P C Sorum1, R Mallick. 1. Departments of Medicine and Pediatrics, Albany Medical College, Albany, New York, USA.
Abstract
OBJECTIVES: To describe the attitudes of pediatricians and other physicians practicing in a fee-for-service environment toward compensation for telephone encounters with patients. DESIGN: Survey by mail. PARTICIPANTS: The 67 pediatric and 634 other private physicians and medical school faculty of Albany County, NY. RESULTS: A total of 479 of all the physicians (68.3%) and 55 of the pediatricians (82.1%) returned the questionnaire. Of these, 69.9% of the total (95% confidence interval, 65.5% to 74.1%) and 58.2% of the pediatricians (95% confidence interval, 44.1% to 71.3%) indicated physicians should be compensated for calls with patients, especially for after-hours calls. This opinion was significantly associated with greater concern about liability for calls, more negative sentiments about after-hours calls, and a longer reported duration of calls. After adjusting for these factors, surgeons and pediatricians were significantly less likely to favor compensation than the group as a whole. Pediatricians in favor of compensation suggested charging a mean of $9.18 (SD $5.05) for 1 to 5 min, $14.00 (SD $8.87) for 6 to 10 min, and $22.27 (SD $12.62) for >10 min. Pediatricians reported documenting in patients' charts a mean of 35. 3% (SD 39.9%) of after-hours calls. CONCLUSIONS: In a mostly noncapitated environment, the majority of pediatricians and other physicians favor compensation for telephone calls with patients. Some specialists, in particular pediatricians and surgeons, are, however, less likely to support this. Additional research into the reasons for these interspecialty differences may help to guide policy decisions on the financing of health care.
OBJECTIVES: To describe the attitudes of pediatricians and other physicians practicing in a fee-for-service environment toward compensation for telephone encounters with patients. DESIGN: Survey by mail. PARTICIPANTS: The 67 pediatric and 634 other private physicians and medical school faculty of Albany County, NY. RESULTS: A total of 479 of all the physicians (68.3%) and 55 of the pediatricians (82.1%) returned the questionnaire. Of these, 69.9% of the total (95% confidence interval, 65.5% to 74.1%) and 58.2% of the pediatricians (95% confidence interval, 44.1% to 71.3%) indicated physicians should be compensated for calls with patients, especially for after-hours calls. This opinion was significantly associated with greater concern about liability for calls, more negative sentiments about after-hours calls, and a longer reported duration of calls. After adjusting for these factors, surgeons and pediatricians were significantly less likely to favor compensation than the group as a whole. Pediatricians in favor of compensation suggested charging a mean of $9.18 (SD $5.05) for 1 to 5 min, $14.00 (SD $8.87) for 6 to 10 min, and $22.27 (SD $12.62) for >10 min. Pediatricians reported documenting in patients' charts a mean of 35. 3% (SD 39.9%) of after-hours calls. CONCLUSIONS: In a mostly noncapitated environment, the majority of pediatricians and other physicians favor compensation for telephone calls with patients. Some specialists, in particular pediatricians and surgeons, are, however, less likely to support this. Additional research into the reasons for these interspecialty differences may help to guide policy decisions on the financing of health care.