Physicians need better line on how, when to respond to patients via telephone

Article Abstract:

''Telephone medicine'', the type of medicine physicians practice when they talk to patients over the telephone, has its share of problems. Patients and physicians apparently approach telephone calls with different expectations. One study of 1,200 calls and the patients who placed them revealed that patients sought advice and reassurance, but doctors thought they wanted diagnoses. Almost half the nation's pediatric residency programs (a specialty in which doctors spend 27 percent of their time on the telephone, according to one study) provide training in telephone management. This can consist of small group discussions, which focus on communication and recognition of the caller's needs, or of guided review of telephone contacts. One study of the effectiveness of such programs found that, after telephone training, physicians perceived a smaller proportion of calls as negative or unnecessary; however, whether better medical care was provided was not evaluated. In general, little time is spent training physicians in handling patients' telephone calls. Emergency physicians want to avoid telephone contact with patients altogether for medicolegal reasons; dealing as they do with unknown, often unreliable, patients, they fear legal reprisal. One study concerning the advice given over the telephone by 61 emergency departments to a caller with the same ''sick child'' found that advice varied widely and was often inaccurate. Only 72 percent of the emergency personnel suggested bringing the child to the hospital for medical attention. It is ironic that, with access to communication growing increasingly easy from the technologic standpoint, legal concerns may ultimately make doctor-patient communication by telephone impossible. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Evaluation, Telecommunications systems, Physician and patient, Physician-patient relations, Telephone, Telephony, Health education, Triage (Medicine)

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Examining life's (genomic) code means reexamining society's long-held codes

Article Abstract:

The Human Genome Project raises a number of concerns related to biomedical ethics. The Human Genome Project is a project to map and sequence all of the genes on the human chromosomes. The project's committee on biomedical ethics sponsored 19 programs across the US in 1991 to discuss issues related to the project. One major concern is the use of genetic information to restrict reproductive rights or to discriminate against different racial and ethnic groups or individuals with genetic abnormalities. But this information may reveal more similarities than differences between different groups of individuals. Health insurance companies refuse to insure individuals with the genes for different genetic disorders, and employers may not want to hire these individuals. Legislation is necessary to prevent the genetic discrimination, and to protect the privacy of individuals. Efforts should be made to provide the public with a high quality science education so that they can better understand the Human Genome Project.

Ethical aspects, Human Genome Project, Chromosome mapping

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