Evidence Based Health Policy,

We  read the paper written by Hajizadeh et al. (1) published in Evidence Based Health Policy, Management & Economics in 2019 and aimed to study the factors affecting outpatient consultation length among specialists in Tabriz City, Iran. Although this was a valuable investigation and its findings were very interesting, some issues should be considered. Our main concern is that the authors did not compare consultation lengthsbetween similar studies conducted in Iran. It seems that comparing consultation lengths conducted in a similar context is valuable and has a great impact on managers, policy-makers, and users’ decision-making.
Consultation length is a fundamental domain of patient–physician communication, so that its insufficiency can negatively affect the effectiveness of treatment and diagnosis process (2). Additionally, the consultation length partly indicates the consultation quality and is a critical element in medical care outcomes and patients’ satisfaction (3-5). In other words, a significant part of the patient satisfaction comes from the interactional communication with the clinical staff, which is confirmed as a key elementin excellent consultation (2-4, 6).
Numerous studies were conducted on consultation length in Iran, which could be included in the Hajizadeh et al. (2, 6-16) study. Hajizadeh et al. (10) concluded that the average length of out­patients’ visits was 6.9 (SD = 2.6) minutes in Sheikh al-Raise clinic in Tabriz (1). However, a similar study conducted at the same clinic during the same time (2015) showed that average duration of clinical consultation was 8.52 (SD = 3.14) minutes. In Qazvin, the mean length of out­patient’ visits in 2011 and 2013 were 5
(SD = 0.6) and 4.67 (SD = 2.43) minutes, respectively(8, 15).The finding of Khori’s study indicated that the average visit time was 6.9
(SD = 2.6) minutes in Gorgan(14). Khiavi(13) carried out a study in Ahvaz in 2015 and reported that the average visit time was 4.88 (SD = 0.12) minutes. An interventional study (16) conducted in Qazvin in 1996 showed thatthe average visit time increased significantly from 4.34 (SD = 1.3) to 5.06 (SD = 1.1) using the participation management. According to a systematic review over the medical visit time, the mean visit time was 4.89 minutes in Iran (11). Furthermore, another systematic review investigated the consultation length and its determinants in outpatient clinics in 34 countries using 189 papers (2).
 Key words
Consultation length, Physician-patient relations, Physicians, Outpatients.
Acknowledgments
The authors would like to thank the Research Center for Evidence-Based Health Management at Maragheh University of Medical Sciences for their support.