August 21, 2018

The Healing Potential of Group Medical Visits

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Stress and anxiety were grinding down 48-year-old Regina Arnold, and her high blood pressure and monthly panic attacks were evidence that something had to change. When her UW Health physician, Lisa Grant, DO, suggested she try a new 5-week series of group medical visits focused on stress relief, Arnold didn’t hesitate. Soon, she was spending her Thursday mornings with a small group of other patients who were there to check in with Grant, talk, and practice meditation and other relaxation techniques together.

Arnold knew she’d had a breakthrough when a panic attack hit and she didn't need to reach for her Xanax. Months later, she’s lowered her blood pressure and resting heart rate and rarely has panic attacks.

“It was one of the best things I’ve ever experienced. It’s done amazing things for my life,” Arnold says of the group medical visits. “I’m coping with my stress a lot better because now I have the tools and the habits. And listening to other people’s stories and knowing you’re not the only one really helps and gives you perspective.”

A Model for Health

While not the standard model of care, group medical visits — also known as shared medical appointments — are becoming more popular nationwide. The groups usually include 8-12 patients who share similar conditions or health needs. Grant’s group medical visits at the Center for Wellness at The American Center are organized around three topics: “Relaxation and Stress Reduction: Building Resiliency,” which meets in the meditation room; “Healing Waters for Pain,” which takes place in a warm water pool; and “Kitchen Wisdom: Cooking, Eating and Living Well,” which takes place in the center’s state-of-the-art learning kitchen.

Grant, who is the medical director of the Center for Wellness, uses an experiential and multidisciplinary approach, drawing on the expertise of a dietitian, chef, health coach, yoga teacher and others to help co-facilitate the sessions. Other UW Health providers offer group medical visits on topics such as nonoperative treatment options for osteoarthritis and low back pain.

“We think that the group medical visit is an innovative and interactive choice,” Grant says. “I feel so strongly about the healing potential for these visits.”

Patients aren’t the only ones benefiting from the model. “It’s a really amazing thing for physicians and providers who are leading the group. I could repeat the same message 15 times a day or I could do it once with 15 people in the room, and in more depth,” Grant explains. “It’s a wonderful and very satisfying way to practice.”

Advantages of the Group Approach

Here are some of the advantages of the group approach for patients:

More time: “Usually when you go to your provider you may get 15 minutes,” Grant notes. “We bring together a group of patients with common healthcare needs or issues, and we meet for an extended visit — usually 90 minutes. The 90-minute time frame gives us an opportunity to provide education and support around certain issues or conditions, and we also have time to provide comfort and get to know each other.”

Although the format may vary by provider, Grant’s patients first check in with a medical assistant, who records their weight, blood pressure and heart rate. After Grant conducts a brief physical exam for each patient, there’s a 10- to 15-minute lesson on a topic relevant to everyone, a group discussion, and then an interactive activity, such as breathing practice, cooking or mindful movement.

Tools for lasting change: The extended format allows physicians and patients to address the root causes of the symptoms that bring many people to the doctor’s office in the first place. “So much of what we see in primary care is related to stress, either directly or indirectly, and we might have time to prescribe appropriate medication but not to teach patients tools to manage the stress,” Grant says. “In the group setting, people tend to receive more information, emotional wellbeing and most importantly, self-management tools.”

Insurance reimbursement: Because every visit includes a brief physical exam and consultation with the physician, the visits are billed to insurance. Any co-pays still apply.

Semi-privacy: Participants sign confidentially agreements and agree not to disclose details about others’ health. While exams are conducted in front of the rest of the group, patients stay in their regular clothes instead of changing into gowns. If there’s a health concern that requires privacy or follow-up after the group visit, that’s also an option.

Peer support: Participants learn from each other, and it’s not uncommon for them to linger after the session to chat. “It’s not quite a class on healthy living or group therapy, though there are elements of both,” Grant explains. “It’s a medical visit observed by others. People often leave the group medical visits really motivated to make a change because it’s empowering and it’s fun.”

Patients have given the group medical visits rave reviews in surveys. But the approach isn’t for everyone, especially for patients who aren’t committed to making a lifestyle change, Grant notes. “For someone who is ready or nearly ready to make a change, or who is curious, it’s going to be a good fit,” she says.

Coming up: New five-week group medical visit cohorts start in mid-October and then again in January. Learn more about upcoming sessions and fill out the online form or call the Center for Wellness at (608) 440-6600.

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