Parents Prefer Doctor's Phone Call -- and the Bill
CLEVELAND -- Doctors estimate
that 30 percent of their medical care for children is handled via
telephone calls, prompting researchers at University Hospitals' Rainbow
Babies & Children's Hospital to examine this practice and conclude
that parents overwhelmingly prefer to have their children's simple
illnesses managed by phone.
Moreover, the recent study showed, families were willing to pay for
this medical care even though doctors rarely charge for it.
"The evidence clearly indicates that telephone care for simple
childhood illnesses is in the best interest of patients, physicians and
insurance carriers -- and should be a benefit covered by insurers,"
says Keith Ponitz, MD, a
Rainbow pediatrician and co-author of a recent study that was presented
at the National Ambulatory Pediatric Association meeting.
Despite the common practice of providing medical care for children over
the phone, physicians traditionally have charged little or nothing for
this service. Not only are physicians not being reimbursed for the time
spent on the telephone, it is valuable time they otherwise would spend
in direct contact with other patients.
Three Rainbow physicians -- Heidi Smith, MD, Andrew Hertz, MD and Dr.
Ponitz, conducted the study of 162 patients. They designed the study to
determine the impact of charging patients for telephone care for
illnesses that did not require face-to-face contact with a physician.
Those childhood illnesses that were treated by doctors over the phone
ranged from conjunctivitis and thrush to vaginitis, allergies and
pinworms.
As part of the study, parents or guardians were informed when they
called the doctor's office that any telephone care would result in a
fee. Researchers recorded their reactions to this news. The
overwhelming majority -- the parents or guardians of 130 patients out
of a total of 162 patients -- chose to have their children receive
telephone care instead of going in for an office visit.
Initially, parents talked to LPNs using a telephone triage process in
which a diagnosis was made, and then were given the option of an office
visit or phone care, and involved the doctor when ordering a
prescription.
The researchers found that when patients were billed for phone care,
the average cost was $17.81, an amount that did not adversely affect
patient care or the family's willingness to take their child to the
same doctor in the future (known as patient retention). Office visits
would have cost $32.07, nearly twice the price of phone care, without
any additional medical benefit to the patient.
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Posted on Thursday, August 12, 2004 (Archive on Thursday, August 19, 2004) |
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