title: The workload of GPs: consultations of patients with psychological and somatic problems compared.
abstract: 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.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, The Netherlands. e.zantinge@nivel.nl
authors.forename: Else M
authors.initials: EM
authors.lastname: Zantinge
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Verhaak
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Kerssens
authors.forename: Jozien M
authors.initials: JM
authors.lastname: Bensing
mesh_terms: 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*