Remote clinical support by telephone for rural district hospital medical officers in the Eastern Cape

Abstract

Background: Rural district hospitals are frequently understaffed and inexperienced medical officers must make clinical decisions with no supervision. Medical officers from rural district hospitals in the Eastern Cape attending a two-week ‘in-reach’ anaesthesia training course at the Port Elizabeth academic complex were provided with subsequent telephonic support that enabled them to contact an experienced anaesthetist in the urban centre with clinical problems for advice. This survey was to determine user perceptions of the utility and effectiveness of the telephonic support system.

Methods: Two questionnaires designed for both rural and urban-based doctors were completed either online or telephonically and were used to assess perceived values and limitations of the support system.

Results: A total of 17 rural doctors, of whom 14 were foreign medical graduates, were eligible and agreed to participate; all were positive about the useful role and value of the programme, although many felt that the telephonic support system needs to be more structured and formalised. Open-ended questions revealed feelings of isolation and insecurity amongst the participants.

Conclusion: The telephonic system is valuable and readily accessible. However, its ready acceptance by the participants should be viewed in the light of the lack of other resources. A systemic approach towards clinical support of medical officers in rural district hospitals should be adopted, which might include remote supervision by telephone.