The concept of “Group Medical Consultations” or “Shared Medical Appointments” (SMA)
These are widely used in UK, US, and Australia and I am very keen to bring this to patients here.
SMA are medical appointments in which multiple patients are seen by a doctor in a supportive and structured group setting. They are an innovative and interactive approach to healthcare that brings patients with common needs together with their physician. The focus is upon the actual delivery of medical care. However, these settings also bring a great deal of patient education and emotional support into the appointment by integrating the help and support of other patients.
Why would any doctor bother setting up a private clinic to do this? Because healthcare in Ireland is broken. I want better for my patients. It’s time to learn from what has worked well in other countries and do things differently.
So, how does it work?
Patients have a one-on-one consultation first and both patient and doctor agree that shared medical appointments or group medical consultations are the right step for the patient. Patients are asked to sign a confidentiality form to participate in the group. So, if you are interested in doing this, this is where you start: a short one-on-one appointment.
The patients in your group will have a shared chronic medical condition, for example: heart disease, obesity, diabetes, arthritis, PCOS. The SMA appointments are longer – much longer – than your usual doctor visit. Average time is 90 minutes to 2 hours.
These can be the same people meeting weekly for a set period, like 6 weeks. These can also be a group of people who drop-in for a regularly scheduled group appointment slot when they feel it’s right for them (DIGMA = Drop-In Group Medical Appointments) For example, an Obesity SMA that is held every Tuesday at 7pm.
What’s the logic behind it? Well, if I see 12 patients for 10-15 minutes each in a morning, I may find myself rushing to squeeze in the same too-quick advice that I repeat to each patient. Communication isn’t great because of the time constraint: the patient doesn’t have time to tell the whole story and I don’t have time to really given personalised and detailed advice that actually makes a difference to disease management.
The alternative is that all 12 patients agree to join together for 2 hours. They share (what they are comfortable sharing) and then we have time to really discuss on to effectively manage their chronic disease. How to make thing better: personalised, detailed, practical steps. You take home what learned with new goals and an action plan. But nothing else – what happens in the group, stays in the group.
And overwhelmingly, patients over multiple 10 year studies have found that this really works. In particular, they found that they were more comfortable and had better communication with their doctor in the setting with other patients. Patients learn from each other as well as from the doctor. Patients also benefited directly from the perspectives of other patients on their health journeys as well as providing motivation and support. Doctors also learn more about their patients, which improves care.
What are common concerns?
Privacy is actually the one that patients raise when they start. In a SMA, a patient will never be forced or asked to share personal information that makes them uncomfortable. Patients are given the option of a pre or post-visit check-in – usually virtually. This is one-on-one with the doctor to bring up something outside the group. Any necessary measurements such as blood pressure or weights are done in private.
What’s the advantage of SMA? Accessible and affordable. This is why I’m so passionate about starting this approach here. SMA makes care accessible and affordable. Access to physician-led healthcare in Ireland is currently limited by waiting lists, short appointment times, or high fees for private outpatient care (even if insured). Once you are set up for SMA, you can book yourself for the next group within days. You can be assured than in a 90 minute to 2 hours appointment, there will be time to really discuss your concerns. Accessibility also has to mean affordable. The average cost of private consultation in Ireland currently is around €200 (range from €140 -250**) In the SMA, the cost is also shared so each appointment is €20.
SMA will start in-person in Remedy Clinic in July. Groups will be based on patient need, but the projection is that there will be groups for Obesity, Type 2 Diabetes, PCOS, Menopause, and Heart Health. Men’s health, mental health, stress reduction are also option, depending on patient need or interest. All patients need a one-on-one assessment before SMA and sign a confidentiality agreement.
If it’s not right for you (and it may not be), traditional one-on-one appointments are always available.
More questions? If you would like to stop by for a few minutes, meet me, see the space, or just informally ask some questions or get more information, drop me an email hello@emdoc.ie.
#lifestylemedicine #newstarts #doctorpatient #MakeHealthcareBetter
**Just a reminder: Before giving out about those high fees, remember that these fees largely reflect the substantial overhead legally required to practice medicine in ROI, including indemnity, support staff, and GDPR-compliant medical record systems.
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