Factors Influencing Consultation Length in General Practice

General practice, the foundation of Australia’s healthcare system, provides care and essential healthcare services to patients as well as acting as gatekeepers to vital secondary medical services. A standard GP consultation of 10-15 minutes. This imposes time constraints on the consultation, that could be a limit for patients with several presenting concerns or a complicated concern. This limitation could compel GPs to compromise on the quality of care either by inadequately addressing patient’s concerns by prioritising time or by frequently extending consultations and running late.  While longer GP consultations have been identified as beneficial in the existing literature, how consultation length relates to the internal factors (problems presented in the consultation) and external factors (social and economic factors) has not been studied. Using 41- video-recorded GP consultations and interdisciplinary approaches (conversation analysis and economic analysis), this thesis studies how external and internal factors within a GP’s consultations relate to consultation length, by studying: i) How do external factors relate to how and when medical concerns are raised? ii) How do internal factors affect the consultation length? iii) What is the pattern of raising medical concerns during a GP consultation?  The results suggest external factors and internal factors affect GP consultation length. Specifically, older patients (35-64 years-old & 65-85+years-old) had shorter consultations, while patients with tertiary education had shorter consultation length. Agenda setting was rarely seen in GP consultation; however, we find it does shorten consultation length. GP driven consultation resulted in shorter consultation length. The results from this thesis emphasise that future policy aimed at improving health care access needs to account for the characteristics of GP consultation along with its length.