Ever since the Black Saturday fires some years back, 774ABC radio is the designated emergency ratio station for Melbourne. As a result, if there’s fire, flood, funny smells- then 774ABC goes onto ’emergency’ footing with frequent warnings and advice interspersed with its normal programs (unless of course it’s a REAL emergency, at which time usual programming is suspended).
There was a fire at a recycling centre in suburban Melbourne this morning, and this triggered 774ABC emergency warnings right in the midst of “Making Christmas Gifts with Craft”- quite a surreal juxtaposition! I was interested that at the end of the warning about toxic smoke, keeping your windows shut, turning off the airconditioner and staying inside etc, there was advice to call Nurse- On-Call if you had any concerns.
Nurse-on-Call is a telephone service that provides 24 hour a day advice from a registered nurse. I’ve never used it. From what I have heard from people who have used it, they’re normally told to go to hospital. This may reflect the demographic of my sample- i.e. old codgers primed for heart attacks, and perhaps it’s different when people ring with a baby or young child. But I can’t help thinking that in these litigious times, it would be unwise to advise to “just wait and see”.
Perhaps in a situation like this though, when people are wanting reassurance as much as anything else, there might be a role for nurse-on-call as a way of deflecting unnecessary panic. But it did make me wonder about the statistics on Nurse-on-Call: is my perception that they always advise ‘go to hospital’ valid? Has it saved hospital visits or increased them? I did actually go to the Dept. of Health webpage where they had their annual report, but it would have taken 8 minutes to download and I thought…..nah.
On to The Conversation website and blow me down….there’s a report on telephone medical advice lines. In a Medical Journal of Australia article, researchers looked at the difference in ‘appropriate referrals’ from GPs, a telephone medical advice line, and self-referral. I’m a bit disconcerted by their definition of ‘appropriate referral’ which ranged from admission to hospital, referral in an inpatient or outpatient clinic, transfer to another hospital, performance of radiological or laboratory investigations- or death in the Emergency Department. (I’m hearing echoes of Monty Python’s ‘I told you I was sick!”) As might be expected, GPs scored the highest in ‘appropriate referrals’ but interestingly telephone-line and self-referrals were ranked much the same- in fact, the self-referrals scored slightly higher.
Moreover, the study found that people when do receive advice to seek medical advice in a non-Emergency Department (so there goes my theory), 50% of people ignored the advice and turned up anyway. The conclusion of the study? The MJA editorialized:
It is not clear that, if offered an informed choice, the community would choose to pay for telephone advice that makes little difference to their behaviour over other health service priorities. In relation to whether an ED visit is required, it appears that a phone call will not answer the question.
The Resident Judge of Port Phillip 