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.

Posted on Thursday, August 12, 2004 (Archive on Thursday, August 19, 2004)
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