[Consultations with third parties in general medicine]

To quantify and describe consultations carried out with third parties in General Medicine.

Prospective and descriptive study.

Three General Medical consulting rooms in INSALUD's Health Area IV, Madrid.

All those consultations carried out with third parties from 15 February 1993 until 200 cases per doctor had been reached. INTERVENTION AND MAIN RESULTS: The data of the patient, the third party and the meeting were recorded for a total of 603 consultations using a third party. These consultations made up 18% of the total number at the three consulting rooms. According to the criterion of the doctor involved, more than half of these consultations were not clinically justified. People attended fundamentally to obtain prescriptions (76%), notes for short periods of time off work (9.6%) and referral to specialists (8.9%). The third party was usually a woman (62%) and spouse or mother of the patient (45 and 28%, respectively).

In the three General Medical consulting rooms studied, which were organized on the traditional model, third-party consultations are common and clinically unjustified in more than half the instances. These consultations are due fundamentally to difficulties of access to Primary Care services. Increasing the General Practitioner's availability for on-demand consultations could lessen this high incidence of third-party consultations.