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Shared Medical Appointments (SMAs)

Monday, August 19th, 2013

There is a new trend in medicine that I find disturbing. I’m talking about the shared medical appointment. A group of patients participate in one shared appointment, 90 minutes or so, with one practitioner or a team of medical personnel.

Advocates of this arrangement say that patients get more time with doctors without increasing doctors’ workloads, and that patients can be an encouragement to one another. I say, it sounds like a way to increase billing without doing any extra work, and that if patients want to encourage one another, there’s always a coffee shop or a support group around the corner. I’m not saying that there’s anything wrong with a patient preferring this method; I just can’t imagine why anyone would. You spend your valuable time and money in order to see your doctor. You should be able to make the most out of every face to face appointment, and not have to share time with other people all seeing the same doctor, whose attention is inevitably divided now.

Each patient should have the right to a private, confidential interaction with a physician. It is well known that people behave differently when other people are around than they do when alone. SMAs require disclosing personal information in front of strangers. A woman might not mention something in a group that she would if she were alone with her doctor. I care about each of my patients too much to impose this kind of group setting on them. Your doctor’s appointment – even routine follow-ups – is your chance to talk with your doctor privately, sharing any concerns openly, and not giving a second thought to who might hear what you say. Furthermore, fans of shared medical appointmets say that they are a way to decrease costs – but they must not mean to patients, because in practice, most SMAs are billed as regular office visits with regular copays.

Finally, studies on SMAs are very limited. You will have to decide if the shared medical appointment is right for you, but you won’t see me implementing them anytime soon. I don’t believe this can ever have the value of consulting with a doctor one-on-one with the focus on you and finding the source of your medical problem. In short, shared medical appointments don’t save patients any time or money and do not deliver the same standard of care that an individual appointment can. This is one trend that I would like to see stopped in its tracks.

– Yvonne S. Thornton, M. D., M. P. H.