Group visits

Also known as shared medical appointments

Key points about group visits

  • Group visits or shared medical appointments (SMA's) are a series of consecutive individual medical consultations in a supportive group setting so everyone can listen, interact and learn.
  • SMAs can help remove patients' doubts about their ability to manage their illness. They can feel inspired by seeing others who are coping well.
  • Providers can also learn from patients about how better to meet their patients' needs.
  • A typical SMA lasts around 60–90 minutes, comprises 6–12 patients and includes a doctor and a facilitator – usually an allied health professional who manages group dynamics and directs the sessions.
  • There are four components needed so that SMAs become standard and routinely used: rigorous evidence, easy ways to pilot models, regulatory incentives to support SMAs and education.
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Group visits are also known as shared medical appointments, structured medical appointments or planned medical appointments.

SMAs are a series of consecutive individual medical consultations in a supportive group setting where all can listen, interact, and learn. SMAs are also called group visits and are an evolving way of managing chronic disease in primary care. An SMA is both an individual consultation and an informal group education session.

Video: Shared Medical Appointments in Australia

(Australian Musckulo-skeletal Network, Australia, 2014)

  • Group exposure in SMAs combats isolation, which in turn helps to remove doubts about one’s ability to manage illness.
  • Patients learn about disease self-management vicariously by witnessing others’ illness experiences.
  • Patients feel inspired by seeing others who are coping well.
  • Group dynamics lead patients and providers to developing more equitable relationships.
  • Providers feel increased appreciation and rapport toward colleagues, leading to increased efficiency.
  • Providers learn from the patients how better to meet their patients’ needs.
  • Adequate time allotment of the SMA leads patients to feel supported.
  • Patients receive professional expertise from the provider in combination with first-hand information from peers, resulting in more robust health knowledge.
  • Patients have the opportunity to see how the physicians interact with fellow patients, which allows them to get to know the physician and better determine their level of trust.

There are two main types of SMAs: drop-in group medical appointments (DIGMAs) and programmed shared medical appointments (PSMAs).

DIGMAs can involve heterogenous groups with a range of standard medical problems. They are conducted at a standard time each week to reduce waiting time and enable acute care more accessible.

PSMAs are a sequence of SMAs in a semi-structured form providing educational input relating to a specific topic. A good example is a diabetes-focused group, which allows patients with diabetes to come together regularly to listen, interact and learn from each other and provides a good opportunity for a facilitator with extra training in diabetes to educate through a lecture or discussion format.

SMAs could comprise 6–12 patients at a time and typically include a doctor and a facilitator, who is usually an allied health professional. The facilitator is the one who manages group dynamics and directs the 60–90 minute sessions. SMAs are suitable for you and your patients if you are frustrated with the limitations of 1:1 consulting.

Video: How to Run a Group Medical Visit

(Accelerating Change Transformation Team - Alberta Health Services, Canada, 2015)

Why are doctors not routinely implementing SMAs to treat physical and mental conditions given the benefits of group interventions? There are four crucial components that are missing:

  1. Rigorous scientific evidence supporting the value of shared appointments.
  2. Easy ways to pilot and refine shared-appointment models before applying them in particular care settings.
  3. Regulatory changes or incentives that support the use of such models.
  4. Relevant patient and clinician education

These are necessary for any highly innovative service-delivery model including SMAs to become standard. 

Shared Medical Appointments Australasia

The Australasian Lifestyle Medicine members have collated a range of resources about group visits and shared medical appointments on the Lifestyle Medicine website. 
They also offer:

Read more(external link).

Shared Medical Appointments Guide

Pinnacle Health Network has created an online guide.(external link)
To view, contact Pinnacle(external link) as the website is password protected. 

Ambulatory Care Improvement Guide

Section 6: Strategies for Improving Patient Experience with Ambulatory Care – Group visits 

Agency for Health Research & Quality (AHRQ), US, 2017

Putting group visits into practice

Guide developed by Massachusetts General Hospital, US, 2012

Introduction to shared medical appointments (SMAs) webinar

This webinar was held on 28 February 2018, featuring Profs Garry Egger and John Stevens, Jordhana Clark (ASLM’s Education Coordinator) and Stephen Penman (Executive Director).

Watch the webinar here(external link) to hear an overview about shared medical appointments and their implementation in Australia.

Information on group visits literature for healthcare providers.

Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

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