Commentary: Dealing with teen patients that are plugged in and tuned out

June 1, 2008

Have you ever met anybody who is plugged in and tuned out? How about the acne patient who is listening to an ipod when you enter the room and continues to listen despite your greeting? How about the acne patient and their parent who are both listening to their own separate ipods and continuing to listen despite your greeting? What should you do?

Key Points

Your options include:

1. Speak louder so they hear you over their head-banging music.

3. Use your suture removal scissors to cut the wires from the iPod to the earplug speakers.

4. Leave the room, go on to another patient, and then return at a later time when they are bored with listening.

5. Take your own iPod out of your white coat, put in your earplug speakers, and enjoy listening with them.

The new plugged-in and tuned-out generation is quite a phenomenon. I worry about children who seem incapable of sitting still without some audio or video entertainment.

It is considered normal for a preschool child to have an attention span of three minutes or less, rapidly moving in a random fashion from activity to activity. This ability to focus should increase with advancing age, so that by the time a child has the hormonal activity to develop inflammatory acne, the attention span should have increased to at least 15 minutes.

I do not think it is unreasonable for an acne patient to discontinue musical entertainment to listen to instructions for the use of oral and topical medications.

Aside from the fact that iPod use creates a distraction during the office visit, I wonder if the need for chronic stimulation inhibits development of the imagination.

I must say that, more than anything else, I value my ability to sit at a boring meeting, listening to a senseless, egotistical speaker, while imagining that I am sitting atop a nebula, watching a black hole engulf matter at a feverish rate.

A vivid imagination eliminates boredom, and the batteries never need replacing. Parents who continually allow their children to plug in and tune out may be preventing the neural development required for original creativity.

There can be no doubt that the ability to listen to high-quality portable music anywhere is marvelous. The electronic entertainment age offers hours of enjoyment. However, use of an iPod to avoid interpersonal interaction is a shame.

The ability to carry on an extended conversation is one of the unique features of humanity - but then so is the capability to plug in and tune out.