A study of telephone advice in managing out-of-hours calls.

Two doctors in a five-partner urban practice recorded details of their out-of-hours telephone calls for a year. No caller was refused a visit, but 474 of the 809 incoming calls (59%) were managed by telephone advice, an unexpectedly high proportion. Although these callers were instructed to telephone again if still worried, only 40 did so during the same duty period, and only 55% of a smaller sample of patients receiving telephone advice only consulted again within a week. No evident detriment to patients' health was observed. Thirty nine (5%) of the 809 incoming calls were managed by an out-of-hours surgery attendance and 296(37%) by a home visit. The urgency of the visits made was categorized retrospectively as high (34% of visits), medium (39%) and low (27%). It is hoped that this descriptive account will foster discussion of the value and implications of telephone advice in managing out-of-hours calls.