Wouldn’t it be great if chronically ill patients could leave your practice feeling like they’d spent two hours with their physician – without the physician spending any more time than a standard office visit? And what if those same patients also left feeling more empowered and supported, more committed to compliance, and less alone in dealing with their illness?
It’s not a time-travel fantasy or a pipe dream. There is a way patients can leave your practice feeling like they got extra attention without your providers spending any more time with them. It’s possible through the magic of a group visit program.
Here’s how it typically works. A physician identifies a group of patients who have a similar, chronic condition that requires frequent visits (a great use of the lists feature in your EHR). Then the practice confirms each patient’s willingness to participate in a group – acknowledging that they’ll be sharing health information with other group members, while also agreeing to keep everyone’s information confidential outside the practice walls. As they arrive, participants have an initial visit in the exam room – depending on their problems, this might involve only vitals and an interview by a nurse, or it might involve a short encounter with the physician. After all of the private visits, all patients complete their visit together in a conference room or the reception area. Each patient hears the feedback their fellow patients are receiving from the physician, and, where appropriate, they can chime in with their insights or support. For example, if a fellow patient is nervous about taking medication for the first time, or switching to a new drug, others in the group who have experience with it can offer feedback.
All patients are with the doctor for nearly the entire 1.5-2 hours of the group session, so they all feel they’ve had a lengthy visit. The longer format gives patients a chance to ask questions that they might otherwise forget in a shorter office visit. The group format also allows your providers to delve deeper into subjects like stress reduction, exercise, and nutrition – perhaps bringing in other experts – and allows patients to share their own experiences towards health improvement goals.
Once a group visit is completed, each patient’s insurance is billed for the appropriate E&M code for their individual situation (even though part of the visit took place in front of all the other patients).
Group visits (also called shared medical appointments) can be a great way for a practice to offer more access, since they’re typically scheduled in an evening to allow for use of common space. Practices may start with a single group, and with meetings quarterly or twice a year (whatever makes sense based on the participants’ follow-up care needs). Once a practice gains momentum with the idea, more groups can be added (or more patients added to the group). And while group visits are typically thought of as a primary care program – diabetes is the classic example of a condition ideal for groups – it can work for any specialty with a large enough population of patients with the same chronic condition. Some examples include HIV, chronic pain, COPD, asthma, cancer, and hypertension. And it can even work for healthy maternity patients who need to come in regularly for pre-natal care as well.
If you’re interested in starting a group visit program, the AAFP is a great place to start – they have many group visit resources on their website.