All patient telephone calls to a two-physician private family practice were recorded for a 2-month period. There were 1264 calls, of which 539 were patient-initiated calls for specific medical problems. The 21 patients responsible for four or more of these 539 calls were labeled high utilizers. Chart comparisons were done for high-utilizer and 20 control patients. Calls of high utilizers were also compared with all other calls. High utilizers were older and showed evidence of more emotional dysfunction, more face-to-face medical contacts, more medical problems in general, and a suggestion of less social support. They did not seem to use the telephone in place of face-to-face visits, but used it in addition to an also higher rate of direct physician encounters.