When a practitioner treats or sees multiple patients at once with the same illness or condition during one appointment, this is known as a group medical visit — or simply put — a group visit. In recent years, group visits in the health sector have grown in popularity for many reasons beyond saving a busy practitioner time. Group consultations are part of a trending movement within modern healthcare, known as participatory care.
What is participatory care?
Participatory care, or participatory medicine, is a medical philosophy in which patients are shifting away from being mere passengers of their health journey and moving towards creating partnerships with their practitioners. In participatory care, practitioners and healthcare providers are their patients’ partners in health. (6)(14)
What is causing this shift towards participatory medicine?
The healthcare sector is now facing profound pressure for change due to the rising cost of healthcare, growing consumer expectations, new technologies, and increasing globalization—just to name a few.
Why are group medical visits growing in popularity?
Trends show that patients are becoming increasingly invested in their health, sometimes bypassing the conventional care model and seeking out integrative health services in a variety of different, innovative ways.
Group style consultations are becoming more popular because they align with these emerging trends and driving elements. Group consultations increase both patient and physician satisfaction. They deliver integrative care that enhances quality, improves overall access, and helps leverage a physician’s time and productivity. (18)(20)
Did you know? According to the Centers for Disease Control and Prevention (CDC), six out of ten adults in the United States have a chronic disease and four out of every ten live with two or more. (4)
What are the benefits of group consultations for patients?
Shared medical consultations don’t just help lighten the workload for busy practitioners. There is strong evidence that group visits benefit patients too. Outlined below are the benefits of group medical visits for patients.
Improves health and overall wellness
Group visits are intended to provide greater access to care, and as a result, have been shown to improve health outcomes for a variety of health conditions, such as prenatal care and diabetes. (18) According to a 2013 systematic review and meta-analysis, patients with diabetes who attended group visits experienced significant reductions in glycated hemoglobin levels. These results are partially attributed to the social support offered by group visits. Furthermore, patients who attended group visits for longer periods experienced the most significant improvements. (8)
Fosters a stronger sense of community and confidence
Research has identified a connection between social isolation and chronic disease. In fact, individuals with greater social participation have a lower risk of developing a chronic illness compared to socially isolated individuals. (3) Group visits are a cost-effective and straightforward way to empower patients, helping them relate and feel a connection to others with similar experiences.
Studies have also shown that patients in group consultations support each other’s care. Patients challenge and advocate for each other in ways that shift patient-provider relationships. (18)
Improves adherence to at-home treatment plans
Studies have shown that peer support increases the likelihood that individuals will adhere to at-home treatment plans. (21)
Reduces visits to the emergency rooms
Among elderly patients who are chronically ill, group visits have been shown to reduce the number of trips to the emergency room and repeat hospital stays when compared to patients who did not partake in group visits. (2)
Reduces cost of care
Group visits can also reduce the cost of care for patients. Patients often pay less for a group consultation compared to a regular one-on-one appointment. As previously mentioned, they are also less likely to incur the added costs associated with emergency care and hospital visits. (19)
What are the benefits of group visits for practitioners?
When it comes to group consultations for healthcare providers, there are several key advantages.
A practitioner who might be able to see five to six patients on a one-on-one basis over a 90-minute time frame can easily see twice that many in the same given time frame by running a group appointment. (11)
By maximizing your time, group medical visits can be more cost-effective which can be especially helpful if you’re running a practice on a lean budget.
Shared medical appointments offer a much more streamlined way of keeping track of different patients’ medical progress. By seeing more patients in a given day, you can make greater progress with treating your patients. (9)
Reduces the risk of professional burnout
With shared medical visits saving time and energy, you may be less likely to suffer from professional burnout. (13)
What do group visits entail?
Generally, group consultations include an individualized medical review as well as additional education, group discussion, and peer support. They vary in length but could be up to 90-minutes in some cases. (12) Outlined below are the three well-established models for group medical visits. All three models are widely used by healthcare systems around the world to improve access and provide comprehensive participatory care to patients. (12)
The cooperative health care clinic concept (CHCC)
The cooperative health care clinic concept (CHCC) is ideal for groups of up to 20 patients who require frequent medical care for multiple chronic conditions, such as diabetes, hypertension, congestive heart failure, or asthma. The CHCC model typically serves the same group of patients for long periods of time. The basic format involves socialization time, an interactive educational session, one-on-one routine care, and an opportunity for questions and answers. (12)
Drop-in group medical appointments (DIGMAS)
Drop-in group medical appointments (DIGMAS) serve on average 12 to 16 patients with common health concerns or chronic conditions. This model is ideal for routine-follow ups and for patients who don’t require detailed examinations or first-time consultations. DIGMAS can be offered daily, weekly, or monthly and allow different patients to attend when they’d prefer. The DIGMAS model allows practitioners to provide basic check-ups and education in a welcoming group setting. It’s common for multiple practitioners to be involved in DIGMAS, including a behaviorist who often facilitates the group and encourages patient participation. (12)
Physicals shared medical appointments (Physicals SMAs)
Offered on a weekly or monthly basis, physicals shared medical appointments (Physicals SMAs) provide care to approximately six to 13 different patients each session. Physicals SMAs typically begin with private examinations for each patient followed by an interactive group discussion. Similar to DIGMAS, Physicals SMAs involve multiple practitioners and the assistance of a behaviorist. (12)
Virtual group visits
Virtual group visits have recently grown in popularity. Facilitating virtual group visits via a secured video conferencing platform can be an effective strategy for keeping your patients engaged and on track with their treatment plans. Virtual visits may also be more convenient for patients with busy schedules or transportation issues. (16)
Furthermore, virtual group visits can be helpful for patients experiencing isolation and loneliness, a common consequence of current physical distancing guidelines. (15)
5 tips for putting group visits into practice
How do you convince patients to start coming to group visits? It may feel like a challenge at first to convince your patients or clients to sign up for shared appointments or consultations when they’ve only known one-on-one treatment.
