Telephone medicine for internists

The role of the telephone in medical practice is important, but often probl ematic. Mistakes in telephone diagnosis and triage can have severe conseque nces. An effective office system can reduce liability risks, and in some ca ses telephone contact can substitute for office visits. Internists feel unp repared to provide telephone care. Therefore, residency education needs to focus on documentation, consultant availability, and performance feedback. Research should focus on improving outcomes, reimbursement issues, and tech nologic advances. This article describes internists' telephone interactions with ambulatory patients, preparation for telephone medicine, and aspects of office telephone systems and makes comparisons with other primary care f ields.