It’s no revelation to say that the US healthcare system is broken. Patients don’t always get the support they need, enough time with a physician, or a chance to discuss their concerns during typical visits. This is not the fault of the physicians: they are overworked and simply don’t have enough time in the day to give every patient the care they require 1.
The way we view healthcare is changing. Our doctors want to educate you to take charge of your health, so you can heal from the roots and come off medications, not go on more of them. This involves having time to support patients properly, and connecting people on facing similar problems, to create a community of support and accountability.
Group medical visits may well be the answer. Described as an ‘impressive tool for change’ by doctors, they provide the healthcare and support needed to empower the individual to take control over their own health.
What is a group medical visit?
Group medical visits involve healthcare professionals meeting with a group of patients to discuss treatment and prevention of chronic disease 2. They include individual evaluation and management of each patient as well as counseling with the group. They provide regular monitoring and support and are a proven, effective method for enhancing patient satisfaction, a patient’s self-care of chronic conditions, and improving outcomes.
They can be used for all types of chronic conditions including 3:
- Chronic pain conditions
- Cardiovascular disease
- High blood pressure
- Overweight and obesity
- Managing several chronic conditions
- And general wellness
They are also called group visits, or shared medical appointments (SMAs).
Why is there a need for group medical visits?
The United States spends more than any other country on healthcare, yet they rank 46th for life expectancy. Pair that with the exponential rise in cases of chronic disease, and we can clearly see something needs to change in the healthcare system 4 5. We need something that can fix:
- Poor patient satisfaction
- Rampant chronic disease and bad health outcomes
- High, unmanageable costs
Group medical visits aim to shift these problems. They give patients more time with a physician, to discuss more of the issues surrounding their illness, and to connect them to a community of similar people that provide support.
It changes the way the physicians act and their role in these visits, they become a facilitator of real patient change and give more power to the patient to take control of their own health and condition, and learn from each other during these sessions 6.
What are the benefits of group medical visits?
Group medical visits are typically cheaper than a one-to-one physician visit. Most insurance plans cover group medical visits, billed as regular medical visits. And when these visits help patients to make effective, long-term changes like reversing diabetes or high blood pressure, patients can expect to see even bigger savings in their future with reduced spending on medications and healthcare visits.
Lasting community bonds
The power of social connection as a predictor of health and longevity is undervalued in our society. In areas of the world known for positive long-term health, and some of the lowest rates of heart disease, diabetes, and other chronic conditions, known as “Blue Zones”, strength of social connections can determine health outcomes, even when you account for a lifelong healthy diet 7.
Living with chronic disease can feel isolating. Group medical visits allow patients to interact with other people living with the same chronic conditions, going through similar life experiences. We are, by nature, social creatures that lean on each other for support. This fulfills that nature in one of the most trying times for people: the face of illness.
It gives patients an opportunity to share their experiences and struggles with people that can understand, and most likely share, the obstacles and worries in ways that others, including your physician, may not. And whilst you may have friends and family that know about your condition, it’s a different feeling to connect with people who share the same daily struggles.
As well as tips for managing their condition, patients share tips for increasing activity, and making healthy diet changes such as new recipes, experiences eating out, healthy swaps they’ve made, and cooking tips.
Some of the reasons patients benefits from community are 8:
- It combats isolation, which helps to remove doubt about a patient’s ability to manage their illness
- Patients learn vicariously about disease self-management through their peers illness experience
- Patients feel inspired by seeing others who are coping well
- Patients receive first-hand advice from peers and professional expertise from their physician, providing more robust and well-rounded health knowledge
The motivation to change behavior is crucial to making long-term health changes. This is often lacking in one-to-one patient care and can be fixed with group medical visits through accountability.
Accountability stems from the community aspect of group visits. Once you start interacting with other people both in and outside the group, the social support from peers makes major lifestyle changes seem more achievable. You know people are holding you accountable and want to see you succeed!
The gift of time
Many features of quality care for disease prevention and cure are missing from traditional patient-provider visits because of time constraints 9. Primary care physicians would need over 26 hours a day to provide guideline recommended primary care 1.
