Does a Previsit Phone Call from the Surgeon Reduce Decision Conflict?

Abstract

Background: There is some evidence that previsit strategies can make in-person visits more productive and efficient. We compared between people who received a phone call before a musculoskeletal specialty visit and people who did not with respect to several factors: (1) decision conflict (difficulty deciding between two or more options), (2) perceived clinician empathy after an in-person visit, and (3) arrival for the scheduled in-person appointment. We also recorded the specialist's opinion that the phone call alone could adequately replace an in-person visit while maintaining quality, safety, and effectiveness. Materials and Methods: In this prospective randomized-controlled trial, 122 patients were enrolled and randomized to receive a previsit phone call by an orthopedic surgeon before a scheduled visit or not. After the in-person visit, patients completed a (1) demographic questionnaire including age, gender, race/ethnicity, marital status, level of education, work status, and comorbidities; (2) Decision Conflict Scale; and (3) Jefferson Scale of Patient Perceptions of Physician Empathy. Results: No significant difference was found between the two groups in decision conflict, perceived empathy, or not attending the scheduled visit. Of the 55 successful phone calls, the surgeon felt that 50 (91%) had the potential to safely and effectively replace an in-person visit. Conclusion: Although a previsit phone call did not reduce decision conflict or improve the patient experience as measured after one visit, there may be merit in studying an increased number of touch points, particularly with some subsets of illness featuring substantial stress or misconceptions. The identified potential for the application and transfer of specialty expertise through telephone alone also merits additional study.