Journal of Community Health

, Volume 6, Issue 3, pp 194–203

The telephone in primary care

  • Peter Curtis
  • Addison Talbot
Review

Abstract

This paper presents a review of the use of the telephone in primary care medicine. The telephone is available to a large majority of United States citizens, a situation that is unusual in other countries. Between 15 and 20% of all primary medical contacts in the United States occur on the telephone. Approximately 40% of routine office telephone contacts are administrative in nature, the remainder involving direct requests for advice or treatment. After office hours, requests for immediate medical advice constitute almost all of the calls (for both daytime and after hours calls). Close to 70% of the medical calls are managed solely by use of telephone.

Although the telephone is effectively used for medical consultation, teaching and survey purposes, it has been shown that health professionals are often ineffective when providing medical care over the telephone. The use of protocols or specific training tends to improve performance, but such programs are not a regular part of medical education.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aronson SH: The Lancet on the telephone 1876–1975.Med Hist 21 60–87, 1977.Google Scholar
  2. 2.
    United Nations Statistical Yearbook 1976. Communications—Telephones168: 620–623.Google Scholar
  3. 3.
    Lucas WA, Adams WC:An Assessment of Telephone Survey Methods. R-2153-NSF. Santa Monica, California, Rand, October 1977.Google Scholar
  4. 4.
    Department of Health, Education, and Welfare. Volume of Physician Visits, 1966, 1967, 1969, and 1971. Public Health Service Publication No 49, 75 Series 10. Washington, DC, Government Printing Office.Google Scholar
  5. 5.
    Greenlick MR, Freeborn DK, Gambill GL et al: Determinants of medical care utilization—The role of the telephone in total medical care.Med Care 11 121–134, 1973.Google Scholar
  6. 6.
    Murphy D, Dineen E: Nursing by telephone.Am J Nurs 75 1137–1139, 1976.Google Scholar
  7. 7.
    Hessel SJ, Haggerty RJ: A study of practice in the mid-60's.J Pediatr 73 271–279, 1968.Google Scholar
  8. 8.
    Bergman AB, Dassel SW, Wedgewood RJ: Time-motion study of practicing pediatricians.Pediatrics 38 254–263, 1966.Google Scholar
  9. 9.
    Strain JE, Miller JD: The preparation, utilization, and evaluation of a registered nurse trained to give telephone advice in a private pediatric office.Pediatrics 47 1051–1055, 1971.Google Scholar
  10. 10.
    Wolfe S, Badgley RF, Kasins, RV, et al: The work of a group of doctors in Saskatchewan.Milbank Mem Fund Q 46 103, 1968.Google Scholar
  11. 11.
    Westbury RD: The electric speaking practice. A telephone workload study.Can Fam Physician 20 69–76, 1974.Google Scholar
  12. 12.
    Steele R, Kraus AS, Smith PM: Doctor-patient contacts in family practice—An exploratory study.Can Fam Physician 14 45–55, 1968.Google Scholar
  13. 13.
    Mcfarlane AH, O'Connell BP: Morbidity in family practice.Can Med Assoc J 101 259–263, 1969.Google Scholar
  14. 14.
    Mendenhall RC, Lloyd JS, Repicky PA, et al: A national study of medical and surgical specialities. Description of the survey instrument.JAMA 240 1160–1168, 1978.Google Scholar
  15. 15.
    Katz HD, Pozen J, Mushlin AJ: Quality assessment of a telephone care system utilizing non-physician personnel.Am J Public Health 68 31–36, 1978.Google Scholar
  16. 16.
    Hercules C, Charney E: Availability and attentiveness. Are these compatible in pediatric practice?Clin Pediatr 8 381–388, 1969.Google Scholar
  17. 17.
    Sturtz GS, Brown RB: Concerning A.G. Bell's invention.Clin Pediatr 8 378–380, 1969.Google Scholar
  18. 18.
    Curtis P, Talbot A, Liebeseller V, et al: The after hours call—An American study.Can Fam Physician 25 283–292, 1979.Google Scholar
  19. 19.
    National Center for Health Statistics. 1977 Summary. Advanced Data from Vital and Health Statistics No. 48, DHEW Publication No. 79-1250. Hyattsville, Md, Public Health Service, 1979.Google Scholar
  20. 20.
    Pope CR, Yoshioka SS, Greenlick MR: Determinants of medical care utilization—The use of the telephone for reporting symptoms.J Health Soc Behav 12155–162, 1971.Google Scholar
  21. 21.
    Weiss JE, Greenlick MR: Determinants of medical care utilization: The effect of social class and distance on contacts with the medical care system.Med Care 8 456–462, 1970.Google Scholar
  22. 22.
    Fischer PM, Smith SR: The nature and management of telephone utilization in a family practice setting.J Fam Pract 8 321–327, 1979.Google Scholar
  23. 23.
    Curtis P, Talbot A: The after hours call in family practice.J Fam Pract 9 901–909, 1979.Google Scholar
  24. 24.
