When visiting the doctor, there may be strength in numbers.
In recent years, a growing number of doctors have begun holding group appointments — seeing up to a dozen patients with similar medical concerns all at once. Advocates of the approach say such visits allow doctors to treat more patients, spend more time with them (even if not one-on-one), increase appointment availability and improve health outcomes.
Some see group appointments as a way to ease looming physician shortages. According to a study published in December, meeting the country’s health care needs will require nearly 52,000 additional primary-care physicians by 2025. More than 8,000 of that total will be needed for the more than 27 million people newly insured under the Affordable Care Act.
“With Obamacare, we’re going to get a lot of previously uninsured people coming into the system, and the question will be ‘How are we going to service these people well?’” said Edward Noffsinger, who has developed group-visit models and consults with providers on their implementation. With that approach, “Doctors can be more efficient and patients can have more time with their doctors.”
Some of the most successful shared appointments bring together patients with the same chronic condition, such as diabetes or heart disease. For example, in a diabetes group visit, a doctor might ask everyone to remove their shoes so he can examine their feet for sores or signs of infection, among other things. A typical session lasts up to two hours. In addition to answering questions and examining patients, the doctor often leads a discussion, often assisted by a nurse.
Insurance typically covers a group appointment just as it would an individual appointment; there is no change in the co-pay amount. Insurers generally focus on the level of care provided rather than where it’s provided or how many people are in the room, Noffsinger says.
Some patients say there are advantages to the group setting. “Patients like the diversity of issues discussed,” Noffsinger said. “And they like getting 1 1/2 hours with their doctor.”
Patients sign an agreement promising not to disclose what they discuss at the meeting. Although some patients are initially hesitant about the approach, doctors say their shyness generally evaporates quickly.
“We tell people, ‘You don’t have to say anything,’” said Edward Shahady, medical director of the Diabetes Master Clinician Program at the Florida Academy of Family Physicians Foundation in Jacksonville. Shahady trains medical residents and physicians to conduct group visits with diabetes patients. “But give them 10 minutes, and they’re talking about their sex lives.”
Though group appointments may allow doctors to increase the number of patients they see and thereby boost their income, many doctors are uncomfortable with the concept, experts say, because they’re used to taking a more authoritative approach with patients rather than facilitating a discussion with them.
According to the American Academy of Family Physicians, 12.7 percent of family physicians conducted group visits in 2010, up from 5.7 percent in 2005.
Some studies have found that group visits can improve health outcomes. In an Italian trial that randomly assigned more than 800 Type 2 diabetes patients to either group or individual care, the group patients had lower blood glucose, blood pressure, cholesterol and BMI levels after four years than the patients receiving individual care.
Doctors say patients may learn more from each other than they do from physicians. “Patients really want to hear what others patients are experiencing,” Shahady said.
Jake Padilla, of Westminster, Colo., participated in his first group visit more than a decade ago, shortly after he had heart bypass surgery.
Padilla, now 67, continued to attend group appointments geared to primary-care patients’ concerns for years after that at the Kaiser Permanente outpatient clinic near his home. (Kaiser Health News is not affiliated with Kaiser Permanente.) He usually went once a month or so, and the members of the group constantly changed.
The holiest plant of the Christmas season may be a raggedy shrub with peeling bark that seems to grow best in a dusty backyard in Tempe, Ariz. This is Boswellia sacra, better known as the frankincense tree. The shrub’s gum resin is one of the three biblical gifts that the wise men bestowed on the infant Jesus. Until recently, Americans who wished to cultivate their…
FRESNO, Calif. — Federal law now allows visitors to carry guns in national parks, but you can’t just slip a loaded pistol into your backpack and take a hike. Pay attention, because this is a little complicated. You will need a concealed weapons permit to carry the loaded gun in the backpack. But you don’t need any kind of permit if you just want to…
A barred owl that drew crowds of onlookers while swooping around at Farewell Bend Park earlier this year may well be dead. The owl was seen from mid-January into last month, regularly hunting for mice and voles along the Deschutes River just upstream of the Old Mill District. It then disappeared about a month ago. Two photographers found a dead owl March 3 about 10…
Move over, large lap pools. Smaller swimming holes are making a big splash. Sure, the economy is playing a role in making this luxury littler: Smaller pool equals smaller budget. But it's more than that, says Brett Berry, owner of Landscape Renderings, a Missouri business that designs and builds outdoor living environments. “You can create a fantastic sense of intimacy and atmosphere with a small…
Q: Why do some vegetables, such as cooked diced carrots, spark when I reheat them in the microwave?A: Microwaves work by sending out electromagnetic waves that vibrate the water, fat and sugar molecules in food, creating heat. The microwave generates an electric field, but the intensity of the electricity varies throughout the microwave. When you cut a carrot into small pieces and heat them in…