BMJ 2000;320:315 ( 29 January )

Letters

Quality at general practice consultations

    Time may not lead to quality
    Authors' reply

Time may not lead to quality

The first 150 words of the full text of this article appear below.

EDITOR---Howie et al claim from their study that the outcome of a consultation in general practice is better if more time is given and if the patient knows the doctor well.1 This conclusion is based on the use of an enablement questionnaire, a high score after a consultation meaning a successful consultation. The authors claim that this is a measure of quality of care, assuming that the degree of enablement predicts outcome. If this assumption is false, then what has been measured in this study? It is simply the degree of doctor as drug.

The study then shows that patients who are given more time in a consultation feel more enabled. The authors conclude that therefore there should be incentives to persuade more doctors to give longer consultations. This study does not show that patients feel more enabled when doctors who generally give quick consultations swap to giving . . . [Full text of this article]
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Relevant Article

Quality at general practice consultations: cross sectional survey
John G R Howie, David J Heaney, Margaret Maxwell, Jeremy J Walker, George K Freeman, and Harbinder Rai
BMJ 1999 319: 738-743. [Abstract] [Full Text] [PDF]

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