IMPULSE CONTROL Electronic devices in the OR aren't the problem. The problem is our inability to control how we use them.

The term "distracted doctoring" is being heard more and more frequently, but the phenomenon isn't limited to physicians. Anyone and everyone — nurses, PAs, NPs, CRNAs, OR staff, even administrators — can be held negligent, and therefore culpable, if they choose to pay more attention to their electronic devices than their patients.

Mobile devices are here to stay and we should be grateful. The technology is wonderful. It lets us instantly dial up a diagnosis, a drug dose or a colleague to consult with. The devices are more valuable than can ever be measured. They give us immediate access to the entire world of medicine, right at our fingertips.

Less wonderful, in the context of health care, is the fact that we can also pull up the ball game, menus, airfares and social media, which we can then use to gripe about having to go through another boring day in the OR. In other words, it's easy to blame the device, but the device isn't the problem. We are the problem. And our inability to control our impulses is something that plaintiffs' lawyers are itching to exploit. The people we see as patients, they see as victims and as jurors. When we jeopardize care or place lives in danger as a result of foolish, self-centered pursuits, verdicts will be swift and harsh. And rightly so.

Through their eyes
Put yourself in the patient's place. Recently a neurosurgeon from Denver was the target of a malpractice suit stemming from multiple phone calls — both business and personal — he took via a wireless headset while performing a procedure. The patient was left paralyzed after surgery — allegedly because the surgeon was distracted. An out-of-court settlement followed, limiting the flow of details, but rest assured the plaintiff's attorney had the phone and Internet records to prove his case.

A Dallas anesthesiologist also recently failed to control those impulses. A cardiac patient he was monitoring for what should have been a routine AV node ablation was pronounced dead 10 hours into the case. The surgeon said the anesthesiologist failed to recognize that the patient's blood-oxygen level was severely compromised until well after the patient turned blue. Now it turns out that the anesthesiologist, after initially denying doing so, was texting and using Facebook during the case. He's likely to pay a steep price for having done so.

Tragic outcomes like these are rare, but every practitioner who gives in to the gadget is tempting fate in the face of potentially devastating consequences, both to the patient and to his or her career.

As practitioners, until we recognize and fully embrace this realization, the problem is only going to get worse. The young professionals now entering the field were born with this technology. The world is their electronic oyster and it has been for as long as they can remember. They are, in a very real sense, addicted to their gadgets.

Into reverse
The fact that the technology is potentially as helpful as it is harmful may be the reason there's been no stampede to outlaw gadgets in the OR, no edicts akin to those against texting while driving that many states now have in place. Nor should we want to ban all devices from the OR. Throwing the baby out with the bath water doesn't solve the problem. Nor does punishing all for the mistakes of some. But it's up to us to act nonetheless. What can we do?

• Set an example. It's up to us as professionals to police our own. That begins with role modeling. Vigilance and focused attention on the patient are paramount. There's no acceptable alternative. Without dedicated mentors to reverse the current trend, the problem will only get worse, leading to further failures and a litany of litigants.
• Speak up. Say something. Those who cross the line need to be told in no uncertain terms that their behavior is unprofessional and unacceptable.
• Eliminate chronic offenders. Those who insist on choosing their own selfish interests over proper patient care must be removed from the profession.

In short, it's going to take a dedicated and concerted effort on the part of the entire healthcare industry and medical community to reverse this alarming trend. If we continue to retreat from consistent patient-first care, the uproar from patients and their attorneys will be deafening.