Interruptions during general practice consultations: negative impact on physicians, and patients' indifference

Fam Pract. 2022 Nov 21:cmac129. doi: 10.1093/fampra/cmac129. Online ahead of print.

Abstract

Background: Interruptions can impact consultation duration, doctors and patients' satisfaction, and quality of care provided. Although most of them seem to have a negative impact, affecting doctor-patient relationship and interfering with clinical reasoning, which increases the risk of error, there is still no evidence on their global impact on consultations.

Objectives: To evaluate the number and duration of interruptions during general practice consultations. To compare physicians and patients' perceptions of their urgency and impact, as well as the overall satisfaction with the consultation.

Methods: Cross-sectional study of a representative sample of annual face-to-face general practice consultations at a Health Centre. Between January and March 2022, anonymous questionnaires were given to physicians and patients after consultation. We performed a descriptive and inferential statistical analysis.

Results: A total of 403 consultations were included. Physicians reported more interruptions than patients (108 vs. 87, P < 0.001). From patients' perspective those interruptions were more urgent (34.5%) compared with physicians' perspective (20.6%; P = 0.029). Patients undervalued their impact on consultations (7.1% of interruptions with a negative impact among patients vs. 24.7% among doctors; P < 0.001). Interruptions did not interfere with patients' satisfaction with consultation (P = 0.135) but were associated with lower physicians' satisfaction with consultation (P = 0.003).

Conclusion: Physicians are more critical regarding consultations interruptions, being more aware of their incidence and reporting more often a negative impact, which translates into lower satisfaction with interrupted consultations. Patients devalue the occurrence of interruptions, showing no concern about their impact on security or privacy, and their satisfaction is not affected by them.

Keywords: efficiency; general practitioners; organizational; patient safety; patient satisfaction; physicians; physician–patient relations; primary care; primary health care; referral and consultation; risk management; time management.

Plain language summary

Interruptions during consultations can impact their duration, doctors and patients’ satisfaction, and the quality of care provided. This study aims to evaluate the number and duration of consultation interruptions, to compare physicians and patients’ perceptions of their urgency and impact, as well as the overall satisfaction with the consultation. For that, 403 face-to-face general practice consultations were analysed through anonymous questionnaires given to doctors and patients after each consultation. Physicians were more critical regarding the consultation’s interruptions, being more aware of their incidence and reporting more often a negative impact. This translated into a lower satisfaction with the consultation where an interruption occurred. Therefore, interruptions seemed to increase physicians stress and dissatisfaction, which may represent a risk factor for burnout and jeopardize patient safety. On the other hand, patients seemed not to be aware of the possible impact of interruptions during consultations. They not only devalued their occurrence, showing no concern about possible impact on their security or privacy, but also their satisfaction with the consultation was not affected by them.