***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: There is a burgeoning literature on communication in general practice . It is often assumed that trained GPs know and practice the techniques described , but that time is a major constraint . In two experimental studies patients were given shorter or longer appointments  , and the doctors ' use of different verbal interventions was measured . Our analysis focused on how individual doctors varied in their use of  interviewing techniques  according to the time available . When more time was available some interventions were used more frequently by all doctors , but for other interventions the response was variable . For example , GPs who normally used facilitation frequently used it more often when greater time was available , whereas doctors who used this technique less frequently tended not to change when more time was available . This suggests that , at least in the short term , there is a differential response to changes in the time available in the consultation , with increased time being a necessary but not sufficient condition to promote the greater use of the communication techniques which doctors use less frequently OBJECTIVE --To see whether extending appointment length from seven and a half minutes or less to 10 minutes per patient would increase health promotion in general practice consultations . DESIGN --Controlled trial of 10 minute appointments . Consultations were compared with control surgeries in which the same doctors booked patients at their normal rate ( median six minutes per patient ) . SETTING --10 general practice s in Nottinghamshire . SUBJECTS--16 general practitioners were recruited . Entry criteria were a booking rate of eight or more patients an hour , a wish for longer consultations , and plans to increase appointment length . MAIN OUTCOME MEASURES -- Duration of consultations ; recording of blood pressure , weight , and cervical cytology in the medical record ; recording of advice about smoking , alcohol , diet , exercise , and immunisation in the medical record ; reporting of the above activities by patients . RESULTS --Mean consultation times were 8.25 minutes in the experimental sessions and 7.04 and 7.16 minutes in the control sessions . Recording of blood pressure , smoking , alcohol consumption , and advice about immunisation was significantly more frequent in the experimental sessions , and the proportion of consultations in which one or more items of health education were recorded in the medical notes increased by an average of over 6 % in these sessions . Patients more often reported discussion of smoking and alcohol consumption and coverage of previous health problems in the experimental sessions . There was little change in discussion of exercise , diet , and weight or cervical cytology activity . CONCLUSIONS --Shortage of time is a major factor in general practitioners ' failure to realise their potential in health promotion . General practice should be organised so that doctors can run 10 minute appointment sessions In a study in which patients were allocated non- systematic ally to surgeries booked at 5 , 7.5 , and 10 minute intervals 623 consultations were taperecorded . In surgeries booked at longer intervals doctors used the extra time to take a fuller history from their patients . In surgeries booked at 10 minute intervals doctors spent more time explaining the patient 's problem , explaining the proposed management , and in discussing prevention and health education , these increases not being evident in surgeries booked at 7.5 minute intervals An experiment was carried out in which patients who were seeking appointments for a consultation in a general practice in south London attended  consulting sessions booked at 5 , 7.5 , or 10 minute intervals . The particular session that the patient attended was determined non- systematic ally . The clinical content of the consultation was recorded on an encounter sheet and on audio-tape . At the end of each consultation patients were invited to complete a question naire design ed to measure satisfaction with the consultation . The stress engendered in doctors carrying out surgery sessions booked at different intervals of time was also measured . At surgery sessions booked at 5 minute intervals , compared with 7.5 and 10 minute intervals , the doctors spent less time with the patients and identified fewer problems , and the patients were less satisfied with the consultation . Blood pressure was recorded twice as often in surgery sessions that were booked at 10 minute intervals compared with those booked at 5 minute intervals . There was no evidence that patients who attended sessions booked at shorter intervals received more prescriptions , were investigated or referred more often to hospital specialists , or returned more often for further consultations within four weeks . There was no evidence that the doctors experienced more stress in dealing with consultations that were booked at 5 minute intervals than at consultations booked at 7.5 and 10 minute intervals , though they complained of shortage of time more often in surgery sessions that were booked at shorter intervals 
    Output:
    
Altering appointment length result ed in modest changes in average consultation length .
There were no consistent differences in problem recognition , examination , prescribing , referral or investigation rates .
There was some evidence that blood pressure was checked more frequently and smoking discussed more often when more time was available .
None of the interventions were associated with differences in patient satisfaction .
CONCLUSIONS Our findings do not provide sufficient evidence to support or resist a policy of altering consultation lengths of primary care physicians .