To see or not to see: a study of after hours telephone calls in a residency program.

This study examined the influence of patient, resident, and environmental variables on the management of after-hours telephone calls. Twenty-one family medicine residents participated in the study; 299 telephone calls in a one-month period at three teaching units were analyzed.A number of variables were found to influence the decision to manage patients on the phone or see them in the office, emergency room or home. Older patients were more likely to be seen at home, and pediatric problems were more likely to be managed on the phone or in the office. There was no relationship between the disposition of the call and the resident's educational level; however, married residents with children were more likely to manage patients on the phone. Measures of the resident's and patient's emotional state at beginning and end of the call were significantly related to patient management.