Walk-in open access in general practice may influence the general practitioner’s (GP’s) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1–8.8, )). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice. 1. Background Quick access to general practice is considered to be a major patient need compelling general practitioners (GPs), policy makers, and administrators to plan how access is managed. Management models promoting quick access have been known as open access, same-day access, walk-in, and advanced access and cover a variety of different aspects of access: patients can attend within a specified time period each day without an appointment, patients can access the GP’s calendar to make their appointment themselves, and specific standards for waiting time. The aims of open access have primarily been to individualise the types of appointments available and thus increase service by making it possible for patients to get an appointment with their preferred GP thereby securing continuity, minimising unnecessary visits and waiting times, and optimising appointment scheduling to boost capacity, better match capacity to demand, and reduce patient no-shows [1–3]. The benefits of open access seem to be unclear and research has so far focused on waits and patient experiences. However, in England 20% of GPs using advanced access reported a lack of resources, and some expressed concerns about the trade-off between immediate access and continuity of care [4].
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