Shared medical appointmentsBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j4034 (Published 30 August 2017) Cite this as: BMJ 2017;358:j4034
All rapid responses
This is an interesting concept for delivering patient care. I note that it is geared toward management of patients with well-understood, chronic conditions and diagnoses that are pretty certain. As a patient, myself (though at one time or another aren't we all?), I have these thoughts:
1. While in a group setting patients may receive a lot of peer support, they may also feel some peer pressure to conform to the group "norm" as regards their own reports about their symptoms or, importantly, about their feelings or attitudes.
2. What happens to "outliers" whose course of illness falls outside the parameters that the group setting can effectively address, whose needs (medical, psychological, spiritual) cannot be addressed in that setting?
3. A mechanism needs to be put in place that will enable a group patient to request a one-on-one session with the relevant specialist, outside of the group meeting time frame.
4. If the biggest benefit for patients of the SMA format is peer support, why not just sponsor various support groups, pure and simple? Why involve doctors or specialists at all as a routine part of such meetings?
Of course, that would eliminate the ability to "count" the meetings as a bona fide medical encounter and bill accordingly--so on the business-of-medicine end of things it wouldn't meet the need as well. But in terms of patient care....
On the other hand, if such meetings were not advertised/presented as medical encounters, patient participation might be much lower and regular attendance more variable.
Competing interests: No competing interests