TELEPHONE MEDICAL-CARE ADMINISTERED BY INTERNAL-MEDICINE RESIDENTS - CONCERNS OF PROGRAM DIRECTORS AND IMPLICATIONS FOR RESIDENCY TRAINING

The objective of this study was to determine the need for telephone me dicine curricula and to help define important content for internal med icine residencies using scales that measure program director attitudes toward telephone medicine. Data were collected by surveying all 416 p rogram directors of accredited internal medicine residencies in the Un ited States. We applied factor analysis to develop reliable attitudina l scales and employed regression models to identify predictors of thes e attitudes. Response rate was 60%. Formal training for telephone medi cine was available in only 6% of programs. The factor analysis showed three attitudinal concepts; all described marked program director disc omfort with aspects of resident telephone prescription. Predictors of improved program director comfort included more frequent documentation of resident telephone calls, chart availability, and clear definition of resident roles pertaining to telephone interactions with patients (P < 0.02 for all predictor variables). These results identify a need for telephone curricula and suggest components that might alleviate pr ogram director discomfort with resident telephone practices.