Abstract
BackgroundLonger consultations in primary care have been linked with better quality of care and improved health-related outcomes. However, there is little evidence of any potential association between consultation length and patient experience.AimTo examine the relationship between consultation length and patient-reported communication, trust and confidence in the doctor, and overall satisfaction.Design and settingAnalysis of 440 videorecorded consultations and associated patient experience questionnaires from 13 primary care practices in England.MethodPatients attending a face-to-face consultation with participating GPs consented to having their consultations videoed and completed a questionnaire. Consultation length was calculated from the videorecording. Linear regression (adjusting for patient and doctor demographics) was used to investigate associations between patient experience (overall communication, trust and confidence, and overall satisfaction) and consultation length.ResultsThere was no evidence that consultation length was associated with any of the three measures of patient experience (P >0.3 for all). Adjusted changes on a 0–100 scale per additional minute of consultation were: communication score 0.02 (95% confidence interval [CI] = −0.20 to 0.25), trust and confidence in the doctor 0.07 (95% CI = −0.27 to 0.41), and satisfaction −0.14 (95% CI = −0.46 to 0.18).ConclusionThe authors found no association between patient experience measures of communication and consultation length, and patients may sometimes report good experiences from very short consultations. However, longer consultations may be required to achieve clinical effectiveness and patient safety: aspects also important for achieving high quality of care. Future research should continue to study the benefits of longer consultations, particularly for patients with complex multiple conditions.
Highlights
The impact of consultation length on doctor–patient relationships, workload, and workforce requirements in general practice has long been debated
There was no evidence that consultation length was associated with any of the three measures of patient experience (P > 0.3 for all)
Adjusted changes on a 0–100 scale per additional minute of consultation were: communication score 0.02 (95% confidence interval [confidence intervals (CIs)] = –0.20 to 0.25), trust and confidence in the doctor 0.07, and satisfaction –0.14
Summary
The impact of consultation length on doctor–patient relationships, workload, and workforce requirements in general practice has long been debated. The 2006–2007 GP workload survey estimated the average consultation length with a GP in the English NHS was 11.7 minutes.[1,2] this figure was calculated by dividing the total time of recorded appointments by the number of patients seen, and may be an overestimate. A recent study suggested consultation length was nearer to 9 minutes.[3] The Royal College of General Practitioners has argued that the 10-minute consultation is unsustainable, recommending that primary care appointments should be at least 15 minutes long, inclusive of examinations.[2] A British Medical Association survey found that 92% of 15 560 GPs felt that 10 minutes for primary care consultations was inadequate.[4]. There is little evidence of any potential association between consultation length and patient experience
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