Health promotion in the general practice consultation: a minute makes a difference.
OBJECTIVE
To see whether extending appointment length from seven and a half minutes or less to 10 minutes per patient would increase health promotion in general practice consultations.


METHODS
Controlled trial of 10 minute appointments. Consultations were compared with control surgeries in which the same doctors booked patients at their normal rate (median six minutes per patient).


METHODS
10 general practices in Nottinghamshire.


METHODS
16 general practitioners were recruited. Entry criteria were a booking rate of eight or more patients an hour, a wish for longer consultations, and plans to increase appointment length.


METHODS
Duration of consultations; recording of blood pressure, weight, and cervical cytology in the medical record; recording of advice about smoking, alcohol, diet, exercise, and immunisation in the medical record; reporting of the above activities by patients.


RESULTS
Mean consultation times were 8.25 minutes in the experimental sessions and 7.04 and 7.16 minutes in the control sessions. Recording of blood pressure, smoking, alcohol consumption, and advice about immunisation was significantly more frequent in the experimental sessions, and the proportion of consultations in which one or more items of health education were recorded in the medical notes increased by an average of over 6% in these sessions. Patients more often reported discussion of smoking and alcohol consumption and coverage of previous health problems in the experimental sessions. There was little change in discussion of exercise, diet, and weight or cervical cytology activity.


CONCLUSIONS
Shortage of time is a major factor in general practitioners' failure to realise their potential in health promotion. General practice should be organised so that doctors can run 10 minute appointment sessions.
Wilson
A
A
Department of General Practice, Medical School, Queen's Medical Centre, Nottingham.
McDonald
P
P
Hayes
L
L
Cooney
J
J
D000328:Adult; D001071:Appointments and Schedules; D004739:England; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008499:Medical Records; D013997:Time Factors