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Favorable Experience in Nurse-Staffed Inner-City Clinic

Nicholas Cunningham, MD, DrPH; Carter Marshall, MD; Emily Glazer, MS

JAMA. 1978;240(25):2749-2751.

Abstract
Off-site pediatric consultation via bidirectional cable television (TV) was instituted to provide backup for nurse practitioners treating sick and well children in a small primary-care clinic. During a year of study of the system, there were 2,161 clinic visits and 285 TV consultations. When both TV and telephone consultation were available, TV was used for 10.8% of the visits, and telephone was used for 9.6% of visits. Staff reactions, though initially skeptical, were ultimately favorable. The system allowed pediatric nurse practitioners to function without on-site physician coverage 40% of the time. The main disadvantages were technical. Further work is needed to assess the reliability and validity of TV consultation and its acceptability in other settings.

(JAMA 240:2749-2751, 1978)

Author Affiliations
From the Department of Community Medicine, Mount Sinai School of Medicine, City University of New York (Drs Cunningham and Marshall and Ms Glazer). Dr Cunningham is presently with the Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York. Ms Glazer is presently with the Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York. Dr Marshall is presently with the Office of Primary Health Care Education, College of Medicine and Dentistry of New Jersey, Newark.

Footnotes
Reprint requests to 630 W 168th St, Vanderbilt Clinic 4-450, New York, NY 10032 (Dr Cunningham).

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