Telephone consultations in general practice: an additional or alternative service?

Abstract

BACKGROUND: There is conflicting evidence about whether telephone consultations in general practice represent additional or alternative contacts with the general practitioner. AIM: A study set out to assess the characteristics of patients using the telephone to consult the general practitioner and whether telephone consultations were used as an additional or an alternative service to surgery consultations during surgery hours. METHOD: The study took place in one practice that has run a 'phone-in clinic' for five years. A questionnaire on perceptions of and attitudes towards telephone consultations was sent to 259 patients who consulted the general practitioner by telephone and to an age-sex matched group of patients whose medical records indicated that they had never consulted the general practitioner by telephone. For both groups, numbers of repeat prescriptions and consultations in the preceding year were determined from medical records. RESULTS: Those who consulted the doctor by telephone were significantly more likely to be aware of the phone-in clinic, to have a telephone at home, to have children aged under five years at home and to be receiving repeat prescriptions and repeat prescriptions for psychotropic drugs compared with those who had never consulted by telephone. Eleven of 226 patients who consulted be telephone (5%) indicated that they would definitely not have made a surgery appointment or home visit request (that is, they represented additional general practitioner workload) while 120 (53%) used the telephone consultation as an alternative to making a surgery appointment and 22 (10%) used the telephone consultation as an alternative to requesting a home visit. CONCLUSION: It appears that the telephone service was being used largely as an alternative access point to the doctor. General practitioners should not be apprehensive about the possible increase in workload generated by introducing telephone consultations, for example in phone-in clinics.