Influence of Shared Medical Appointments on Patient Satisfaction: A Retrospective 3-Year Study

The use of Shared Medical Appointments (SMA) has grown dramatically in the last decade. By design, SMA lead to increased provider access and reduced clinical redundancies. However, SMA models also carry inherent limitations which must be identified and controlled. The article mentions SMA patients reporting lower satisfaction across the personal physician communication domain. Our bariatric surgery practice, which follows a SMA model for post-surgical follow-up care, has attempted to alleviate the depersonalization which can occur in a group-based care model.

Specifically, our program has the nurse coordinator conduct all post-bariatric surgery SMA. In other words, the nurse coordinator is the "constant" for patients, present at every SMA, from appointment check-in to check-out. The nurse coordinator also conducts a portion of the group-based education, along with a registered dietitian. In an effort to personalize the individual portion of the SMA, the nurse coordinator communicates (via phone or secured messaging) with patients 1 to 2 days prior to their SMA, to get a sense of each patient's particular concerns. This communication accomplishes two primary ends: it gives the patient the individual attention they desire; and it allows the nurse coordinator to prioritize the individual portion of the SMA (when the patient is seen privately by the MD/NP/PA).

Our program has also developed a screening process prior to the scheduling of a particular patient in a SMA. Patients who had a complex post-surgical course, have a particular impairment (visual, auditory, language, etc.), or are not comfortable meeting in a group setting, are scheduled individually with necessary members of the care team. SMA-based care models seem ideally suited for specialty care patient populations (i.e., post-bariatric surgery, diabetes) where there is a large group of patients with similar education needs. Patients serve as a form of support group to their patient peers, exchanging their experiences and learnings with one another. The benefits, however, extend beyond the patients. Providers often report increased satisfaction when participating in a SMA, as it injects variety in to their usual practice, while simultaneously increasing their clinical access. Various areas of medicine have and will continue to benefit from the use of SMA. Care has to be taken, however, to identify the patient populations best served by such care models and for opportunities to reduce the liabilities inherent in the same.

Competing interests: None declared