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Published On May 18, 2017

Policy

The Mobile Menace

Talking and texting while driving cost hundreds of lives every year. Should physicians intervene before those accidents happen?

Being on the phone while driving is “like driving with your eyes closed,” says Amy Ship, an internist at Beth Israel Deaconess Medical Center in Boston. “It’s absurd that we tolerate that kind of behavior.”

While 14 states ban handheld cell phone conversations and 46 prohibit texting while driving, an estimated 660,000 drivers still do one of these two things every day. Distracted driving (which also includes activities such as eating, conversing with passengers and adjusting the radio) accounted for nearly 400,000 accidents and 3,500 deaths in 2015 alone. In fact, traffic deaths rose 14% in the past two years, the greatest increase in half a century.

Ship believes that she and other physicians have a role to play in the crisis, and not just when these drivers end up in the emergency room. In an essay in The New England Journal of Medicine, she urged her fellow practitioners to use physician visits as a time to talk to patients about their phone use in the car, in the same way they might ask about exercise, smoking or drinking habits.

In her practice, Ship starts by asking patients about seat belt use, then moves on to texting and phone calls. “If they tell me they text, I basically put down my pen and talk about how horrific that is,” she says. “I try to listen and then I share what I understand about the risk.”

For example, one influential study from 2006 found that driving while talking on the phone, whether using a hand-held phone or a hands-free setup, is roughly the equivalent of driving drunk. During a phone call, drivers are slower to apply the brakes and end up in more accidents.

“When you’re driving down the road and talking, you have to multitask,” says Daniel Simons, a professor of psychology at the University of Illinois. But doing many things at once can lead to missing critical information. In one study, Simons and his colleague, Christopher Chabris, found that when people were asked to watch a video and count the number of times a group of people passed a basketball, half of subjects focused so intently on the task that they failed to notice a person walking across the screen in a gorilla suit. Drivers on the phone may similarly miss important things like pedestrians, motorcycles or traffic signals when their attention is divided.

And new kinds of distractions are being built into cars. Some models now boast touch-screen displays the size of small televisions and other Internet-connected features. “It’s not uncommon to see 20 or 30 multi-function buttons on the steering wheel,” says David Strayer, professor of cognition and neuroscience at the University of Utah, who conducted the study that found distracted driving to be like driving drunk.

Strayer started by studying pilots dealing with complex interfaces in the cockpit. He switched to distraction in cars as cell phones became ubiquitous, and he has given several briefings to House and Senate committees about distracted driving.  “We rely on auto manufacturers to decide whether they should enable a feature,” Strayer says. Then, when people see a feature built into their car, they may wrongly assume someone has deemed it to be safe.

Last year, Strayer published a new model that identifies key cognitive processes that are compromised in the distracted driver. He hopes that this research can help guide how new technology gets integrated into automobiles.

“Distraction from technologies at drivers’ fingertips may directly relate to injuries and deaths,” says Strayer. “It’s a public health crisis.”

Ship doesn’t think that physicians alone can head off the problem, but says that they can advocate for more sweeping reforms. Phone manufacturers can limit what phones can do in moving vehicles. Legislators can enact stricter laws, and outreach programs can raise awareness. In one such effort, a message from the American Academy of Orthopaedic Surgeons says, “Orthopaedic surgeons would rather keep your bones strong than put them back together again.”

“I don’t use my phone in my car,” says Ship. “I never have, and that’s lucky, because I think it’s a habit that’s a little like smoking. Once you start, it’s harder to stop.”

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