Education Research: Patient telephone calls in a movement disorders center Lessons in physician-trainee education

Objective: Telephone medicine is part of clinical practice, but there are no published data on the volume, nature, and time allocation of patient-related telephone calls received in a movement disorders center. Such data might provide insights which augment patient care, and may be instructive regarding medical education, since patient-related telephone calls are often addressed by physicians-in-training. Methods: Characteristics of patient-related calls to a movement disorders center were prospectively recorded during a 2-month period. Results: A total of 633 calls were generated by 397 patients. The average time per call was 6.6 +/- 4.7 minutes. Disease-related questions (35.1%), treatment-related questions (21.3%), and side effect reports (15.3%) represented the majority of calls. Patients with Parkinson disease, Tourette syndrome (TS), and atypical parkinsonism (AP) called more frequently, while patients with dystonia and tremor called less frequently. Conclusion: Patient telephone calls contribute substantially to the patient care in a movement disorders center and represent an important aspect of training, providing an opportunity for movement disorders fellows to develop independent decision-making skills and monitor effectiveness of their physician-patient counseling. Parkinson disease, Tourette syndrome (TS), and atypical parkinsonism ( AP) contribute disproportionately to the total patient telephone volume, possibly due to coexisting obsessive-compulsive and impulse-control comorbidities in patients with TS, and complications or a change of diagnosis and prognosis in patients with AP. Emphasis on the management of these specific diagnostic groups early in fellowship training may be warranted. Neurology (R) 2009; 73: e50-e52