Implementation
- Determine the schedule that will best suit patient and physician needs. If your practice decides to hold multiple group visits that are disease specific, consider holding them on a regular schedule. For example, hold the diabetes group every second Tuesday morning and the cardiac group every third Tuesday morning. Surveying the patients in your practice might also help you to determine the schedule and frequency of these visits.
- Recruit the patients who will be included in the program. Consider the number of patients needed to make shared medical appointments financially feasible for your practice. The typical size of a group is 15 to 20 patients. The physician may decide to discuss the group visit option with a patient during a traditional office visit, or he/she may invite patients to participate by phone or email. Make sure that all participating patients understand that attendance is voluntary. Again, in order to ensure that group visits are financially productive for your practice, you will also need to think about the payment mix of the patients that you recruit.
- Begin the shared medical appointment. Patients should check in with the receptionist and be directed to the meeting room. There should be a worksheet started on each patient that will include their vital signs, a list of current medications, allergies, and any other issues the patient would like to relay to the physician. Elect a qualified member of the care team to facilitate the session in case the physician is running late. Be sure to emphasize the confidentiality of the session's discussions. Your office may choose to develop a confidentiality form that patients and their attending family members can complete. This type of office visit may also be an ideal time for the physician and his/her care team to bring in an educator or speaker.
- Allow time for private consultation. It is not unusual for a patient or two to require a consultation or an exam that is private in nature. In such cases, the physician and patient generally meet after the session. While the physician is talking with or assessing a specific patient, the behaviorist or nurse will typically facilitate group discussions.
- Document the visit. After the shared medical appointment, the patients' records should include any changes in medications or prescriptions, any problems discussed, and the physician's comments. The worksheet should be similar to the documentation that would be produced from a traditional office visit. The care team should meet to discuss their impressions of how the session went and determine if any changes need to be made.
- Evaluate your overall program. Clearly, this is an important component of any type of medical care. The satisfaction of the patient, physician and care team members has a strong effect on current and future outcomes.
Group Visits
