The efficacy of telephone consultations in ear, nose, and throat (ENT)

Background: Telephone consultations have been shown previously to be effective and safe in general practice and in specialties for specific conditions such as human immunodeficiency virus (HIV), inflammatory bowel disease (IBD) and epilepsy. They include certain advantages such as gain of time, but these must be balanced against potential disadvantages in terms of efficacy and patient satisfaction. Until recently, there was no information available on the adequacy of telephone consultations in ear, nose, and throat (ENT). Methods: The study design was a cross-sectional observational study in the context of a service improvement project in a single ENT department during the COVID-19 pandemic. Telephone consultations by three ENT doctors were studied over a 3-week period. Total consultation time, including administrative tasks, and telephone call time were calculated and compared to pre-COVID consultation times. Clinician-assessed adequacy of the consultation was determined. Results: Ninety-six consultations were included;65 were deemed adequate whereas 31 were inadequate due to the lack of examination. Telephone consultations took an average of 16 minutes, of which 9 minutes were spent on the telephone call, compared to an average of 20 minutes for face to face consultations. Conclusions: Telephone consultations were quicker than face to face consultations by 20% and were an appropriate alternative in two-thirds of cases. This suggests that routine practice would benefit from the addition of telephone consultation with selected patients, based on clinical presentation and patient preference. © Journal of Hospital Management and Health Policy. All rights reserved.

A change in clinical practice for aural foreign bodies - what we learnt from the coronavirus disease 2019 pandemic.

OBJECTIVE: This case series, conducted during the coronavirus disease 2019 pandemic, investigates the impact of leaving aural foreign bodies in situ for a prolonged period of time, including the risk of complications and success rates of subsequent removal attempts. METHOD: A retrospective study of aural foreign body referrals over a six-month period was carried out. RESULTS: Thirty-four patients with 35 foreign bodies were identified (6 organic and 29 inorganic). The duration of foreign bodies left in situ ranged from 1 to 78 days. Four patients suffered from traumatic removal upon initial attempts. First attempts made by non-ENT specialists (68.8 per cent) all failed and were associated with a high risk of trauma (36.4 per cent). CONCLUSION: Because of the coronavirus disease 2019 pandemic, this is the first case series to specifically investigate the relationship between the duration of aural foreign bodies left in situ and the risk of complications. Our data suggest that prolonged duration does not increase the incidence of complications.