Issues affecting residents’ attitudes about telephone medicine for ambulatory patients

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Abstract
Background: Telephone medicine is an important component of internists’ practices. Their patients’ calls are often complex and lead to further medical care. However, telephone medicine skills are seldom taught during internal medicine residencies. Purpose: This study sought to identify characteristics of residency education and issues important to residents that shape their attitudes about telephone management of ambulatory patients. Methods: Residents (N = 388) in 10 diverse programs were surveyed confidentially. Responses were grouped into descriptive and attitudinal items and analyzed using factor analysis. Descriptive scales and demographic items were used as independent variables to predict attitudinal scales. Results: The residents surveyed expressed discomfort with telephone medicine. However, they identified receiving performance feedback from a variety of sources, having access to consultants, having charts available, and documenting calls as important components to their satisfaction with telephone medicine. A predictive model for satisfaction with telephone medicine was built (R2 = .22) using 3 descriptive scales that concerned these aspects of telephone medical practice. Conclusions: Several issues were identified as being associated with satisfaction in this important aspect of ambulatory medical practice, and they should be considered in developing telephone medicine curricula.