Group Medical Appointments Get Another Look

Michelle Wilson Berger for HealthLeaders Media , June 7, 2012

This model, around since the mid-1990s, is now getting more attention. In a shared medical appointment, eight to 10 patients with a common denominator—a chronic condition such as diabetes, or elderly adults in need of a road map to aging well—see the doctor together for a long visit, often 90 minutes. Joining the session in some cases are a nurse, a behaviorist, and a documenter, each working to help the appointment run smoothly.

For visits that require a physical exam, each patient sees the physician in private room while the facilitator leads the group. With exams complete, the group reconvenes for a physician-led discussion. Through this approach, not only do patients interact more with the doctor, but they also learn from each other in an open, safe setting. Even though the physician sees more patients, he or she doesn't feel rushed due to the extended length of the visit.

"Working harder and doing more isn't the best answer," Sumego says. With shared medical appointments, "we're utilizing a concept that is basically more effective; it leverages resources, and we're offering it to our patients so that they have a high-quality visit." The key to making this work requires selecting the right high-impact specialty, working with a physician leader and team passionate about that specialty, and designing the group visit with both its physician and patient population in mind.

Group appointments take root
Back in 1988, Edward B. Noffsinger, PhD, received the scary diagnosis of pulmonary hypertension, "potentially lethal cardiopulmonary condition" as he describes it. For the two-and-a-half decades prior, he'd been director of oncology counseling and chronic illness services at Kaiser Permanente, so he knew how this country's healthcare delivery system worked. Yet as a patient, he was underwhelmed by his treatment. "I had the best doctors really anyone could hope to have, but I found that medical care as it was being delivered just wasn't satisfactory," he says. "It was very frustrating for the patient, for the doctor, the waits were very long to get in, the visits too rushed. The poor doctors, they looked worse than you felt."

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2 comments on "Group Medical Appointments Get Another Look"

M. Bennet Broner, PhD (6/7/2012 at 1:07 PM)
This is deja vu all over again. Around 1993 I developed a group health maintence group concept focused around a psychologist and a health educator. I shopped the idea to the Center for Family Practice at the University of Alabama, Birmingham; and at Cooper Green Mercy Hospital (county run)and both saw no practical need for it. I wonder if they'd feel the same today? Presently, I am redeveloping the program for a non-medical non-profit.

Adrian Scipione (6/7/2012 at 9:46 AM)
I can't imagine this improving the care that the patient receives. It is highly improbable that every single patient in that group session would be as open and honest with their physician as if they were one on one, particularly if they have concerns about one treatment plan over another. It appears to me that, outside of a few cases that would be enhanced by a group meeting (ie. educating the patient on what to expect from their knee replacement surgery), this would stifle a dialogue in instances where that is very important. It is entirely a different matter where the course of treatment and the informed consent has already been obtained and you are merely going through the specific process and educating the patients on what they can expect. I am a non-believer who needs to be convinced about the advantages of this.




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