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Physician attitudes regarding telephone medicine

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Abstract

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.

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References

  1. Robert Wood Johnson Foundation. Medical Practice in the United States. Princeton, NJ: Robert Wood Johnson Foundation; 1981.

    Google Scholar 

  2. Radecki S, Neville R, Girard R. Telephone patient management by primary care physicians. Med Care. 1989;27(8):817–22.

    Article  PubMed  CAS  Google Scholar 

  3. Johnson B, Johnson C. Telephone medicine: a general internal medicine experience. J Gen Intern Med. 1990;5:234–9.

    PubMed  CAS  Google Scholar 

  4. Greenlick M, Freeborn D, Gambill G, Pope C. Determinants of medical care utilization: the role of the telephone in total medical care. Med Care. 1973;11(2):121–34.

    Article  PubMed  CAS  Google Scholar 

  5. Bertera E, Bertera R. The cost-effectiveness of telephone vs clinic counseling for hypertensive patients. Am J Public Health. 1981;71:626–9.

    Article  PubMed  CAS  Google Scholar 

  6. Infante-Rivard C, Krieger M, Petitclerc M, Baumgarten M. A telephone support service to reduce medical care use among the elderly. J Am Geriatr Soc. 1988;36(4):306–11.

    PubMed  CAS  Google Scholar 

  7. Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch G. Telephone care as a substitute for routine clinic follow-up. JAMA. 1992;267:1788–93.

    Article  PubMed  CAS  Google Scholar 

  8. Evens S, Curtis P, Talbot A, Baer C, Smart A. Characteristics and perceptions of after-hours callers. Fam Pract. 1985;2:10–16.

    Article  PubMed  CAS  Google Scholar 

  9. Darnell J, Hiner S, Neill P, et al. After-hours telephone access to physicians with access to computerized medical records. Med Care. 1985;23:20–6.

    Article  PubMed  CAS  Google Scholar 

  10. Fosarelli P, Schmitt B. Telephone dissatisfaction in pediatric practice: Denver and Baltimore. Pediatrics. 1987;80(1):28–31.

    PubMed  CAS  Google Scholar 

  11. Fosarelli P, Katz H. Residents on the phone. Pediatrics. 1987;79(2:311–2.

    PubMed  CAS  Google Scholar 

  12. Hannis M, Elnicki M, Morris D, Flannery M, and the TELI Group. Can you hold please? How internal medicine residents deal with patient telephone calls. Am J Med Sci. 1994;308(6):349–52.

    Article  PubMed  CAS  Google Scholar 

  13. Fleming M, Skochelak S, Curtis P, Evens S. Evaluating the effectiveness of a telephone medicine curriculum. Med Care. 1988;26(2):211–6.

    Article  PubMed  CAS  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 

  15. Perrin E, Goodman H. Telephone management of acute pediatric illness. N Engl J Med. 1978;298:130–5.

    Article  PubMed  CAS  Google Scholar 

  16. Curtis P. The practice of medicine on the telephone. J Gen Intern Med. 1988;3:294–5.

    Article  PubMed  CAS  Google Scholar 

  17. Wood P. Pediatric resident training in telephone management: a survey of training programs in the United States. Pediatrics. 1986;77(6):822–5.

    PubMed  CAS  Google Scholar 

  18. Curtis P, Talbot A, Liebeseller V. The after-hours call: a survey of United States family practice residency programs. J Fam Pract. 1979;8(1):117–22.

    PubMed  CAS  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 

  25. Freeman T. A study of telephone prescriptions in family practice. J Fam Pract. 1980;10:857–62.

    PubMed  CAS  Google Scholar 

  26. Spencer D, Daugird A. The nature and content of telephone prescribing habits in a community practice. Fam Med. 1990;22:205–9.

    PubMed  CAS  Google Scholar 

  27. Hamadeh G. Documentation of after-hours telephone contacts by family medicine residents. Fam Med. 1989;21:305–6.

    PubMed  CAS  Google Scholar 

  28. Verdile V, Paris P, Stewart R, Verdile L. Emergency department telephone advice. Ann Emerg Med. 1989;18(3):278–82.

    Article  PubMed  CAS  Google Scholar 

  29. Katz H, Wick W. Malpractice, meningitis, and the telephone. Pediatr Ann. 1991;20(2):85–9.

    PubMed  CAS  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.

    Article  Google Scholar 

  32. Minnesota Medical Association. Prescribing issues grant report to the board of medical examiners. Minn Med. 1990;73:36–42.

    Google Scholar 

  33. Greenhouse D, Probst J. After-hours calls in a family practice residency: volume, seriousness and patient satisfaction, Fam Med. 1995;27:525–30.

    PubMed  CAS  Google Scholar 

  34. Wood P, Littlefield J, Foulds D. Telephone management curriculum for pediatric interns: a controlled trial. Pediatrics. 1989;83:925–30.

    PubMed  CAS  Google Scholar 

  35. Marklund B, Silfverhielm B, Bengtsson C. Evaluation of an educational programme for telephone advisers in primary health care. Fam Pract. 1989;6(4):263–7.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. East Carolina University School of Medicine, Room 389TA, PCMH, 27858-4354, Greenville, NC

    Mark D. Hannis MD

Authors
  1. Mark D. Hannis MD
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  2. Ruth L Hazard MD
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  3. Marylee Rothschild MD
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  4. D. Michael Elnicki MD
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  5. Thomas C. Keyserling MD, MPH
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  6. Robert F. DeVellis PhD
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the TELI Group

Additional information

Received from the University of North Carolina, Chapel Hill

Supported by grants from the General Internal Medicine Faculty Development Program at the University of North Carolina, Chapel Hill (PE54004, HRSA Bureau of Health Professions, Rockvtile, Md.), the Alliant Community Trust Fund Grant at Alliant Hospital, Louisville, Ky., the East Carolina University School of Medicine Research Trust Fund, Greenville, NC, the Moses H. Cone Memorial Hospital, Greensboro, NC, the Scott and White Brindley Foundation, Temple, Tex., and the Dean’s Office of the School of Medicine at Virginia Commonwealth University, Richmond.

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Hannis, M.D., Hazard, R.L., Rothschild, M. et al. Physician attitudes regarding telephone medicine. J Gen Intern Med 11, 678–683 (1996). https://doi.org/10.1007/BF02600159

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