Out of psychologist’s illness, group medical visits are born

In the early 1990s, a middle-aged health psychologist, Ed Noffsinger, Ph.D., developed a serious illness — pulmonary hypertension.

For a period of several years he found himself exhausted, lying in bed for days, barely able to breathe. As time wore on, he felt angry, alone and frightened. His wife was sympathetic, but she was taking care of their three young children and her ill father. She didn’t have much time or attention to listen to Ed’s fears and concerns.

Also, he was very frustrated with the health care system. It was hard to get in to see his doctor and when he did, his visits were too short. He realized what he needed — good access to medical care, longer visits and emotional support from other patients with similar concerns.

From his experience as a patient, the concept of “shared” or group medical visits was born.

These shared visits consist of a group of eight to 12 patients of a physician, who meet with their doctor for a 90-minute visit. Typically, groups of patients with similar medical conditions, such as diabetes, heart disease, headache, Parkinson’s disease, congestive heart failure, back problems, chronic pain or rheumatoid arthritis are grouped together.

At these visits, each patient’s medical concerns are addressed by their physician in the group setting. The provider is able to educate his or her patients about medications, symptoms and treatments.

At the same time, patients are able to listen and learn from each other. A health psychologist moderates this extended appointment, with the doctor’s medical assistant or nurse available for injections or other health maintenance.

In the mid-2000s, I helped facilitate a variety of shared medical appointments with medical specialists for patients with rheumatoid arthritis, diabetes, multiple sclerosis, migraines, and back pain. Adults with these chronic health problems are hungry for contact with others who struggle with the same condition.

Doctors can provide education and medication, but fellow patients can provide hope and encouragement.

Interestingly, large sophisticated health care systems like the Cleveland Clinic, Harvard Vanguard Health, Dartmouth-Hitchcock Medical Center, and the Veterans Health Administration, have instituted these programs to provide patients with chronic illness better access and more time with their providers, and emotional and practical support from fellow patients.

In the 21st century, the previous gold standard of healthcare — the individual visit with a health care provider — is evolving into many new forms of care that focus on improving the patient experience, quality of care and better access: telemedicine using Skype; “E-visits” using email; urgent care clinics; multi-disciplinary teams that focus on specific illnesses and conditions; health apps that monitor physiological indicators; and now, shared medical appointments.

I believe that as patients, we will have the opportunity to explore these new ways of receiving care and learning how to live happier and healthier lives.

Dr. Paul Schoenfeld is director of The Everett Clinic’s Center for Behavioral Health. His Family Talk Blog can be found at www.everettclinic.com/family-talk-blog.