Perceived versus actual consultation patterns in an inner city practice

Consultation patterns in a practice with no appointment system, situated in a socially deprived area, were examined to confirm or refute one doctor's perception that the consultation rate was much higher than average. Seventy five per cent of a sample of patients (n = 394) had consulted in the previous year. The mean annual consultation rate was 3.8 (range 0 to 29) but the median was 3.0 and the mode 0. Among 222 patients consulting over one month the mean annual consultation rate was 10.0 (range 0 to 47) with a median of 9.0 and a mode of 6. The duration of consultation (n = 506) varied from one to 25 minutes (with mean, median and modal values of 5.3, 4.0 and 4 minutes respectively) and 53% of patients received between one and four minutes. The overall consultation rate was not high, particularly in view of the socioeconomic deprivation of the practice population, and the doctor's perception of excessive consultation was explained by the high consultation rate among attenders. The consultation pattern, particularly of males, was not conducive to a preventive approach. The mean was a poor descriptor of the average consultation rate or duration.