GP consultations: less time, but more antibiotics

More GPs face greater time pressure in their daily practice. US researchers look on possible relations of shorter doctor appointments and poorer quality of care.

Key points

The sources of time pressure

Many GPs have long been aware of the limited availability of doctors to match population sizes and their needs. There is often a shortage of doctors, particularly in rural areas. As a result, doctors in these areas have to care for more and more people - even though they cannot add more hours to their working week. In addition, life expectancy continues to rise and age-related illnesses in GP practices are becoming increasingly complex.

This shortage of care provision is particularly noticeable in the USA, where there is a two-tier insurance system. Reimbursements for state-insured patients are often significantly lower than for those who are insured by their employers or privately. It is therefore not always easy for these patients to get timely appointments, or to spend enough time with doctors.

Does the quality of care suffer as a result of doctors' time pressure?

Whether and how the shortage of time actually influences doctors' actions and whether the quality of care suffers as a result has not yet been investigated. A recent study from the USA scrutinised precisely this issue.

The researchers analysed data from more than 8 million visits to doctors in 2017. These visits were made by just over 4 million patients to around 8,000 GPs.

Does this lead to changes in medical behaviour?

Researchers found that if a patient spends less time with their practitioner, the risk of unnecessary antibiotic administration for respiratory infections increases. The same applies to the prescription of benzodiazepines and opiates for pain. At the same time, every minute that doctors spend longer with their patients reduces the risk of prescribing these drugs. 

People with state insurance and people with Hispanic or African-American roots were particularly disadvantaged by this approach.

In this context, there is certainly a need for action to tackle the limited provision of GP care. However, the responsibility here lies not only with the doctors. The study data also show that there may well be bias in patient care. Doctors can benefit from taking a look at the available data and, if necessary, making the necessary corrections and adjustments on their everyday professional practice.

  1. Neprash HT, Mulcahy JF, Cross DA, Gaugler JE, Golberstein E, Ganguli I. Association of Primary Care Visit Length With Potentially Inappropriate Prescribing. JAMA Health Forum. 2023 Mar 3;4(3):e230052. doi: 10.1001/jamahealthforum.2023.0052. PMID: 36897582; PMCID: PMC10249052.