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Patient Phone Calls: Acitvity-Based Cost Analysis Related to Outpatient GI Practice


Majithia, Raj T., MD; Johnson, David A., MD, FACP, FACG

American Journal of Gastroenterology: September 2007 - Volume 102 - Issue 2 - p S430–S431

Internal Medicine/Gastroenterology Division, Eastern Virginia Medical School, Norfolk, VA.

Purpose: Phone calls to a physician's office from patients occupies the time of many personnel in a gastroenterology practice. The objective of this study was to evaluate the time impact and cost effect of these phone calls on an out-patient GI practice with focus on medication related questions.

Methods: Prospective blinded study involved 100 consecutive calls that were passed to the nursing staff by the receptionist. Nurses were blinded as to the intent of the study and were told it was a quality assurance program. Time logs were assessed for each stage of the consecutive calls including the receptionist, nurse and physician stages. Standard office policy was that the physician review all telephone call communications.

Results: Call times for medication related calls were analyzed with time rounded to the nearest min. 30% of calls were medication related. Of these, 10% were due to side effects of medication prescribed, 50% due to lack of efficacy, 5% due to questions concerning medication dose, 20% related to cost and availability, and 15% for other reasons. Medication categories for the calls were IBD: 26%, hepatic: 22%, acid/peptic: 21%, IBS: 20%, and other: 11%.

Please refer to Table 1.s

Table 1

Table 1

The average cost incurred to the practice by a medication related call was $20.29. Other additive potential costs such as overtime or other “opportunity costs” were not assessed by this analysis.

Conclusion: Using an activity based cost accounting analysis, these data show that medication related patient calls to physician offices have considerable indirect related costs that are expenses incurred by the physician practice. Studies are underway, using similar survey data to compare these results to the impact of electronic medical records.

© The American College of Gastroenterology 2007. All Rights Reserved.