More on Cellphones in Hospitals and How Doctors Deal with Evidence

 
Last Friday I mentioned a study done at the Mayo Clinic where they looked at the practice of banning cellphone use in hospitals [Cell Phones Can Cause Death in Hospitals]. The study concluded that there is no scientific evidence to support such a ban. Cellphones and BlackBerry's do not interfere with hospital equipment, according to the study.

Tuesday's Globe and Mail had a skeptical front page article on banning cellphones in hospitals [Hole Poked in Hospital Cellphone Shroud].

Cellphone use does not interfere with medical equipment and should be allowed in hospitals, according to a study that turns years of warnings on its head.

The study comes amid a sharp debate within the medical profession, with some institutions beginning to loosen their rules while others stick to the view that the devices can be dangerous to patients.

Among the people interviewed was Chris O'Conner at Mississauga Trillium Health Centre. This large teaching hospital is part of the University of Toronto Medical School. It's my local hospital and I've been there many times, both as a patient and a visitor.

Trillium lifted their ban on cellphones two years ago. Not only that, the staff is encouraged to communicate with each other using BlackBerrys and other devices. According to O'Conner, this has not only improved efficiency but also enhanced patient safety by avoiding communications lapses.

So, why are cellphones banned at other hospitals? Is this a problem? I don't know whether you could say the ban is a serious "problem," but it sure is an inconvenience. For parents sitting in an emergency waiting room for 6 hours it is frustrating to have to rely on a pay phone to keep others informed of what's happening. For those of us who are picking up someone from a hospital, it is annoying to not know when a patient is about to be discharged. (We recently had to pick up a patient from a large downtown teaching hospital. Fortunately they don't ban cellphones so we were able to keep in touch with the patient and find out when he was going to be released.) For patients in a hospital bed it is sad that they can't use their cellphones to talk to friends and relatives.

These concerns are real enough but my main interest is the conflict between rationalism and superstition. The Globe and Mail also interviewed spokeswoman Brandy Delves from a major Vancouver hospital.

A spokeswoman for Vancouver Coastal Health said last night that cellphones and other handheld communication devices continue to be banned near sensitive equipment there, including ventilators and incubators.

While a few hospitals have begun to buck the trend, conventional wisdom supports the VCH's view that these devices could interfere with crucial equipment.

Typical of this concern were warnings from the U.S. Federal Communications Commission that electromagnetic waves from cellphones could shut down electronic devices in hospitals.

These fears were firmly enough entrenched to have made their way into popular legend.

According to an e-mail that made the rounds in 2003, a young girl died during a routine operation because "some idiot" used a cellphone near the operating theatre.

"Be compassionate," this e-mail went on to urge. "Do not use your hand phone at any hospital or places where you are told not to use it. You might not be caught in the act, but you might have killed someone without knowing it."

That message was later debunked by snopes.com (an Internet site about urban legends), and, according to a study released by the Mayo Clinic, the fears it addresses are groundless.

The article goes on to note some of the findings of the Mayo Clinic study then returns to a comment from the Vancouver Hospital.

But the policy-makers at VCH are not convinced. Spokeswoman Brandy Delves said the hospital has had the same policy since 1996, banning cellphones and other hand-held communication devices in key areas. "We have reviewed all the recent literature and have decided to keep our current policy," she said last night.

This is interesting. It's very hard to prove a negative so one can't expect absolute "proof" that cellphones are harmless in a hospital setting. Once the idea of possible danger has been planted it always seems better to be safe than sorry. Nevertheless, all of the so-called evidence of danger has been refuted and there are hospitals that have lifted the ban. Those hospitals do not seem to be losing patients due to unexpected equipment failures. In light of data like this why would "policy-makers," many of whom are doctors, not make a rational decision to lift the ban?

What is it about our psychology that causes some people to reject scientific/rational evidence when it conflicts with their superstitions? Even people who are trained in "evidence-based" medicine seem to be incapable of applying the methodology in real life.