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Gather ’Round

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The average face time patients enjoy with their physicians during an office visit is about 17.4 minutes, according to the National Center for Health Statistics. But what if a physician could promise patients more than an hour of attention? That’s the concept behind a new approach to office visits that has yet to hit the mainstream: group medical appointments.

First envisioned 10 years ago by physicians at Kaiser Permanente Colorado Medical Group, group appointments typically gather eight to 20 patients with the same diagnosis, such as diabetes, asthma, high blood pressure or congestive heart failure. The patients meet in an extended session, usually with one physician and possibly a medical assistant, a nurse, or a diabetic educator or dietician.

GreenField Health, a five-physician internal medicine practice and consultancy in Portland, Ore., has held four appointments for diabetics over the past year and a half. The visits are divided into three half-hour segments, beginning with introductions and a standardized presentation by a physician. A group discussion lets patients talk about how they manage their diet, exercise and blood sugar levels. Finally, each patient gets individual exam room time with the physician to discuss things they don’t want to share with the group.

Jill Arena, GreenField’s chief operating officer, says the concept and structure of the appointment is explained beforehand, so patients know what to expect. “They can have an individual appointment if that’s not their cup of tea. We don’t want anyone to feel like they’re forced to be a part of a group visit,” she says. Keeping the flexibility built into the system makes it easier for patients to give it a try, and Arena says the visits often become a “mini-support group” for patients.

“The perception upon leaving the practice is that they got an hour and a half with their doctor, and you’re not going to get that in the traditional setting,” she says.

Physicians stand to gain, as well. Group visits are a time-saver because they allow doctors to see more patients at one time and avoid repeating information to multiple patients. Still, billing for group visits is a new science, so practices should anticipate a learning curve before going all in. “It doesn’t have the attention of the payors yet because not a lot of people are doing it, so there aren’t a lot of rules,” says Arena. “On the flip side, there’s a fair amount of ambiguity about how you bill, so you want to make sure that the provider gets full credit for the service performed without over-billing.”

—Kara Olsen