Intended for healthcare professionals


Delays in accessing primary care

BMJ 2008; 337 doi: (Published 18 September 2008) Cite this as: BMJ 2008;337:a1435
  1. Moyez Jiwa, professor of health innovation1,
  2. Andrew Knight, clinical senior lecturer2
  1. 1Curtin Health Innovation Research Institute, PO Box U1987, Perth, WA, Australia 6845
  2. 2Department of General Practice, the University of Sydney, Katoomba NSW 2780, Australia
  1. m.jiwa{at}

    Need to be understood to prevent adverse health outcomes

    Many theories exist about the decision to consult a general medical practitioner.1 2 Key influences include the characteristics of the patient, the medical practice itself, the nature of the disease or symptom, and the time of day. These factors are now of particular interest as we ponder the association between access to doctors and the effect on the prognosis of life limiting illness. Changes in policy on the availability of medical practitioners in the United Kingdom have potential clinical consequences; one of these, delay in seeking timely access to appropriate interventions, is explored in the linked study by Lasserson and colleagues (doi:10.1136/bmj.a1569).3 The study found that the opening hours of general practices seem to influence patients’ healthcare seeking behaviour after a transient ischaemic attack and minor stroke and can increase delay in assessment.

    It has been shown repeatedly that people have the greatest confidence in their usual doctor and will procrastinate if faced with the prospect of consulting a different doctor …

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