Time may not lead to quality

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. …