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ARTICLE |

Compensating Physicians for Telephone Calls FREE

Paul Clay Sorum, MD, PhD; Martin A. Strosberg, MPH, PhD
[+] Author Affiliations

Reprint requests to Albany Medical College, A-130, Albany, NY 12208 (Dr Sorum).


JAMA. 1994;272(24):1949-1950. doi:10.1001/jama.1994.03520240077045
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PHYSICIANS should be compensated for the time they spend talking with patients by telephone.

Probable Benefits  The telephone is very useful for patients. They can speak to the office nurse or the physician and do so frequently. From 1976 through 1978, a large percentage of patient-physician encounters were by telephone: 19% of general practitioner encounters, 18% of family practitioner encounters, 28% of pediatrician encounters, 23% of general internist encounters, 20% of obstetrician/gynecologist encounters, and 12% of general surgeon encounters.1 Moreover, information and advice obtained by telephone are usually free.Use of the telephone also benefits third-party payers. Contact with the nurse or physician can prevent visits to the emergency department or the physician's office. For example, the majority of after-hours callers to one family practice clinic reported that they would have gone straight to the emergency department if they had not been able to call.2 The results are

REFERENCES

Mendenhall RC. Medical Practice in the United States: A Special Report of the Robert Wood Johnson Foundation . Princeton, NJ: Robert Wood Johnson Foundation; 1981;.
Evens S, Curtis P, Talbot A, Baer C, Smart A.  Characteristics and perceptions of after-hours callers. Fam Pract . 1985;;2:10-16.
Bertera EM, Bertera RL.  The cost-effectiveness of telephone vs clinic counseling for hypertensive patients: a pilot study. Am J Public Health . 1981;;71:626-629.
Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG.  Telephone care as a substitute for routine clinic follow-up. JAMA . 1992;;267:1788-1793.
Eden J.  Benefit design in health care system reform: patient cost sharing. JAMA . 1994;;272:12.
Yanovski SZ, Yanovski JA, Malley JD, Brown RL, Balaban DJ.  Telephone triage by primary care physicians. Pediatrics . 1992;;89:701-706.
Krasnik A, Groenewegen PP, Pedersen PA, et al.  Changing remuneration systems: effects on activity in general practice. BMJ . 1990;;300:1698-1701.
Braithwaite SS, Unferth NO.  Phone fees: a justification of physician charges. J Clin Ethics . 1993;;4:219-224.
Emmons DW, Simon CJ.  Recent trends in managed care.  In: Gonzalez ML, ed. Socioeconomic Characteristics of Medical Practice 1994 . Chicago, Ill: American Medical Association; 1994;:25-31.
Inglehart JK.  The struggle between managed care and fee-for-service practice. N Engl J Med . 1994;;331:63-67.

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Mendenhall RC. Medical Practice in the United States: A Special Report of the Robert Wood Johnson Foundation . Princeton, NJ: Robert Wood Johnson Foundation; 1981;.
Evens S, Curtis P, Talbot A, Baer C, Smart A.  Characteristics and perceptions of after-hours callers. Fam Pract . 1985;;2:10-16.
Bertera EM, Bertera RL.  The cost-effectiveness of telephone vs clinic counseling for hypertensive patients: a pilot study. Am J Public Health . 1981;;71:626-629.
Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG.  Telephone care as a substitute for routine clinic follow-up. JAMA . 1992;;267:1788-1793.
Eden J.  Benefit design in health care system reform: patient cost sharing. JAMA . 1994;;272:12.
Yanovski SZ, Yanovski JA, Malley JD, Brown RL, Balaban DJ.  Telephone triage by primary care physicians. Pediatrics . 1992;;89:701-706.
Krasnik A, Groenewegen PP, Pedersen PA, et al.  Changing remuneration systems: effects on activity in general practice. BMJ . 1990;;300:1698-1701.
Braithwaite SS, Unferth NO.  Phone fees: a justification of physician charges. J Clin Ethics . 1993;;4:219-224.
Emmons DW, Simon CJ.  Recent trends in managed care.  In: Gonzalez ML, ed. Socioeconomic Characteristics of Medical Practice 1994 . Chicago, Ill: American Medical Association; 1994;:25-31.
Inglehart JK.  The struggle between managed care and fee-for-service practice. N Engl J Med . 1994;;331:63-67.
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