It is not surprising when a research study said that on average a primary healthcare seeking patient gets only 48 seconds of service from a physician in Bangladesh though in last one decade the number of public and private medical colleges mushroomed and subsequently the number of doctors also increased. The average consultation length varied across the world, ranging from 48 seconds in Bangladesh, the lowest consulting time, to 22.5 minutes in Sweden. The infrastructure development or GDP growth rate can’t change the human development index, whereas primary healthcare and quality education improvement in the country can, but we are lagging in both the sectors. Despite many successes in MDG attainment, many indicators of public health are still below the regional average and global standard.
The study conducted by British Medical Journal found that 18 countries representing about 50 percent of the global population spend five minutes or less with their primary care physicians. A total of 179 studies were identified from 111 publications covering 28,57,0712 consultations in 67 countries under the survey. It found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. It is worrisome that a large proportion of the global population has only a few minutes with their primary care physicians. Such a short consultation length was likely to adversely affect patient healthcare and physicians’ workload and stress.
There were 15 countries with their most recently reported consultation length at less than five minutes, 25 countries with 5-9.9 minutes, 11 countries with 10-14.9 minutes, 13 countries with 15-19.9 minutes and three countries with less than or equal to 20 minutes. Australia, the UK, and the USA had sufficient data points to determine long-term trends. The reasons for such striking differences may reflect a number of factors, including issues relating to governance, workforce, access, continuity, comprehensiveness, and coordination. For example, in countries such as Pakistan, Bangladesh, and China, there is no appointment system, and individual primary care physicians may undertake over 90 consultations a day with a considerable amount of time taken up providing repeat prescriptions.
The government has a plan to recruit 5000 physicians through the 39th Bangladesh Civil Service examination. Hopefully, the workload would be eased per physician in this highly populated country. Undoubtedly, the consultation length has strong relation with quality healthcare service and proper diagnosis of diseases. So, by increasing the number of physicians in primary healthcare centers, by ensuring that physicians stay at their respective workplaces during working hours, and by setting up more health complexes in rural areas we can effectively change the existing horrible scenario of primary healthcare service.
