Use of Telephone Medicine for the Care of Patients with Human Immunodeficiency Virus Infection or AIDS: Comparison of a Private Infectious Disease Practice with a University Clinic Practice

Gathering information on a patient, interpreting the data, determining the urgency of the patient's problem, ascertaining the need for medical intervention, and providing medical advice or prescriptions via the telephone are defined as telephone medicine. Telephone contact between patients and their health care providers is an important method of cost-effective care. When a patient calls a physician and medical advice is given by anyone in the office, a binding physician-patient relationship is formed. Telephone medicine is described in literature on pediatrics and family medicine, but few articles have appeared in internal medicine or infectious diseases journals even though less than or equal to 27% of physician-patient contacts that involve internists occur over the telephone. Callers to general internal medicine physicians are usually >50 years old; the majority are female; and 22% of the calls result in a new prescription, most commonly an antibiotic. In one report, most physicians were described as being unsatisfied with telephone practices in their offices; however, formal training can improve the effectiveness of telephone activities. We used SAS descriptive statistics (SAS Institute, Cary, NC) to analyze the content of 109 consecutive patient calls made during office hours to our multidisciplinary, university HIV/AIDS clinic and to analyze the content of 67 calls (of 125 patient calls) related to the care of HIV-infected patients made during office hours to a single-physician infectious diseases private practice.