Follow up by telephone

It may be just as good to talk on the telephone as in a clinic

Health service workers seem to regard the telephone as intrusive. For patients and staff alike, mention of the telephone conjures up images of haughty, unhelpful receptionists and tardy, impolite switchboard operators. Its insistent ring demands immediate attention, interrupting the ward round and disturbing consultations. For patients a call from the hospital is often bad news, and they are expected to call the hospital only when absolutely necessary. Even in the newly consumer conscious NHS the interaction between staff and patients over the telephone can hardly be described as convivial.

And yet, with a little imagination, the much maligned telephone could be used to improve patients' care. Take several examples from the United States. Jones et al have shown that telephone follow up of patients attending an emergency room can be beneficial.1 In one month 281 patients (15% of the total) were selected for such contact. Two fifths of the patients needed clarification of instructions they had received on discharge, and six out of seven patients who reported a worsening of symptoms received medical intervention. More recently, a randomised trial tested whether telephone follow up can be used as a substitute for routine follow up in clinics.2 Doctors doubled the interval between clinic visits in the intervention group and contacted …