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Communication with patients and the duration of family medicine consultations
Francisco Javier Valverde Bolívar1, Miguel Pedregal González2, Herminia Moreno Martos3
1Unidad Docente de Medicina Familiar y Comunitaria de Jaén, Distrito Sanitario Jaén-Jaén Sur, Jaén, Spain.
Objective:
To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style.
Design:
Cross-sectional multicentre study.
Location:
Primary Healthcare Centres in Andalusia, Spain.
Participants:
A total of 119 tutors and family medicine physician residents.
Principal Measurements:
Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care.
Results:
The mean duration of consultations was 8.8min (sd: 3.6). The consultation tended to be longer when the physician had a patient-centred approach (10.37±4.19min vs 7.54±2.98min; p=0.001), and when there was joint decision-making (9.79±3.96min vs 7.73±3.42min: p=0.001). In the multivariable model, longer consultations were associated with obtaining higher scores on the CICAA scale, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and a smaller number of daily visits (r2=0.32). There was no correlation between physician or patient gender, or problem type.
Conclusion:
A more patient centred medical profile, increased shared decision-making, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and less professional pressure all seem to be associated with a longer consultation.
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