Most patients wait alone in a cramped exam room for a scheduled appointment as their physician rushes through back-to-back individual patient visits lasting an average of 22 minutes each. With the growing trend of shared medical appointments, a patient and his/her peers spend a full 90 minutes with their personal physician. Shared medical appointments are a small but growing part of primary care as well as for a variety of medical specialties. According to the American Academy of Family Physicians, the percentage of its members offering shared medical appointment more than doubled, to nearly 12 percent, between 2005 and 2012. At the Cleveland Clinic, nearly 10,000 group appointments were logged between 2002 and 2014. Promoted as the wave of the future in outpatient care, group appointments are changing the way physicians and patients view medical treatment.
HOW IT WORKS
For example, a group of five to ten patients gather at an appointed time in a conference room where nurses record vital signs, administer injections, and attend to other basic medical needs. Physicians then provide an educational talk, followed by a lengthy question-and-answer session. Doctors may also have brief one-on-one discussions with patients regarding prescriptions or specific concerns. The entire event lasts between 90 minutes to two hours — a huge gain for patients while saving time for the physician. These visits give patients a chance to share common concerns about their ailments with their peers, hear the answers to questions they might never have thought of asking, and learn how to better manage chronic conditions. Although doctors are seeing more patients at one time, they say shared visits allow them to go into more detail on relevant issues and to develop better relationships with their patients. Group practices may have a dozen groups rotating monthly so that specific days of the week are reserved for group medical appointments.
Shared visits are not a replacement for annual physicals and are not suited for handling major medical issues that require a physical exam. However, they are increasingly used to care for people with chronic conditions —such as asthma, diabetes, coronary artery disease, congestive heart failure, Parkinson’s disease, blood pressure control, and obesity — who need monthly or frequent follow-up appointments.
To comply with regulations of the Health Insurance Portability and Accountability Act (HIPAA), patients are asked to sign forms agreeing not to share the information of others who attend the shared visit and authorizing the disclosure of their own information to the group.
FACILITY PLANNING IMPLICATIONS
In order to conduct shared appointments, a room that can seat from five to 10 patients comfortably is required that is easily accessible from the patient reception/waiting area. The typical physician’s office suite rarely provides a patient care space that is any larger than an exam/consult room designed for one-on-one interaction. Although large clinics are occasionally designed with a large conference room that can be used for both patient education and staff meetings, space for group appointments is usually equipped differently.
Instead of a large conference table surrounded by chairs or a classroom-style seating arrangement, a group appointment room requires comfortable chairs arranged in a circle that allows the physician to circulate between the patients while making notes on a wall-mounted whiteboard or on a tablet which can be projected on a large computer monitor. Patient flow is another consideration. Depending on the nature of the group appointment, the attendees may be privately weighed, have their vital signs taken, or meet briefly one-on-one with a care provider before or after attending the group appointment. Other facility options include using the waiting room or a staff break room if a specific time of day or week can be reserved exclusively for the group appointment.
This article is an update of a previous post.