Contents - Middle East Journal of Family Medicine

ORIGINAL CONTRIBUTION & CLINICAL INVESTIGATIONeffect on health promotion (McPhee et al., 1984; Wilson,1985; Howie et al., 1991; Alsever, 1995; Lowe, 2000;Engstrom et al., 2001; Ogden et al., 2004). In Britishgeneral practices the average consultation time rangedfrom 5.5 to 6.6 minutes (Wilson, 1985; Roland et al.,1986; Wilson, 1991; Carr-Hill et al., 1998; Deveugele,2002;). In Australia the average GPs consultation timeranged from 3 to 39 minutes with a mean of 14.8 minutes(Britt et al., 2002) and in the United States (Levinson andChaumenton, 1999) the mean visit length was 13 minutes.It was observed in Saudi Arabia, a neighboring country,time of 5.69 minutes (Al-Shammari, 1991; Bener, 1992),and in the United Arab Emirates it ranged 5 to 6 minutes(Annual Health Report 2000), and in the present study inthe State of Qatar the average consultation time rangedfrom 4.7 to 8.4 minutes.Managed care companies encourage primary carephysicians to limit referrals to specialists and provideas much of the needed services themselves. As a result,generalist and specialist physicians are now in directcompetition with one another (McPhee et al., 1984;Alsever, 1995). Many physicians in urban areas arespecialists whose expertise is not really relevant tothe general population, but their numbers augmentthe physician-population ratio (Alsever, 1995). Also,competition between generalists and specialists in afragmented system only serves to further weaken theposition of physicians in the health care industry (Cramand Ettinger, 1998). Furthermore, the referral systemand communication between generalists and specialistscan be further explored in Qatar and other neighboringcountries populations.Finally, efficient medical communication depends on anunderstanding of the patient perspective. When consultingthe regular doctor, trust and satisfaction are associated.(Baker et al., 2003) The feeling of not having to hurryduring the consultation is more important than the actualnumber of minutes (Steine et al., 2000). Patients’ levelof emotional involvement and their specific expectationsare often undisclosed. However, short consultation timein Primary care and tertiary care and also of generalistand specialist physician competition, would always be aproblem in the developing and developed countries.CONCLUSIONThe consultation length has increased in Qatar duringthe decade; however, it is still short by international andwestern standards. The care provided by generalist andspecialist physicians differ in terms of workload, qualityand cost. Furthermore, in part both specialists and generalpractitioners are blamed for failure to deliver high qualitycare.Table 1. The mechanism of type of visit, appointment and delay of Hamad General Hospital in Doha-Qatar,during the period 5-16 April 2005, (N = 7970).Variables Minutes Waiting Minutes Seen by DoctorN Mean±SD Median Mean±SD MedianType of VisitNew 1664 57.4 ± 44.0 49.5 15.7 ± 14.9 10Follow Up 6306 56.4 ± 45.4 47.0 13.5 ± 13.0 10Type of Appointment With Appointment 7339 57.3 ± 44.8 49.0 14.0 ± 13.6 10Without Appointment 463 50.1 ± 49.4 35.5 12.4 ± 11.4 10Referral from Inpatient 168 47.8 ± 42.1 38.0 14.8 ± 11.5 11Physician Level Consultant 3021 54.1 ± 45.1 45.0 13.9 ± 13.0 10Specialist/Physician 4927 58.3 ± 45.1 50.0 14.0 ± 13.8 10Type of Delay Missing File 341 79.7 ± 48.2 75.0 13.1 ± 13.0 10Delay in Lab 18 75.6 ± 48.1 71.0 19.7 ± 10.0 17.5Unavailability of Doctor 128 84.7 ± 54.5 75.5 13.0 ± 10.4 10Delay in Radiology/Ultrasound 37 87.5 ± 47.7 84.0 26.5 ± 23.8 15Lab Results 64 36.3 ± 28.4 28.5 16.2 ± 11.3 15Wrong Appointment Date 17 97.5 ± 75.2 91.0 10.4 ± 7.3 9Radiology Results 50 75.6 ± 52.2 64.0 26.5 ± 25.3 15Others 537 64.4 ± 52.6 50.5 34.9 ± 26.8 306MEJFM - Volume 5 Issue 1 - January 2007