    Hogg W: The doctor after hours. (unpublished report) Gatineau Memorial Hospital, Wakefield, Quebec, 1976.Google Scholar
  25. 25.
    Rosenblatt RA: On-call in a family residency: Implications for patient care and residency training.J Fam Pract 6 327–331, 1978.Google Scholar
  26. 26.
    Murray TS, Barber JH: The workload of a commercial deputizing service.J R Coll Gen Pract 27 209–211, 1977.Google Scholar
  27. 27.
    Hall DW: The off-duty arrangements of general practitioners in four European countries.J R Coll Gen Pract 26 19–34, 1976.Google Scholar
  28. 28.
    Strasser PH, Levy JC, Lamb GA, et al: Controlled clinical trial of pediatric telephone protocols.Pediatrics 64 553–557, 1979.Google Scholar
  29. 29.
    Perrin EC, Goodman HC: Telephone management of acute pediatric illnesses.N Engl J Med 298 130–135, 1978.Google Scholar
  30. 30.
    Gorrell RL: Taming the terrible telephone.Physician's Management 18 40–44, 1978.Google Scholar
  31. 31.
    A physician's most abused instrument.Malpractice Digest 3: Sept/Oct 1979.Google Scholar
  32. 32.
    Birdwhistell R: The language of the body. The natural environment of words. In A Silverstein (ed):Human Communications. New York, John Wiley and Sons, 1974. Pp 203–320.Google Scholar
  33. 33.
    Grumet GW: Telephone therapy: Review and case report.Am J Orthopsychiatry 49 574–584, 1979.Google Scholar
  34. 34.
    Kravitz H, Korach A, Murphy JB, et al: The telephone in the diagnosis of respiratory disease.Am J Dis Child 106:83–84, 1963.Google Scholar
  35. 35.
    Nickerson HJ, Biechler L, Witte F: How dependable is diagnosis and management of earache by telephone?Clin Pediatr 14 920–924, 1975.Google Scholar
  36. 36.
    Miller WB: The telephone in outpatient psychotherapy.Am J Psychother 27 15–26, 1973.Google Scholar
  37. 37.
    Greene MS: Ring-A-Day: A telephone reassurance service.Health Soc Work 1 177–181, 1976.Google Scholar
  38. 38.
    Wang MK, Kirkham FT: Use of the telephone in a health maintenance service for the chronically ill. A preliminary report.J Chronic Dis 24 489–494, 1971.Google Scholar
  39. 39.
    Mapes RW, Lewis EW, Jr, Corell DA, et al: Feasibility study of a pediatric telephone consultation service.Pediatrics 50 307–311, 1972.Google Scholar
  40. 40.
    Bartlett MH, Johnston A, Meyer TC: Dial access library-patient information service.N Engl J Med 288 994–998, 1973.Google Scholar
  41. 41.
    Cooper SS: Teaching by telephone.Nurse Education 4 10–13, 1979.Google Scholar
  42. 42.
    Greitzer L, Stapleton FB, Wright L, et al: Telephone assessment of illness by practicing pediatricians.J Pediatr 88 880–882, 1976.Google Scholar
  43. 43.
    Ott JE, Bellaire J, Machotka P, et al: Patient management by telephone by child health associates and pediatric house officers.J Med Educ 49 596–600, 1974.Google Scholar
  44. 44.
    Brown SB, Eberle BJ: Use of the telephone by pediatric house staff: A technique for pediatric care not taught.J Pediatr 84 117–119, 1974.Google Scholar
  45. 45.
    Smith SR, Fischer PM: Patient management by telephone: A training exercise for medical students.J Fam Pract 10 463–466, 1980.Google Scholar
  46. 46.
    Curtis P., Talbot A: After hours call: An aspect of primary care education.J Med Educ 5555–57, 1979Google Scholar
  47. 47.
    Committee on standards of child health care.American Academy of Pediatrics 2 45–54, 1972.Google Scholar
  48. 48.
    Curry TA, Schwartz MW: Telephone assessment of illness: What is being taught and learned.Pediatrics 62 603–605, 1978.Google Scholar
  49. 49.
    Bashshur R, Lovett J: Assessment of Telemedicine: Results of the initial experience.Aviat Space, Environ Med 48 65–70, 1977.Google Scholar
  50. 50.
    Moore GT, Willeman TR, Bonnano R, et al: Comparison of television and telephone for remote medical consultation.N Engl J Med 292 729–732, 1975.Google Scholar
  51. 51.
    Conrath DW, Dunn EV, Bloor WG, et al: A clinical evaluation of four alternative telemedicine systems.Behav Sci 22 12–21, 1977.Google Scholar
  52. 52.
    Colombotos J: Personal versus telephone interviews. Effect on responses.Public Health Rep 84 773–778, 1979.Google Scholar
  53. 53.
    Pless IB, Miller JR: Apparent validity of alternative survey methods.J Community Health 5 22–27, 1979.Google Scholar
  54. 54.
    The legal problem of the telephone. Emergency physician legal bulletin Vol 1, 2. Med-law Publishers, Inc, Box 293, Westville New Jersey 08093.Google Scholar
  55. 55.
    The telephone in general practice, editorial.Br Med J 2: 1106, 1978.Google Scholar
  56. 56.
    Copeland D: Why (and how) I charge for telephone advice.Med Econ 56 77–79, 1979.Google Scholar

Copyright information

© Human Sciences Press 1981

Authors and Affiliations

  • Peter Curtis
  • Addison Talbot

There are no affiliations available

Personalised recommendations