Group Visits: Are They Right for Your Medical Practice?

Group visits, or shared medical appointments, are an underutilized opportunity for busy practices to solve patient-demand problems they are struggling to meet, and to make sure patients get the care they need, when they need it. This may be particularly important for practices with chronic-care patients, but other patients can benefit too. I think of it as a "silent opportunity," because so few medical practices have committed the time to explore the concept of shared medical appointments. It's really a great way to meet excess demand that burdens an appointment schedule, provide interactive care that improves patient service, and create shorter wait times. It can even be financially advantageous, so let's get the conversation going.

1. Extending the patient visit

The reasons physicians consider group visits are numerous, beginning with the demands on their time and the increased frustration of not being able to give more time to patients, especially those with chronic illnesses or complications. This often requires a practice to squeeze more full-length visits into an already demanding schedule. Physicians who seek to improve service, compliance, and outcomes for chronic-care patients will discover added value in shared medical appointments. They are also an attractive option for pediatric practices doing well visits for infants; OB/GYN practices giving obstetric care at the first prenatal visit to discuss diet, vitamins, exercise, and general pregnancy care; and caring for asthmatic patients in allergy practices.

2. A new way to provide care

Think of the types of care you provide in a whole new way and you just might discover group visits will work for you too. The Institute for Healthcare Improvement's (IHI's) Triple Aim Initiative is a framework that was established to "optimize health system performance." The Triple Aim outlines three areas of focus:

• Improving the patient experience of care (including quality and satisfaction);

• Improving the health of populations; and

• Reducing the per capita cost of healthcare.

Shared medical appointments can contribute to achieving these goals.

3. Shared patient experiences

Group visits enable a practice to bring a group of patients with the same disease together to discuss the common issues they share, and how to better manage their chronic condition. At the same time, each of the attendees has individual time with the physician or ancillary provider for an examination and specific treatment recommendations.

Shared medical appointments can improve patient access to care and expose patients to new treatments. For example, consider a repetitive strain injury and group sessions with a physical therapist. These sessions are valuable to patients in numerous ways - besides the opportunity to commiserate with other patients. People learn first-hand about how different work settings and ergonomic shortcomings can contribute to repetitive strain. Together patients learn techniques to apply at home and the therapist has the luxury of spending more time with the group than the allotted time for an individual visit.

4. Power in numbers

Group visits have added appeal to a number of patients. They like the support they get from people that share their problems and health conditions. The shared medical appointment often contributes to improved compliance when patients hear one of their peers report improvement once they adhered to their treatment regimen. This can be a significant gain in meeting the IHI's triple aim of reducing cost, improving satisfaction, and achieving better clinical outcomes.

Group visits require a practice-wide commitment, starting at the top: the physicians and administration. Do you intend to implement shared medical appointments for your diabetic patients, pulmonary patients, those with immune diseases, or patients suffering with a specific heart disease? Perhaps it is a cohort you would not typically think of, such as patients who might be healthy if they weren't obese. These patients might respond well to a shared medical appointment where their peers could provide much needed support under the direction of a physician, combined with a nutritionist.

Executing the group visit model of care requires significant planning and educating staff and patients. There are space needs, staffing considerations, and knowing how to manage the work flow. The practice must also obtain privacy waivers from the patients in advance and take essential steps to make sure patients keep their appointment and show up on time. Overall, if you are committed, well organized, and tend to details ahead of time, you are likely to be successful and pleased with the results, along with your patients.