The "five minute" consultation: effect of time constraint on clinical content and patient satisfaction.

Abstract

An experiment was carried out in which patients who were seeking appointments for a consultation in a general practice in south London attended consulting sessions booked at 5, 7.5, or 10 minute intervals. The particular session that the patient attended was determined non-systematically. The clinical content of the consultation was recorded on an encounter sheet and on audio-tape. At the end of each consultation patients were invited to complete a questionnaire designed to measure satisfaction with the consultation. The stress engendered in doctors carrying out surgery sessions booked at different intervals of time was also measured. At surgery sessions booked at 5 minute intervals, compared with 7.5 and 10 minute intervals, the doctors spent less time with the patients and identified fewer problems, and the patients were less satisfied with the consultation. Blood pressure was recorded twice as often in surgery sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals. There was no evidence that patients who attended sessions booked at shorter intervals received more prescriptions, were investigated or referred more often to hospital specialists, or returned more often for further consultations within four weeks. There was no evidence that the doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals than at consultations booked at 7.5 and 10 minute intervals, though they complained of shortage of time more often in surgery sessions that were booked at shorter intervals.

In the Wake of the 2003 and 2011 Duty Hours Regulations, How Do Internal Medicine Interns Spend Their Time?

“…1 Prior studies have found that more time spent with patients may improve patient satisfaction, patient education, and clinical outcomes, and reduce inappropriate prescribing. [19][20][21][22] In the wake of the 2003 and 2011 work hours limitations, the proportion and absolute amount of time spent in direct patient care has dropped in both Fletcher's study 14 and this study. As a result, the total time residents can expect to spend learning from patients appears to have decreased, which may affect the quality of the patient-physician relationship and the quality of care delivered.…”

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

“…27,28,49 Physicians and patients believe visit duration is important for quality of care. 50,51 Longer visits are associated with higher communication quality, 52 greater ease of discussing problems, 53,54 and more participatory decision-making 54 by patients. Constraining visit length to reduce health-care costs may place minorities and patients with suboptimal disease control at higher risk for poorer quality communication and disease outcomes.…”

Consultation in general practice: a standard operating procedure?

“…Although there is no real evidence that longer is better, some benefits of longer consultations have been mentioned. Research showed that in longer consultations doctors prescribe less [4,5], listen better to their patients, identify more problems, explore more psychosocial problems and provide more health promotion [3,6]. When we take these measures as a proxy for quality, longer consultations seem to be better [5,7,8].…”