Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Telephone House Calls - A Thing of the Future?

Category: Child Care


The July/August issue of HEALTH MAGAZINE had an interesting article on telephone house calls. It reported that in 1879, shortly after the telephone was invented, doctors diagnosed many things over the phone. One example was child's barking cough, being typical of croup. Today they recommend more telephone house calls as a way of improving medical care. A study done at Dartmoth Medical School tracked about 500 men who had problems such as high blood pressure, heart disease and diabetes. Half of them visited their doctors frequently. The other half had half as many regular visits but received three phone calls at regular intervals from their physicians between appointments. The half receiving the phone calls averaged $850 less in cost per patient over the two years time. They had about 20% fewer office visits and took about 15% less medication. They spent almost 30 days less in the hospital and over 40% less days in intensive care. Their medical care was about 30% cheaper overall. The reason is theorized to be that the telephone calls uncovered many health problems before they became serious. An example given was a patient who called with shortness of breath and an increase in chest pain, the physician recommended going to the hospital for a minor adjustment in treatment. This could prevent a rip to the intensive care unit at a considerably greater cost a few weeks later. Among the patients polled who received the phone calls, there was a feeling of greater contact with their physicians and an appreciation of not having to spend lots of time traveling and waiting in offices. They felt closer to their physicians and they enjoyed the relationship.

Pediatricians probably answer more phone calls than any other specialty. One of our important jobs is reassuring worried mothers and fathers that the majority of things observed in their children are minor and will resolve. Nevertheless, we do pick up on lots of potentially serious situations and appropriately recommend seeing the child rather than waiting over the night or the weekend. I predict we will see more and more telephone medicine in all specialties, particularly the primary care specialties in coming years. Hopefully, this will make for a better overall medical care in our society and for better doctor/patient relations.