THE GENERAL-PRACTITIONERS USE OF TIME - IS IT INFLUENCED BY THE REMUNERATION SYSTEM

The practice pattern of 116 general practitioners in 60 rural municipa lities in Northern Norway was studied with respect to length of consul tation, the weekly number of consultations and the proportion of retur n visits. The average length of consultation was 14 mins, and only sli ghtly lower for fee-for-service (FFS) doctors (13.7) than for salaried ones (14.8). The weekly average number of surgery consultations was h igher for FFS doctors than for the salaried (63 vs 49), but the weekly number of hours spent consulting and the proportion of return visits were about the same. Further, the characteristics of the health care s ystem (doctor density and doctor turnover) were associated with variat ions in the doctors' use of time. The most consistent effects, even if weak, were the age and sex of the patients. The strongest effects on the length of consultation were referrals and various medical procedur es. This suggests that in this instance the medical condition at hand would appear to have a greater influence on the doctors' use of time t han either the remuneration system or other characteristics of the hea lth care system. Although the association between the doctors' use of time and the type of remuneration was weak, the study indicates that t he type of remuneration does matter. Consequently, financial incentive s can be used to influence the practice pattern of GPs.