Thursday, April 18, 2013

Group Teaching With Physicals

Around the country the idea of group physicals has been gaining momentum. A recent article in Everyday Health "Group Appointments With Doctors: When Three Isn't a Crowd" explains it well. Before you get creeped out thinking of the doctor examining everyone in a big room, everyone still gets a private exam. The benefit is getting more detailed information and sharing questions with others in a similar interest group.

There are so many teaching points to discuss at annual well visits that it is impossible to fit them into a typical 15-20 minute appointment. If you're really interested in the recommendations (and I will admit I fall short on addressing every one of these sundry things at standard visits and still won't be able to fit them all into the group visit) they are found on Bright Futures.

A solution many doctors are finding helpful to cover more topics is to do a group teaching session to review all the nutrition, safety, development, and vaccine information, then break into individual rooms for history taking, vitals, vaccines, and exams. This eliminates the repeated advice and instruction for separate patients, allowing more to be discussed with a group of patients and still allow time for individual exams.

The benefits to patients are many:
  • More information shared in a comprehensive manner
  • Start on time!
  • Individual time with the nurse and physician 
  • Potential to learn from others in the same age group (from discussion/questions raised)
Since summer walk in clinic tends to be slow and many teens need physicals before school starts, I think the opportunity is presenting itself to have a Saturday morning session. Although it is hard to know exactly how it would pan out, I expect that the entire time will be about an hour (which is about the same time for a standard well visit, but less time waiting). Some kids would check in before the discussion to have their vitals and exam, others would arrive for the session and have the exam afterwards. This would allow everyone to be there less overall time, with more information shared. This venue does NOT allow time to be devoted to other health issues, such as chronic illnesses and prescription refills. People who wish to discuss a laundry list of things will be asked to return for a separate visit to be able to devote appropriate time to issues. (This applies to standard well visits as well since each topic can be given its own importance at a separate visit.)

If your teen(s) (13-18 years) would like to participate in this pilot project, please call the office to get on a list of interested people. Be sure to let staff know any blackout dates you can't attend. I will assess how many people are interested, available dates, and ages of the interested teens to offer a few dates for appropriate ages. If your teen already has an appointment scheduled, my staff can move them to the group visit easily.  At the end of the session you will be asked to complete a survey about the concept and the work flow of the visit.

If this idea works out, I will add other age groups.  I think newborns would especially benefit, because they could follow with the same group as the kids age, allowing them to form bonds with other families and get support for all the concerns of their age group.

Call the office soon if you're interested!

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