MUMBAI: The average time that India's neighbourhood doctors , called primary care consultants, spend with patients is a negligible two minutes. Neighbouring Bangladesh and Pakistan seem worse off, with the length of medical consultation averaging 48 seconds and 1.3 minutes, respectively, according to the largest international study on consulting time, published in medical journal BMJ Open.Contrast this with first-world countries such as Sweden, the US or Norway where a consultation crosses 20 minutes on an average. "It is concerning that 18 countries covering around 50% of the world's population have a latest-reported mean consultation length of five minutes or less. Such a short consultation length is likely to adversely affect patient care and the workload and stress of the consulting physician," said the BMJ Open study conducted by researchers from various UK hospitals.Patients are the losers here, spending more at pharmacies, overusing antibiotics and sharing a poor relationship with their doctors, said the study.The shorter consulting time could mean larger problems in the healthcare system. In the Indian context, local experts said it is a reflection of overcrowded healthcare hubs and a shortage of primary care physicians.Primary care doctors are different from consultants trained in a particular branch of medicine.The finding of an average two-minute consult across India didn't surprise many. Health commentator Ravi Duggal said, "It is well known that patients get less time with doctors due to overcrowding in hospitals." Doctors in public hospitals end up consulting two to three patients at one time due to the crowds at OPDs. "It is, hence, not uncommon for doctors to mix up symptoms between two patients," he said.Private clinics and hospitals are not less crowded. "Private doctors, especially general physicians, have such crowded OPDs that they only listen to symptoms and rarely conduct a physical examination," said Duggal, adding that a patient's quality of care gets compromised in the process.Former Maharashtra Medical Council member Suhas Pingle blamed overcrowded clinics and the overburdened healthcare system.There is also India's peculiar "prescription" of a good doctor. "In India, we believe the best doctor is one who doesn't charge and is available 24x7. This is not practical," said Dr Pingle. Many doctors take lower charges so that they can get more patients. "Consultation length will obviously be shorter because there are only so many hours that a doctor can work," said the general physician.The main difference between western and Indian consultation is the nature of the disease. The BMJ Open study looked at the overall picture of poor primary healthcare in countries.