[Primary care consultations: are they all by the doctor?]

To find out the proportion of primary healthcare consultations that could be attended by another professional other than the doctor.

multicentre cross-sectional study.

Primary healthcare, west-gipuzkoa region, with 17 health centres taking part.

Reasons for consultation dealt with by 38 doctors over 5 days.

Age, sex, frequency, category, initiative, reason for consultation and ideal level of healthcare.

A total of 4,377 patients who generated 5,592 consultations were included. The average frequency was 10 visits/year. The large majority (93.1%) of consultations took place in the centre, 5.4% by telephone and 1.5% were home visits. A total of 74.4% of the consultations were requested, 17.2% arranged by the doctor, 6.4% arranged by protocol, 2% at the request of other professionals, and 8% were urgent. The reasons were; 71.5% (95% CI: 69.8-73.2) were medical clinical, 7.2% (6.2-8.2) minor symptoms, 18.4% (17.1-19.5) bureaucratic, and 2.9% (2.3-3.3) for information. The consultations for medical reasons accounted for 80.5% (79.3-81.7) and 19.5% (18.3-20.7) were for non-medical reasons. Non-medical reasons made up 29.3% of the telephone consultations, 20.2% of the consultations in the centre, and 2.4% of the home visits, as well as 16.7% of the urgent consultations. The ideal level of healthcare was considered to be doctor 80.7%, 13.2% nursing and 2.8% administrative. In the consultations for minor symptoms, nursing was considered the ideal level in 65.3% of cases.

One out of every 5 consultations could be dealt with by a professional other than the doctor, which in 5 hours of consultations would allow 1 hour to be gained which could be used for other activities.