The Annals of Internal Medicine has published research on the use of group medical visits as a part of the care program for patients with diabetes and hypertension. (Annals Research) One of the big chunks of health care cost is physician services. New technology-based methods to simplify patient-physician encounters are becoming popular. These include use of video, phone, email and text messaging, sometimes from a home computer and sometimes from a kiosk at the worksite or a retail store. The goal is to lessen the fee for the encounter, which is okay from the doctor’s perspective because less cost is incurred to perform the interaction. Another method for lowering the charge is to use group visits.
Group visits may work particularly well for patients with chronic disease, since they may have an added benefit of allowing patients to share experiences and provide support for each other. In the annals study, patients from two VA clinics had several group visits a year with a team that included a physician, a pharmacist and nurses. The patients in the shared medical appointment group showed better blood pressure control than those in usual care. While their glucose control appeared better, that outcome did not reach statistical significance.
The group visit patients had less use of the emergency room and of primary care visits and used inpatient hospitalization less. The intervention was estimated to cost about $460 per year per patient, but the researchers did not assign a value to the lower utilization, so no net cost or benefit was calculated. Based on the likely costs of ER, primary care and hospital use, however, it would appear that the intervention at least broke even. Shared medical appointments may be another method to use primary care physicians more efficiently, especially for chronic disease patients.