ارتباط با بیماران و مدت زمان مشاوره پزشکی خانواده Communication with patients and the duration of family medicine consultations

Introduction There are many different factors that influence interaction between patient and physician in medical practice, including the duration of the consultation.1,2 The appropriate length of a consultation is a controversial issue.1 In Spain there are precise limits (10 min minimum on average), that under no circumstances should be exceeded.3 The Spanish Public Health System allocates 6 min on average to consultations, much less than the 10—15 min allocated in other European countries and the 20 min in North America and Canada.1,4 A longer duration would allow a more comprehensive approach, exploring risk factors, prevention, and improving lifestyle.1,2 By contrast, a consultation lasting less than 10 min, in addition to increasing dissatisfaction, could cause malpractice and higher costs.1 Several factors have been associated with longer consultations; older professionals, female patients, increased patient participation, a greater number of reasons for consultations or type of problem (psychological or social).5—8 Other factors such as if the patient is accompanied, are not so clear. For some authors this does not increase consultation length,9,10 while for others it does.11 The gender of the professional also seems to have an influence; women generally carry out longer consultations, which seems related to a more patient-centred experience, encouraging them to express themselves more.5,12—14Lastly, some authors find to communicate better with patients, a longer consultation is required.6,7 The importance of this finding would lie in the proven link between adequate communication and improvement of health.15,16 In Spain, a country where the increase in consultation time is a continuous demand, the relationship between consultation time and communication with patient has hardly been addressed. In this study, we plan to discover how consultation length is distributed, as well as the factors associated with longer or shorter medical consultations in primary care. In particular we aim to understand whether better communication and a more patient-centred, participatory style consultation requires more time.