The workload of GPs: consultations of patients with psychological and somatic problems compared.
BACKGROUND
GPs report that patients' psychosocial problems play a part in 20% of all consultations. GPs state that these consultations are more time-consuming and the perceived burden on the GP is higher.


OBJECTIVE
To investigate whether GPs' workload in consultations is related to psychological or social problems of patients.


METHODS
A cross-sectional national survey in general practice, conducted in the Netherlands from 2000-2002.


METHODS
One hundred and four general practices in the Netherlands.


METHODS
Videotaped consultations (n = 1392) of a representative sample of 142 GPs were used. Consultations were categorised in three groups: consultations with a diagnosis in the International Classification of Primary Care chapter P 'psychological' or Z 'social' (n = 138), a somatic diagnosis but with a psychological background according to the GP (n = 309), or a somatic diagnosis and background (n = 945). Workload measures were consultation length, number of diagnoses and GPs' assessment of sufficiency of patient time.


RESULTS
Consultations in which patients' mental health problems play a part (as a diagnosis or in the background) take more time and involve more diagnoses, and the GP is more heavily burdened with feelings of insufficiency of patient time. In consultations with a somatic diagnosis but psychological background, GPs more often experienced a lack of time compared to consultations with a psychological or social diagnosis.


CONCLUSIONS
Consultations in which the GP notices psychosocial problems make heavier demands on the GP's workload than other consultations. Patients' somatic problems that have a psychological background induce the highest perceived burden on the GP.
Zantinge
Else M
EM
Netherlands Institute for Health Services Research, Utrecht, The Netherlands. e.zantinge@nivel.nl
Verhaak
Peter F M
PF
Kerssens
Jan J
JJ
Bensing
Jozien M
JM
D000328:Adult; D000368:Aged; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013997:Time Factors; D016526:Workload / Q000706:statistics & numerical data*