It’s essential to make group visits feel additive to a patient’s current health journey and treatment plan — not a replacement that takes up less time. The following elements are key to keep in mind when you are looking to include group appointments in your practice. (7)
Invite patients to group consultations personally
When it comes to setting up group visits, be sure to invite patients personally. It’s essential that your patient or clients feel as though their group visits are complementary to, rather than a replacement, for individualized care and one-on-one appointments. Consider extending a personal invitation to patients via email, phone call, or in person during an individual appointment.
Grow your group visits with social media platforms and newsletters
In addition to reaching out to patients personally, it’s beneficial to share emails with your patient base as well as promote group consultations on your social media platforms. Let patients know about the upcoming group consultations or specific educational workshops you may be holding — and give them an easy way to sign up!
Emphasize to patients that they have more access to your time
With group visits, patients can spend more, not less time with you as their practitioner. Group visits provide the opportunity to delve into more in-depth topics with your patients.
Assure patients that their privacy is still a priority
Be sure to ease your patients’ privacy concerns by letting them know medical examinations and testing are still all performed privately. It remains their choice to share personal information during group consultation discussions.
Have patients sign a confidentiality commitment
It can be helpful to have all your patients who participate in group sessions to sign a confidentiality commitment to ensure privacy.
The bottom line
Group visits provide a comfortable, practical, and integrative approach to participatory care. Group consultations also offer practitioners the opportunity to bring in other alternative and supporting health specialists, further supporting patient education and wellness.
If you are looking for more detailed information and insight on group consultations and participatory care, we recommend reading James Maskell’s new book, The Community Cure. It provides a comprehensive guide on group visits, including how they originated, as well as more details into what they are, how to run them, how to avoid pitfalls and overcome challenges, and the absolute best practices for launching and managing group visits.
The Fullscript collective helps guide our company to evolve, adapt, and support integrative medicine.Learn more!
- Andersson, N. (2018). Participatory research – A modernizing science for primary health care. Journal of General and Family Medicine, 19(5), 154–159.
- Beck, A., Scott, J., Williams, P., Robertson, B., Jackson, D., Gade, G., & Cowan, P. (1997). A randomized trial of group outpatient visits for chronically ill older HMO members: The cooperative health care clinic. Journal of the American Geriatrics Society, 45(5), 543–549.
- Cantarero-Prieto, D., Pascual-Sáez, M., & Blázquez-Fernández, C. (2018). Social isolation and multiple chronic diseases after age 50: A European macro-regional analysis. PLOS ONE, 13(10), e0205062.
- Centers for Disease Control and Prevention. (2021). Chronic diseases in America. CDC. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
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- Houck, S., Kilo, C., & Scott, J. (2003). Group visits 101. https://www.umassmed.edu/globalassets/diabetes-division–department-of-medicine/resources/groupvisits101.pdf
- Housden, L., Wong, S. T., & Dawes, M. (2013). Effectiveness of group medical visits for improving diabetes care: A systematic review and meta-analysis. Canadian Medical Association Journal, 185(13), e635–e644.
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- Lavoie, J. G., Wong, S. T., Chongo, M., Browne, A. J., MacLeod, M. L. P., & Ulrich, C. (2013). Group medical visits can deliver on patient-centred care objectives: Results from a qualitative study. BMC Health Services Research, 13(1), 155.
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- Northern Health. (2007). Group medical appointments. http://www.hqontario.ca/Portals/0/documents/qi/learningcommunity/roadmap%20resources/advanced%20access%20and%20efficiency/step%205/pc-nha-group-medical-appointments-manual-en.pdf
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- Shibuya, K., Pantalone, K. M., & Burguera, B. (2018). Virtual shared medical appointments: A novel tool to treat obesity. Endocrine Practice, 24(12), 1108–1109.
- Steyn, P. S., Cordero, J. P., Gichangi, P., Smit, J. A., Nkole, T., Kiarie, J., & Temmerman, M. (2016). Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: A scoping review. Reproductive Health, 13(1), 88.
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