Your next doctor's visit could get crowded

(Bloomberg Business) — In a typical doctor’s visit, you wait around for a while, get your vitals checked, and spend a few minutes alone in a room with a physician. It’s private and short. Some doctors, frustrated by a relentless schedule of 15-minute, one-on-one visits, are experimenting with appointments that are neither.

According to the American Academy of Family Physicians, around 10 percent of family doctors already offer shared medical appointments, sessions that bring together a dozen or more patients with similar medical conditions to meet with a doctor for 90 minutes. With pressure from the government and insurers to bring down the cost of care while treating the increasing number of people with health insurance, patients can expect group visits to become more common. “It’s efficient. It’s economical. It’s high-quality care when it’s done right,” says Edward Noffsinger, a California psychologist who created the model in the 1990s at Kaiser Permanente, the state’s largest health maintenance organization (HMO).

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In a group visit, exams and tests are still conducted privately, but patients discuss their ailments in front of the group. The theory is that each patient can learn from the others’ experience, and doctors get to have a longer, more relaxed discussion instead of hopscotching to three or four exam rooms in an hour. “You have one appointment with 10 observers,” says Marianne Sumego, an internist at the Cleveland Clinic. “Patients are really getting the equivalent of 10 visits.” Sumego started doing shared visits 15 years ago and has led the health system’s expansion of the practice in the past four years. She says Cleveland Clinic has conducted more than 10,000 group visits in recent years. The approach is particularly useful for patients who are managing such chronic conditions as diabetes, asthma, or osteoporosis, she says. Sumego also conducts regular group checkups for women. “This model is really attractive in being able to let me spend more time with my patients,” she says.

As for the effectiveness of group medical visits, there haven’t been extensive studies. An analysis of existing research published by the Department of Veterans Affairs in 2012 found that the approach helped diabetics control blood sugar and blood pressure, but what the impact is on hospital admissions or total health-care costs was less conclusive. There’s some evidence that group pain treatment may help manage such conditions as back pain or arthritis, according to a review by the Cochrane Collaboration, which synthesizes medical evidence. Another Cochrane review, covering just two studies, found similar outcomes for pregnant women in group visits compared with those who got one-on-one prenatal care.