ABSTRACT
A 6-month prospective study was carried out at the General Practice Unit in Wildey and at two privately run group practices. An after-hour call was defined as any request for care outside regular office hours. Information recorded by the doctor included estimation of the necessity of the call and his or her reaction to it. Wherever possible, patients were contacted at a later date by an interveiwer who recorded the type of management, the patient's perception of his or her main reason for calling and the satisfaction with the service received. A total of 557 calls were made, representing 3.0 percent of the total workload (office visits and AH visits). Of the 339 patients interviewed the majority gave discomfort and anxiety as their main reason for calling. Two hundred and twenty-nine of all patients (41.1 percent) were managed on the telephone. One hundred and thirty-six of these were among the group of patients interviewed. Only 6(4.4 percent) were dissatisfied with the service received. Three hundred and seventy of all calls (65.4 percent) were judged by the doctor as being necessary. Only 68 (12.0 percent) were judged to be totally unnecessary. The majority of calls (61.4 percent) engendered interest and satisfaction with only 99 (18.2 percent) evoking anger and frustration. Surprisingly, only 4.0 percent of 52 patients interviewed, who belonged to the latter group, were dissatisfied with the service received. This study has shown that a great deal of satisfaction can be derived from doing after-hour work. Areas of educational importance have also been identified, such as the need for teaching the skills of "telephone medicine", dealing with anger and frustration and the "very unnecessary" call (AU)
