Author(s): Stoffel JT, Hansen M, Moinzadeh A
OBJECTIVES: To characterize the content and sources of after-hour telephone calls from a general urology practice so that common themes can be identified and incorporated into the education of urology residents.
METHODS: After-hour telephone calls were prospectively assessed for 6 months by a single senior urology resident. Calls occurring on weekends/holidays and between 5 PM and 8 AM on weekdays were directly referred to the on-call resident. The day of week, time, source, initiating event, and required action from each call was recorded. Exclusion criteria included calls regarding established hospital urology in-patients and duplicate calls from individual patients calling more than once within 24 hours.
RESULTS: Eighty-seven calls were collected. Seventy percent occurred on weekends, primarily between 8 AM and 5 PM. The most common source was from outpatients (56%) followed by emergency room physicians (30%). In general, 61% and 26% of all calls regarded new urologic symptoms and postoperative issues, respectively. Urinary calculi were the most common specific reason for a call, followed by lower urinary tract symptoms and hematuria. An acute urologic evaluation was required for 27% of all telephone calls. Nine patients (10%) required admission within 48 hours of calling.
CONCLUSIONS: The education of urology residents should emphasize telephone evaluations of patients who present with urinary calculi and common postoperative issues. The number of after-hour calls may be able to be reduced if patients and nonurologist physicians are also educated in the management of nonacute urologic problems. PMID: 14550428