Patient use of a mixed appointment system in an urban practice.

The number of practices that run appointment systems has sharply increased recently. Such practices may have difficulty in fitting in urgent or extra consultations. A study was made of 639 patients who attended a practice whose surgeries are run on a mixed system of open access and by appointment. There were important differences in the type of patient and problem seen in the two types of surgeries, notably in age, social class, and presenting complaint. Some patients may be disadvantaged by surgeries that are run by appointment only.