BMJ 2001;323:266-268 ( 4 August )

Primary care

How should hamsters run? Some observations about sufficient patient time in primary care

David Mechanic, director. 

Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ 08901-1293, USA

Correspondence to: mechanic@rci.rutgers.edu

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

In a recent editorial in this journal Ian Morrison and Richard Smith commented on doctors' dissatisfaction with not having sufficient time for their patients and suggested the need to redesign care to better meet the needs of patients.1 Yet to address such a redesign requires a sound factual basis. Although the consensus in the United States has been that managed care has required substantial reductions in the time that patients spend with their doctor, consultation time increased between 1989 and 1998 for prepaid and non-prepaid visits, primary and specialty care, new and repeat visits, and visits for common problems as well as for serious illness.2 Studies of how primary care doctors worked in the United States and in the United Kingdom over the past several decades can contribute to a more refined diagnosis.


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I have drawn on 35 years of studying medical practice in the United States and United Kingdom, my reprint collection, . . . [Full text of this article]
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