Can You Hold Please? How Internal Medicine Residents Deal With Patient Telephone Calls

Outcomes of telephone medical care

“…The absence of a formal training curriculum in telephone management is not unique to this residency training program, 16 and the TELI group and other investigators have shown that the effective introduction of a telephone management training program is feasible and desirable. [17][18][19][20][21][22][23] The focus of this study was telephone calls made by patients to the covering practice physician, not to the patients' primary physician. Physician recommendations, patient relief, satisfaction, and outcomes may be different if the physician has a long-term relationship with the patient to whom they are giving medical advice over the telephone.…”

Telephone medicine for internists

“…Residents have reported spending an average of 4 hours weekly doing telephone medicine, which is about equal to the amount of time that they spent in ambulatory clinic. 37 However, residents expressed difficulty in dealing with patient calls. They lacked confidence in their abilities and felt that many of their patient calls were inappropriate.…”

“…38 In addition, residents' telephone interactions often went undocumented. 37 Despite these problems, they felt that telephone patient contacts were a rewarding part of their practices. In a multifactorial analysis, the factors related to comfort and satisfaction with telephone practice were chart availability (both as a reference and for documentation), receiving performance feedback, and having consultants available.…”

Preventing communication errors in telephone medicine

“…In almost one third of telephone encounters, physicians and patients see the reason for the call differently, 2 with patients viewing a higher number of their calls as ''true emergencies'' than physicians. 3,4 Communication errors in telephone medicine can result in adverse outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. In 1 study using simulated patients, less than one half of resident and attending pediatricians took an adequate history, and more than one third made inappropriate management decisions.…”

“…Telephone communication—the primary mode of communication between physicians and patients outside of the office visit—is rife with potential errors. These errors stem from both the inherent challenges of telephone communication and from the frequent disconnect between physicians and patients 2–4 because of a lack of visual cues, technical difficulties, and cross‐coverage. In almost one third of telephone encounters, physicians and patients see the reason for the call differently, 2 with patients viewing a higher number of their calls as “true emergencies” than physicians 3,4 …”