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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Minding Your Mind Minding Your Mind

The Downsides of Multitasking

February 24, 2012

By Michael Craig Miller M.D.

Harvard Medical School

I was multitasking while driving home from work a week or so ago. Stuck in traffic, I looked to my right and saw a woman driving a luxury car, staring down at her lap. It was too dangerous for me to both drive and wag my finger at the same time, so I took a deep breath and concentrated on my driving.

Of course, it is now well known that driving while texting is dangerous. It may even be too dangerous to talk on the phone using an earpiece while you're behind the wheel. Many people take pride in how well they multitask. But they may be overestimating their prowess.

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Multitasking or Rapid Switching?

When you are doing more than one activity at a time, are you paying attention to both simultaneously? Or are you actually trying to rapidly switch back and forth? Be honest.

For many if not most people, what they mean by multitasking is rapidly switching their attention back and forth.

For example, when people are texting while driving, they are looking at the road, at their phone, glancing back up at the road, back to the phone, and so on. But they have to be lucky. And I'm not talking about being caught by a vigilant police officer.

If road conditions change rapidly (and they often do), it can lead to a fender bender or worse. I personally know of at least one death that resulted from texting while driving. And in 2009, a trolley crashed in my neighborhood, apparently because the driver was texting with his girlfriend.

Most people, fortunately, survive their multitasking. But in daily life, multitasking may jeopardize life in another more persistent way: It interferes with learning and working. It may also get in the way of having fun.

Multitasking increases the chances of making mistakes and missing important information and cues. Multitaskers are also likely to do less well when it comes to absorbing new information that the brain has to retrieve later.

In fact, neuroscientists at the University of California San Francisco and elsewhere have shown that multitasking negatively affects "working memory." Working memory is that part of memory where you actively use information — information you have just learned or that you have retrieved from long-term memory. Working memory is needed for problem solving or for the complex mental processes that are active when we are being creative. Multitasking interferes with these important functions and the interference has the greatest impact in older adults.

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When A Doctor Multitasks

What may be less well known is that doctors may also be putting their patients at risk because of multitasking.

Dr. John Halamka is the Chief Information Officer at Harvard Medical School and at Beth Israel Deaconess Medical Center — and one of the leaders in the field of computers in medicine. He recently authored a case report for the Agency for Healthcare Research and Quality. He described what happened to a 56-year-old man with dementia who was admitted to the hospital to have a feeding tube put in his stomach.

One of the man's doctors had increased the dose of blood-thinning medicine the man was taking. (Blood thinners are drugs used to reduce the risk that a clot will develop in the bloodstream.) The next day, the doctor, who was not convinced the patient needed the blood thinner, asked a resident (junior doctor) to temporarily stop the order for the medicine.

Using her handheld computer, the resident began to make the change via a computerized order entry system. Part way through, she received a text from a friend. She responded to the text, but then forgot to go back and complete the order. As a result, the man was kept on that blood thinner. His blood became so "thin" that, two days later, it was discovered he had bled into the sac around his heart. As a result, his heart couldn't pump properly. He needed surgery to drain the blood.

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Give a Task Your Undivided Attention

A solution to the problem is to pay attention to how you're paying attention.

If you are watching television while browsing the Internet, you might decide that neither activity is important enough to demand your full attention. But if at least one of the activities is significant to you, don't give it short shrift.

By being fully engaged with the pursuit, you may experience a number of positive effects, such as more pleasure, faster learning or greater productivity. Maybe even all three.

Here's something else you should know: The brain does multitask. But not in the way the word is commonly used. Much, if not most, of the brain's multitasking goes on without your knowing. Many of the activities of life are automatic — even when driving a car, we don't have to consciously think about the movement of our hands on the steering wheel or our foot on the gas pedal. And one part of the learning process — the brain's consolidation of memories or of physical skills (like playing an instrument or skiing) — often occurs out of consciousness, even while asleep.

But attention as a function of the brain probably works better when it is not divided. And paying close attention to what you are learning, while actively reading or practicing the violin, pays off later with consolidation behind the scenes.

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It's Time to Focus

Strangely, drivers and doctors both hold life in their hands. Thus, they need their hands free.

Yes, doctors, nurses and other health care professionals are busy folks. It's understandable that they resort to multitasking. But some multitasking — as in the case Dr. Halamka described — increases risk. Dr. Halamka, who has helped pioneer the use of electronic medical records and doctors' use of handheld devices, writes that hospitals and other health care settings need to help doctors cope with the distractions that come with the use of new technologies.

We can all help, too. No one responds very well to scolding. But when the person driving your car is tempted to send a text message, you can say, "Please just drive." And if your doctor is glancing down at the mobile phone instead of interacting with you, you can speak and up and ask him or her to do just one thing — be your doctor.

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Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

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