Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Attention please 


To connect more meaningfully, clinicians need to be more interesting than a young person’s phone. Finding creative ways to engage these patients will improve the relationship. 

A few of my teenage patients pull out their phones as they sit down for a visit, and mechanically respond to my questions about their mood, sleep, medication side effects, and possible thoughts of suicide, all while staring at their screen. Most patients though, fully engage. They look me in the eyes, listen carefully, and share their experiences, like we used to do before cell phones became part of everyone’s apparel. This basic interaction makes our jobs special and helps us trust our own doctors when they look at us instead of a computer screen.   


We’ve all been with friends who, during a short pause in our conversation, start texting. It’s hard to keep people’s attention these days. Sometimes it’s only one text, and others, an entire conversation with someone else. You’re left trying to figure out what’s the appropriate thing to do when you’re with company, but alone. We’ve also seen content online, posted without permission, of video- or voice-recordings of people’s interactions.  


Of course, no one is physically harmed in these instances and we all should be able to handle some divided attention from others. But is it ideal? Ideal or not, paying more attention to your phone than to the people around you is so common that in 2012, an advertising agency coined the term phubbing, a neologism created out of “phone” and “snubbing,” to describe this behavior. Most research on the topic focuses on the addictive aspects of smartphone use, its associations with low self-esteem, and the communication aspects of phubbing. Some studies investigate how phubbing decreases the quality of interpersonal interactions, for example, showing conversations to be less empathic when a phone is on the table.  


A significant number of studies are on parents phubbing their children, a concerning behavior in itself, but also because of what it teaches them. A problem with phubbing is that it creates more phubbers, and it becomes normalized. Google is filled with images of young people sitting in group circles, each looking at their own phone. The pictures reflect a reality. 


Given the addictive potential of smartphone use, advice on how to use it in the presence of others can go a long way. Just like we tell new and seasoned drivers to not drink and drive, we can adopt this simple message: “Don’t meet and text.” Having phone-free zones, silencing phones when socializing, and setting up goals for healthy and polite phone use may be helpful. One can also choose to call out the behavior, which I’ve done with my own patients. I tell them for how long I’m going to need their full attention, without distractions, and having an end in sight is usually enough for them to put the phone away. 


It takes effort to ignore a text and postpone responding to it. Awareness is the first step to change habits.  


Finally, here’s a great guide on how to stop phubbing to share with patients, family, friends, and colleagues.  












This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.