[Communication time and recording in primary care interviews].

Objective: To describe the different fractions of the time used in on-demand medical consultations and their possible association with certain indicators of attendance.
Design: A descriptive, observational study.
Setting: An urban health centre.
Participants: Patients who attended with a prior appointment for on-demand consultations with one of the Health Centre's family doctors between 27th September and 29th November, 1993.
Measurements and Main Results: An observer with a chronometer measured the different fractions of time in 263 interviews. The 50% of the interview time was taken up by bureaucratic and recording activities; and the other 50% by doctor-patient communication and investigation. Bureaucratic recording time (prescriptions, sick-notes...) makes up 72% of total recording time, while the remaining 28% is for the writing-up of the clinical notes. Times for initial listening (23%), questioning (23%), investigation (21%) and information-education (26%) correlate positively among themselves. The average time dedicated to writing the clinical notes was significantly greater when the total consulting time was 3 to 4 hours than when it was 2 to 3 hours (p = 0.04). The average time dedicated to writing prescriptions was greater when the total number of patients per day was over 20 (p = 0.005); while the average time spent listening to the patient was greater when 21 to 25 patients per day were seen than when the figure was 10 to 20 or 26 to 29 patients per day.
Conclusions: There is a need for certain organisational changes in consultations or some kind of bureaucratic-administrative support, if the fraction of interview time dedicated to doctor-patient communication is to be increased.