The importance of list size and consultation length as factors in general practice.

It is commonly believed that longer consultations are essential to better care and that this can only be achieved by lowering list sizes. The results of a survey of general practitioner trainers show that, on average, the time given to each patient was longer when general practitioners had lower list sizes, but that for a substantial minority of doctors list size played no part. Although the evidence is inconclusive, patients registered with lower list size general practitioners consulted more and received prompter attention. Doctors with smaller lists worked shorter hours and felt less overworked. However most of the correlates were weak owing to great individual differences of practice style between general practitioners. If a case for lower list sizes is to carry force, stronger evidence is needed that patients will receive more of their general practitioners' attention.