Peter K Orton1, Denis Pereira Gray2. 1. Research Unit, Aviation Medica Aviation Medica, Essex, UK and Peter-Orton@msn.com. 2. University of Exeter, St Leonard's Research Practice, Exeter, UK.
Abstract
BACKGROUND: The length of consultations is an important factor affecting the quality of care in general practice. It is however difficult to study as many factors are simultaneously involved. Much that is known is about patient factors as so far, doctor factors have been neglected. OBJECTIVE: To investigate multiple factors affecting consultation length, how they interact and the association between consultation length and patient-centredness. METHODS: Previously collected observational data from 38 National Health Service NHS GPs in England stratified according to doctor's gender, experience and degree of emotional exhaustion were used. Multiple regression analyses were applied to 822 audio-recorded and timed consultations. Each consultation was analysed for the doctor's gender, patient's gender, experience, level of emotional exhaustion and patient-centredness. RESULTS: We previously reported that 261/564 (46%) of GPs in Essex England were emotionally exhausted. Here, we found that male and female doctors respond differently to both experience and emotional exhaustion, which are associated with differences in their consultation length. The effect of experience on consultation length is only observed in male doctors: the more experienced, the shorter their consultation. Emotional exhaustion affected consultation length in opposite ways for females and male GPs: exhausted female GPs had shorter consultations, while exhausted male doctors had longer ones. Longer consultations were significantly more patient-centred and were associated with female patients. CONCLUSIONS: We found five factors affecting consultation length significantly. Moreover, these factors can predict the consultation length.
BACKGROUND: The length of consultations is an important factor affecting the quality of care in general practice. It is however difficult to study as many factors are simultaneously involved. Much that is known is about patient factors as so far, doctor factors have been neglected. OBJECTIVE: To investigate multiple factors affecting consultation length, how they interact and the association between consultation length and patient-centredness. METHODS: Previously collected observational data from 38 National Health Service NHS GPs in England stratified according to doctor's gender, experience and degree of emotional exhaustion were used. Multiple regression analyses were applied to 822 audio-recorded and timed consultations. Each consultation was analysed for the doctor's gender, patient's gender, experience, level of emotional exhaustion and patient-centredness. RESULTS: We previously reported that 261/564 (46%) of GPs in Essex England were emotionally exhausted. Here, we found that male and female doctors respond differently to both experience and emotional exhaustion, which are associated with differences in their consultation length. The effect of experience on consultation length is only observed in male doctors: the more experienced, the shorter their consultation. Emotional exhaustion affected consultation length in opposite ways for females and male GPs: exhausted female GPs had shorter consultations, while exhausted male doctors had longer ones. Longer consultations were significantly more patient-centred and were associated with female patients. CONCLUSIONS: We found five factors affecting consultation length significantly. Moreover, these factors can predict the consultation length.
Authors: Denis Pereira Gray; Kate Sidaway-Lee; Helen Kingdon; Molly Dineen; Philip Evans; Alex Harding Journal: Br J Gen Pract Date: 2019-12-26 Impact factor: 5.386
Authors: Esther H A van den Bogaart; Mariëlle E A L Kroese; Marieke D Spreeuwenberg; Ramon P G Ottenheijm; Patrick Deckers; Dirk Ruwaard Journal: BMC Fam Pract Date: 2019-11-09 Impact factor: 2.497
Authors: Sarah Stevens; Clare Bankhead; Toqir Mukhtar; Rafael Perera-Salazar; Tim A Holt; Chris Salisbury; F D Richard Hobbs Journal: BMJ Open Date: 2017-11-16 Impact factor: 2.692