Are group medical appointments a solution to physician shortages?

Apr 10, 2013

Miami Health Care Clinic Treats Patients

Instead of a one-on-one doctor’s visit, would you share your appointment with a group of strangers that have similar symptoms?; Credit: Joe Raedle/Getty Images

Under the Affordable Care Act, a surge of people will need health care, but how will medical professionals be able to accommodate everyone? The Annals of Family Medicine projects that an additional 34 million people will receive health insurance and will need over 51,000 more primary care physicians by 2025 to meet that need.

When Massachusetts law mandated health care coverage for its estimated half a million uninsured, wait times for primary care physicians increased. To solve this problem, some physicians in Massachusetts started practicing “shared medical appointments” (SMA), also known as group visits. In this model, five to 13 patients see the doctor at once for a session that can last up to two hours.

For example, patients with diabetes who have similar difficulties share an appointment. After each patient signs a confidentiality agreement, the doctor and perhaps a team of various medical personnel examine each patient one-by-one. Then the doctor leads a discussion with the entire group about questions and symptoms. In addition to getting more time with a physician, patients are learning from one another’s medical experiences. Doctors are able to see more patients in a day and do not need to repeat general information over and over. Also, instead of waiting for months for an individual appointment, patients would not have to wait as long for a group visit.

There are plenty of concerns about shared medical appointments. Many patients are reluctant to discuss private information with other people, especially information related to illegal drugs and sexual problems. Some doctors also find the group setting to be awkward and prefer the confidentiality of individual appointments.

Have you ever participated in a shared medical appointment? Is this new model a plausible solution to health care needs? If group visits gain popularity, would those unwilling to be in a group visit wait longer for individual visits? Are group visits a step forward in health care reform or an attempt to stretch resources?

Evelina Sands, Administrative Director at North Shore Physicians Group in Massachusetts; she has been instituting shared medical appointments for three years.

Wells Shoemaker, M.D., Medical Director of the California Association of Physician Groups, practiced primary care pediatrics for 25 years on the Central Coast and has conducted shared medical appointments. He currently works with medical groups across the state for quality improvement, health disparities, and primary care revitalization. He co-leads Governor Brown’s current task force on Health System Redesign for California.

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