integrate technology in the patient encounter.  I adhere to the fact that what the patient believes you’re doing is as important as what you’re doing.  Until patients understand how smartphones fit into the physician’s (or nurse’s) workflow perhaps we should tell them what we’re doing.

And one last thing.  My clinic has signs requesting that cell phones not be used in the exam rooms (the clip art graphic depicts the old Motorola StarTAC phone, my first cell phone in the mid-90’s).  Note to self:  It’s almost 2011.  Cell phones are serious tools for doctors and parents.  Got to get rid of the signs.


thuc December 23, 2010 at 1:36 pm

im relieved to hear that it doesn’t just happen to me. one time, during my ortho rotation, i was using my phone to look articles up in between the times that my attending and i were seeing patients. he never said anything about it. until i saw my rotation evaluation after the month was over saying i needed to stop texting during clinic. it was frustrating to get that negative remark on my eval when i wasn’t texting, i was looking up ortho topics!!!

DrV December 23, 2010 at 8:40 pm

I’m guessing had you had your nose between two pieces of dead wood you would have seen honors. Amazing. Think of yourself as some kind of pioneer.

John Mandrola December 23, 2010 at 8:03 pm


I keep a folder of AF-ablation pics on my iphone to show patients. They are almost as cool as a white board.

Also, Epocrates is incredibly useful. This week, I was on my iphone with a referring doctor. He was asking about a drug interaction with an anti-arrhythmic drug. I wasn’t sure if I could talk and check Epocrates at the same time. Bu using hand gestures, the friendly hospitalist standing next to me understood what I needed, and was kind enough to let me use his iPhone–in mid-conversation–so I could access the app without hanging up. In a matter of seconds, I gave the answer–and sounded smart.


DrV December 23, 2010 at 8:43 pm

Very cool. I haven’t fully tapped the power of my iPhone but I’m workin’ on it.

Thanks for chiming in, John.

Liz Ditz December 29, 2010 at 5:33 pm

are Epocrates etc. available for the iPad?

The tiny pictures of tiny objects (like pills) are OK, but for the (ahem) elderly patients such as myself, the larger images the iPads afford is a help…

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