I was interested to see Rod Sampson’s article;1 many years ago I read something similar, and decided to try it myself, albeit without the post-appointment interviews. We offered my patients 5, 10, 15, or 20-minute appointments; it worked very well; I was pleasantly surprised. Patients had a good idea of how much time they would need; very few requested the longer ‘slots’ so my fears of being overwhelmed proved unfounded.
We did not continue the experiment because at the time I had a policy of accepting phone calls from patients; this interrupted the consultation (although if I let the phone ring more than three times the receptionist understood that I was not going to answer) but saved having to ring back, with the problems that engendered for the patient in terms of having to stay by the phone for an unpredictable period of time. However, what happened was that for each phone call, I ran that little bit late, so if there were several calls the later patients were kept waiting for longer than I (or they) would have wished.
All this was long before QOF, but there would seem to be no reason why such a system could not work well, with an extra few minutes added on for those doctor-centred elements. Thus the patient would feel they had had a fair hearing, and the doctor would not feel pressured into trying to squeeze the QOF components into a 10-minute slot if the patient’s agenda was a long one. After all, who tells the patient that the appointment is for 10 minutes? With this system, the patient knows exactly how long they’ve got. Also, the doctor would not have in the back of his or her mind the oft-quoted fear of the patient who brings a list, surgeries would not overrun, waiting rooms would not be full of disgruntled patients; the benefits would seem considerable on both ‘sides’.
The obvious counter-argument is that surgeries would take longer, or that fewer patients would be seen. That was not the case when I tried it; Sampson’s article makes no mention of this aspect; clearly more information is needed, but in the meantime, why not try it?
- © British Journal of General Practice 2013
