Intended for healthcare professionals


Quality at general practice consultations

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:315

Time may not lead to quality

  1. Dan Kremer, general practitioner (
  1. Bexhill on Sea, East Sussex TN40 1DQ
  2. Department of Community Health Sciences-General Practice, University of Edinburgh, Edinburgh EH8 9DX
  3. Department of Primary Health Care and General Practice, Imperial College School of Medicine, Chelsea and Westminster Hospital, London SW10 9NH

    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. …

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