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首页> 外文期刊>BMJ: British medical journal >How to conduct telephone consultations
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How to conduct telephone consultations

机译：如何进行电话咨询

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Up to a quarter of patient-physician interactions occur via telephone in settings such as US internal medicine and UK primary care. Telephone consultations have the potential to improve access, convenience, and choice and are the most common alternative to face-to-face consultations. Comparative studies show that patients are equally satisfied with both forms of consultation. However, randomised controlled trials and time series studies show that telephone consultations do not necessarily reduce workload for clinicians. There are times when they may be unsuitable. The lack of visual cues and inability to examine the patient are key disadvantages that necessitate careful consideration as to whether phone consultation is safe and effective. Phone consultations tend to narrowly focus on presenting symptoms, and patients are often not comprehensively assessed. A recent Cochrane review underlines the lack of training in phone consulting competencies, and audits suggest unwarranted variation in physicians' behaviour on the phone. Based on best available evidence (sometimes expert opinion), we present an approach to telephone consultations in primary care that is largely applicable to other settings such as outpatient clinics.
机译：在美国内科和英国初级保健等环境中，通过电话发生了多达四分之一的患者 - 医学互动。电话咨询有可能改善访问，便利性和选择，并且是面对面咨询的最常见替代方法。比较研究表明，患者对两种形式的咨询都同样满意。但是，随机对照试验和时间序列研究表明，电话咨询不一定减少临床医生的工作量。有时候它们可能不合适。缺乏视觉提示和无法检查患者是关键缺点，需要仔细考虑电话咨询是否安全有效。电话咨询往往会狭窄地关注症状，并且通常无法全面评估患者。最近的Cochrane评论强调了电话咨询能力缺乏培训，审核表明，电话中医生行为的无理差异。根据最佳证据（有时是专家意见），我们提出了一种在初级保健中进行电话咨询的方法，该方法主要适用于其他设置，例如门诊诊所。

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