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Gestion des RDV par les secrétaires médicales des patients nécessitant un traitement pour une DMLA en France

Age-related macular degeneration (AMD) is a common degenerative retinal disease that causes a progressive loss of vision. Early detection is crucial as there is no cure that returns vision already lost. We have performed a survey using disguised calls to assess whether medical secretaries correctly evaluate the urgency of the patient’s condition.

In June 2016, Kantar Health Institute conducted a survey that consisted of disguised calls to 100 French eye clinics, with a representative sample of regions and clinic types: private versus hospital. Each clinic received 5 calls according to 5 different scenarios: a patient with sudden worsening of vision, an AMD patient with similar symptoms in the fellow eye, a mother of a squinting child, a diabetic patient who needs a dilated fundus examination and a patient who wants an eye test. We collected the appointment dates and the types of referrals that were provided by telephone.

79% of calls for a check-up visit resulted in an appointment, with a median interval of 58 days (mean 87, SD 81). 69% of calls for diabetic patients resulted in an appointment, with a median interval of 36 days (mean 63, SD 60). For an AMD patient suffering from symptoms of AMD in the fellow eye, 50% of calls resulted in an appointment, with a median interval of 4 days (mean 22, SD 42). 49% of calls resulted in referrals, 26% to a hospital with at least the name of the institution, 25% to a colleague with specific contact details, 4% to a specialist eye clinic and 45% with no specific contact details. In the case of sudden diminished vision, 42% of calls resulted in an appointment, with a median interval of 2 days (mean 5, SD 9). The remaining calls (58%) resulted in a referral, 47% of which to a hospital with at least the name of the institution, 5% to a colleague with specific contact details, 48% of secretaries referring the patient with no specific contact details. 38% of mothers calling for a child with strabismus were given an appointment, with a median delay of 15 days (mean 22, SD 32). 61% of patients were referred. 18% of centres refused to give appointments in any situation.

Some eye clinics consider the urgency of the situation when giving appointments, but it proved unsatisfactory for a large majority of patients presenting with symptoms of AMD

Education of medical secretaries is necessary to reduce the occurence of calls resulting in appointments that do not relate to the actual urgency of the situation.  Growing demand of eye care services highlights the need of increasing the number of ophthalmologists and to make their offices more efficient.