Shared medical appointments have their benefits, but it can be tough to get patients and providers on board with any new care model, say a British doctor and a business school professor.
Shared appointments, in which patients meet with the doctor along with others who have similar conditions, can improve outcomes and patient satisfaction while reducing patient wait times and costs, say Kamalini Ramdas, Ph.D., a London Business School professor, and Ara Darzi, M.D., from the department of surgery at Imperial College London, in a New England Journal of Medicine perspective piece.
Despite the fact that shared appointments have been used successfully for more than 15 years at the Cleveland Clinic, in the Kaiser Permanente system and in other places, many healthcare organizations haven’t jumped on board. Reasons include a lack of incentives and fears that shared appointments undermine the patient-physician relationship.
But there are other factors affecting why they haven't caught on yet, according to Ramdas and Darzi:
A lack of scientific evidence to support the value of shared appointments. In-depth observational studies and patient-reported outcome measures would provide evidence and allow doctors to tailor shared appointments for specific patient populations, they say.
Not enough time to pilot and refine the shared-appointment models before adopting them. For instance, the Aravind Eye Hospitals network in India has experimented with shared appointments for glaucoma patients. They first tested the concept by offering shared counseling to patients who were waiting between tests during regular appointments. They then tested a couple of ideas before introducing shared appointments on a Friday afternoon, when the workload is lightest.
A misunderstanding about the model. “Many patients may hesitate to participate in a shared appointment for their annual physical, imagining that they would meet fellow patients in their underwear,” they write. In fact, in a typical shared appointment for female patients at the Cleveland Clinic, the doctor performs pelvic and breast exams and discusses test results with each patient in private. The remainder of the appointment is conducted as a shared appointment.
The authors suggest that doctors observe existing programs to learn about the model, as patients undergoing treatment for chronic illnesses, such as diabetes, may feel less alone and more accountable in a group setting.