Evolving general practice consultation in Britain

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7355.104 (Published 13 July 2002) Cite this as: BMJ 2002;325:104

Increasing consultation time may not be straightforward

  1. Phil Wilson (p.wilson@clinmed.gla.ac.uk), general practitioner,
  2. Alex McConnachie, statistician,
  3. Mark Stirling, general practitioner
  1. Department of General Practice, University of Glasgow, Glasgow G12 0RR
  2. Ferguson Medical Practice, Broxburn Health Centre, Broxburn EH52 1JZ
  3. Pharmacy Practice and Medicines Management Group
  4. School of Healthcare Studies, University of Leeds, Leeds LS2 9UT
  5. Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TN

    EDITOR—Freeman et al plead for longer consultations in British general practice.1 A pilot study performed with six general practitioners in Glasgow shows that breaking the habit of short consultations may be difficult and longer consultations may lead to higher health service costs.

    Our study piloted a randomised controlled trial of the effect of an increased booking interval on identification of the patient's psychological distress.2 Each doctor's surgery was randomised to either 10 minutes per patient (the normal booking interval) or 15 minutes. One of us (MS) offered locum sessions to make up the shortfall in available consultations. We recorded 65 consultations at each booking interval for each practitioner. After the consultation, patients completed the general health questionnaire-12; doctors estimated psychological distress using a six point scale and recorded important outcomes of the consultations. Consultations were timed by a research assistant.

    Data were collected from 781 consultations. When booking interval was increased by 50% consultation length increased by 12%, from 8.7 …

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