Physician attitudes regarding telephone medicine
OBJECTIVE: To measure physicians’ attitudes regarding telephone medicine and identify determinants of these attitudes.
DESIGN: Cross-sectional survey.
SETTING: Ten internal medicine residency programs in the United States.
PARTICIPANTS: Graduates from 1988 through 1992. The response rate was 62% (n=356).
MEASUREMENTS AND MAIN RESULTS: Survey items were assigned to one of four types of variables: demographic, attitude, training, or system variables. We used factor analysis to consolidate information from the individual questions about attitudes. Six scales describing attitudes toward telephone medicine were identified. Cronbach’s α was greater than 0.70 for all scales. One scale measured physicians’ satisfaction and confidence with the management of patient calls. Other attitude scales measured the helpfulness of personal experience or informal education and the importance of formal training in telephone medicine. Three of the scales measured how comfortable the physician felt prescribing over the telephone. We used regression analysis to predict physician attitudes towards telephone medicine using the demographic, training, and system variables. Availability of the patient’s chart, feeling prepared for telephone medicine by one’s residency training, and being comfortable prescribing narcotics by telephone predicted satisfaction and confidence with the management of patient calls (R2=.25).
CONCLUSIONS: Several physician attitudes regarding telephone medicine can be measured reliably. Our findings suggest that improving systems for managing patient calls and improving telephone training for physicians will improve physician satisfaction and confidence with the practice of telephone medicine.
Key wordsphysician attitudes telephone medical education survey scales
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- 1.Robert Wood Johnson Foundation. Medical Practice in the United States. Princeton, NJ: Robert Wood Johnson Foundation; 1981.Google Scholar
- 14.Huber E, George D, and the TELI Group. Are internal medicine graduates prepared for telephone practice? J Gen Intern Med. 1994;9(suppl 2):77.Google Scholar
- 19.SAS Institute. The PRINCOMP and VARIMAX procedures. In: SAS/STAT User’s Guide, Version 6.03. Cary, NC: SAS Institute; 1988;751–72.Google Scholar
- 20.SAS Institute. Standard least squares model fitting and stepwise regression. In: JMP Statistics and Graphics Guide, Version 3. Cary, NC: SAS Institute; 1994;137–71, 197-231.Google Scholar
- 21.DeVellis R. Guidelines in scale development. In: Scale Development: Theory and Applications. Newbury Park, Calif: Sage Publications; 1991;51–90.Google Scholar
- 22.Elnicki M, Hannis M, Flannery M, and the TELI Group. The inadequate preparation of residents for telephone interactions with ambulatory patients. J Gen Intern Med. 1994;9(suppl 2):74.Google Scholar
- 23.Cykert S, Elnicki D, Flannery M, and the TELI Group. Factors affecting residents’ attitudes toward patient telephone encounters. J Gen Intern Med. 1994;9(suppl 2):73.Google Scholar
- 24.Madlon-Kay D. Institution of a “no narcotics” policy for after-hours telephone calls. J Fam Pract. 1991;32(6):92–4.Google Scholar
- 30.Killilia B. Undocumented phone calls: a liability issue. Indiana Med. 1990;83(10):768–9.Google Scholar
- 31.Elnicki M, Hannis M, Cykert S, Flannery M, Morris K, Keyserling T, Devellis R, and the TELI Group. The use of factorially derived scales to assess issues affecting residents’ attitudes about telephone medicine for ambulatory patients. Teaching and Learning in Medicine. 1996;8(3):142–7.CrossRefGoogle Scholar
- 32.Minnesota Medical Association. Prescribing issues grant report to the board of medical examiners. Minn Med. 1990;73:36–42.Google Scholar