Group visits give physicians the time to do more than just prescribe another pill, they can provide:
- Teaching and health education
- Experimental activities
- Complementary and integrative therapies such as mindfulness, meditation, and yoga
- Symptom and pain management
- Talks on nutrition, exercise, stress, and sleep
Patients are also given more time to discuss the psychosocial issues related to their illness, which are sometimes overlooked. This helps patients put their illness into perspective, and boosts their confidence in taking control of their health and self-managing abilities.
The benefits to group visits are not theoretical, science has repeatedly put them to the test. Numerous studies, systemic reviews, and meta analyses demonstrate the advantages of group medical visits.
One meta-analysis found that group medical visits significantly improved HbA1c, a measure of blood sugar for diabetes management, in participating patients 2.
Better physician-patient relationship
Physicians can better understand how to meet a patients’ needs by interacting more with patients in a group setting. Consequently, they provide better support with prevention, treatment, and self-management of the patient's conditions.
Patients who have been involved in group medical visits report 10:
- Improved communication with their clinician
- Improved overall satisfaction with the visit
- Feeling their physicians were less hurried
- More time allotted to discuss healthcare issues
- Being more satisfied with their care compared to individual visits
It also allows patients to see how their physician interacts with other patients, which can build patients trust in their physician 8.
Still not sure?
People may struggle with the idea of a shared medical visit, especially around privacy concerns. How are you protected in this group setting? Everyone that joins a group medical visit signs confidentiality paperwork to protect each other's data. These groups are a safe and regulated space to create a community of people who want to get better. The team reminds all patients of the importance of respect to all participants, and that information shared stays within the room, as it is completely private and confidential. These ground rules are established before the visits begin.
The bottom line
Group medical visits still provide standard care features including patient evaluations, necessary lab tests, and updated flows and chart sheets, with the same confidentiality and respect. They have added benefits of a supportive community, human connection, and more time with a physician.
Physicians are incredibly skilled, often life-saving, valued members of society, but the healthcare system lets them down. Group medical visits benefit both the physician and patient by providing more time for these visits.
The group medical visit model allows us at Mora to offer patients an hour a week with a dedicated specialist physician and the chance to build a supportive community.
If you’re struggling to take hold of your condition, and feel you’re at a standstill with current care, give this approach a try. Talk to one of our PAs today.
1. Porter, J., Boyd, C., Skandari, M. R. & Laiteerapong, N. Revisiting the Time Needed to Provide Adult Primary Care. J. Gen. Intern. Med. (2022) doi:10.1007/s11606-022-07707-x.
2. Housden, L., Wong, S. T. & Dawes, M. Effectiveness of group medical visits for improving diabetes care: a systematic review and meta-analysis. Can. Med. Assoc. J. 185, E635–E644 (2013).
3. Parikh, M., Rajendran, I., D’Amico, S., Luo, M. & Gardiner, P. Characteristics and Components of Medical Group Visits for Chronic Health Conditions: A Systematic Scoping Review. J. Altern. Complement. Med. 25, 683–698 (2019).
4. Berwick, D. M., Nolan, T. W. & Whittington, J. The Triple Aim: Care, Health, And Cost. Health Aff. (Millwood) 27, 759–769 (2008).
5. Raghupathi, W. & Raghupathi, V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health. Int. J. Environ. Res. Public. Health 15, 431 (2018).
6. Lavoie, J. G. et al. Group medical visits can deliver on patient-centred care objectives: results from a qualitative study. BMC Health Serv. Res. 13, 155 (2013).
7. Buettner, D. & Skemp, S. Blue Zones: Lessons From the World’s Longest Lived. Am. J. Lifestyle Med. 10, 318–321 (2016).
8. Kirsh, S. R. et al. A realist review of shared medical appointments: How, for whom, and under what circumstances do they work? BMC Health Serv. Res. 17, 113 (2017).
9. Tai-Seale, M., McGuire, T. G. & Zhang, W. Time Allocation in Primary Care Office Visits: Time Allocation in Primary Care. Health Serv. Res. 42, 1871–1894 (2007).
10. Wadsworth, K. H. et al. Shared medical appointments and patient-centered experience: a mixed-methods systematic review. BMC Fam. Pract. 20, 97 (2019).