Chronic diseases like diabetes, heart disease, asthma, and obesity affect many people in the U.S. According to the Centers for Disease Control and Prevention, six out of ten Americans have at least one chronic disease. Four out of ten have two or more. Managing these diseases requires regular doctor visits, learning how to take care of yourself, changes in daily habits, and support to help with behavior. Traditional visits with a doctor usually are short and may not fully help patients, especially for complex diseases. Shared Medical Appointments (SMAs), also called group visits, are a new way to help manage these chronic conditions. This article looks at how SMAs work to help patients feel more capable and satisfied. It explains how SMAs are set up and why they matter for medical offices in the U.S.
Shared Medical Appointments include several patients meeting at the same time with healthcare providers. They usually have the same or similar chronic conditions. These visits mix usual medical care with education and support from others. Patients get health checkups, talk about managing their diseases, learn new information, and share with others facing similar issues. The session often starts with group talks, then individual health checks, and sometimes questions or personal advice. Usually, 10 to 16 patients join each session, which lasts two hours or more.
SMAs began in the 1990s. John Scott, M.D., at Kaiser Permanente Denver started the first SMA for older patients who used a lot of healthcare. Since then, SMAs grew in primary care, helping patients with diabetes, arthritis, asthma, and obesity.
Many patients with chronic illnesses say that short visits with the doctor are not enough for learning how to manage their disease, getting advice, or talking about lifestyle changes. A regular visit to a primary care doctor usually lasts 17 to 24 minutes, but chronic diseases need more time than that.
In doctor visits, clinicians often repeat the same advice to each patient, which wastes time. SMAs save time by teaching many patients together. Patients also get to learn from each other, share stories, and offer support.
The group setting in SMAs helps patients support each other and learn together. Research shows patients in SMAs are often more satisfied with their care than those who see the doctor one-on-one. This is important because when patients are more involved, confident, and able to manage their illness, they usually have better health results.
Doctors also benefit. At the first Cooperative Health Care Clinic, doctors liked caring for groups better than individual patients because the visits were more interactive and efficient.
SMAs fit well with team-based care. Doctors, nurses, health coaches, dietitians, and mental health specialists work together. In lifestyle medicine SMAs, providers focus on diet, exercise, stress, and other treatments without drugs. This helps treat the root causes of chronic diseases.
In one SMA for diabetes, education covers blood sugar checks, medicines, nutrition, and ways to handle stress or depression. This kind of care is hard to fit into short doctor visits.
The COVID-19 pandemic increased the use of telehealth, including virtual SMAs. Virtual visits make it easier by removing travel and scheduling problems. Patients join from home, sometimes with family, which helps them feel more comfortable. Virtual visits also reduce the need for space in medical offices.
Virtual SMAs follow privacy rules and use secure platforms that meet healthcare laws. They also let patients from faraway places join, helping those in rural or less served areas get care.
Adding technology and automation makes SMAs more efficient for doctors and patients.
Scheduling and Patient Identification: AI systems can look at patient records to find patients who would benefit from SMAs. Automated tools help set up group visits, send reminders, and handle cancellations.
Documentation and Coding: Automated tools simplify writing notes for group visits. They reduce errors and help with billing codes. AI can find missing info or suggest codes, improving payment.
Patient Communication and Education: AI chatbots or virtual helpers give instructions before visits, educational materials, and collect patient reports. This helps patients get ready and reduces time spent teaching basics during visits.
Post-Visit Monitoring and Follow-Up: AI works with devices that check health between visits, like blood sugar or blood pressure monitors. It alerts doctors if there are problems. Automation can schedule follow-up visits or suggest changes in care plans.
Data Analytics and Quality Improvement: Data from SMAs can be studied with AI tools to find trends in results, resource use, and patient satisfaction. Practice managers use this info to improve programs, motivate staff, and meet reporting needs.
Some companies offer AI-driven phone help and appointment scheduling that reduce office work and make patient communication smoother. This lowers no-shows and improves patient access.
SMAs help reduce healthcare gaps seen in low-income, rural, and BIPOC groups. Social, economic, and cultural barriers often stop these groups from getting regular care. Group visits, in person or virtual, help by lowering travel needs, offering more appointments, and providing community support for managing diseases.
Group visits that respect language, diet, and traditions build better trust and engagement. Health coaching and behavioral support tailored to community needs strengthen patient relationships over time.
Studies show SMAs with health coaching help rural and underserved patients better manage diabetes by increasing knowledge, skills, and confidence.
Medical offices should plan for costs like staff training, patient recruitment, EMR changes, and setting up space for SMAs. Still, studies show SMAs usually have neutral or positive financial results in the medium to long term.
Shared Medical Appointments offer a way to improve managing chronic diseases by combining medical care, patient education, and group support. Research from different U.S. healthcare settings shows SMAs improve patient satisfaction, health results, and provider efficiency while keeping or lowering healthcare costs.
Using telehealth and new technology tools like AI and automation help make SMAs easier to run and grow in many practices. For medical practice managers, owners, and IT staff, adding SMAs using digital tools and team care can help with challenges in chronic disease care, improve patient access and involvement, and keep practices financially stable as healthcare changes.
Underserved populations, particularly BIPOC and rural communities, face economic, social, and cultural barriers including affordability, limited availability of services, and lack of continuous relationships with healthcare providers.
Telehealth can enhance access by offering remote consultations, thereby overcoming barriers related to transportation and scheduling while allowing for personalized health support and frequent practitioner-patient contact.
A continuous relationship with healthcare providers fosters trust, which is critical for enhancing care access, especially for low-income families who may face multiple barriers.
Team-based care involves multiple healthcare staff collaborating on patient care, enhancing communication, expanding access, and efficiently delivering essential services like patient education and self-management.
SMAs involve groups of patients with similar conditions meeting with healthcare providers, allowing cost-effective education, peer support, and improved patient empowerment and satisfaction.
Studies indicated that community-based approaches including health coaching significantly improved patient engagement and self-management skills in low-income adults with type 2 diabetes.
Cultural background, primary language, and social circumstances are critical to developing effective treatment plans, as they shape patients’ experiences and access to care.
Telemedicine can address challenges related to distance and transportation, providing personalized health interventions that improve chronic disease management outcomes.
Health coaching has been shown to enhance knowledge, skills, and confidence in patients, significantly improving their ability to manage chronic conditions.
Group visits in functional medicine provide educational opportunities, foster peer support, and allow for deeper engagement with patients, ultimately improving health outcomes and patient satisfaction.
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