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Patients Benefit From Group Medical Appointments

Getting in to see a headache specialist can take months and the appointments are never long enough to ask all your questions. Could group medical appointments be a solution that allows patients to spend more time with their doctors as well as learn from other patients? The motivation behind shared medical appointments is to “ease physician shortages, and reduce patient and doctor dissatisfaction over constantly feeling rushed during appointments.” The idea is a little off-putting at first, but patients with a variety of medical conditions — and their doctors — are finding great benefit in such appointments (according to news articles, at least).

A group visit can have as many as a dozen patients and last for as long as two hours. Every patient is asked for his or her concerns and can ask questions and provide input to other patients. The doctor acts as a facilitator and answers questions, often covering more topics than they could in a shorter visit. A physical exam, if necessary, is still done in private. Studies indicate that patients treated in groups actually have better outcomes than those who see their doctors in traditional appointments.

These appointments sound like a hybrid doctor’s visit and support group with the added benefit of a trained medical professional who can correct misunderstandings. Unlike a support group, I doubt there’s much exploration of the emotional burden and quality of life issues associated with illness. It would, however, introduce patients to others with similar struggles in their geographic area, thus possibly promoting support groups that gather spontaneously. It might also bring home to doctors just how much an illness impacts their patients’ lives.

I wonder how it works for patients who are in different stages of their treatment. Would a migraineur who has tried dozens of preventives benefit from being in a group with someone who had only tried two, and vice versa? I’m not ready to give up my one-on-one time with my headache specialist just yet, but the idea of a group visit is fascinating.

Would you attend a group medical appointment, whether for migraine or another illness? If you already have, what did you think and would you do it again?

6 Responses to Patients Benefit From Group Medical Appointments

  1. Nilofer says:

    I think it would be a great idea. I find I have so many questions but I think that there are only a handful of people who could address them. For instance, I know that gluten upregulates zonulin (zonulin is made by the body and opens the tight junctions between intestinal cells). This process leads to leaky gut syndrome. Then, the body sees all of these food particles (which it really should NOT see)and then the immune system can react to them. So, one question is, if dairy is eaten with gluten, and undigested food gets into the blood stream, does the body create antibodies to both? Is there cross-reactivity so that the antibodies attack not just the piece of cheese, but proteins in teh body that look like cheese (have a similar amino acid sequence)? I would do anything for a group session with someone like Dr A. Fasano.

  2. Sarah says:

    I know of a couple of people thought they were lactose intolerant for years until they found out that they actually were coeliacs. Once they had stopped eating gluten (and given their intestines some time to heal), they found they were able to eat dairy again. It’s not quite the same thing as Nilofer is asking about (lactose intolerance is not an immune response, it’s the lack of an enzyme that processes the lactose sugar), but it does show that one problem can exacerbate/cause another.

  3. J Hattori says:

    Kerrie
    How are you doing on the Ritalin? Group appts sound great but would not work in Canada because of the different way that doctors bill the system unlike USA
    Julia

  4. Nilofer says:

    I have found that after avoiding gluten (as perfectly as I can but I certainly have mishaps) I have been able to tolerate more dairy than before. I am afraid to have too much and certainly haven’t tried aged cheeses, just some American cheese here and there and if I have milk with de-caf coffee, I take a lactase pill for good measure. Microbial diversity or change in gut microbes is a big part of the puzzle. Since humans don’t have the enzyme necessary to break down a portion of the gluten (I think the gliadin) this undigested product sits there and bacteria digest it for us. Except, these might not be the friendly, good bacteria that we would want. Do the waste products of these bacteria also elicit a zonulin response, furthering a leaky gut? Same with lactose, since we don’t (a lot of us at least) produce lactase, the enzyme that breaks down lactose, bacteria will do it for us. Are these good bacteria? Do they produce toxic byproducts instead of good by products like short chain fatty acids? Probiotics go a long way but since bacteria outnumber our cells 1000 to 1, it is not an easy task to get a nice set of flora. Eat lots of green leafy veggies is a good start.

  5. Nilofer says:

    Oops, mistake above: “bacterial cells outnumber human cells by ten to one” (not 1000:01) as written in Moises Velasquez-Manoff’s recent book “An Epidemic of Absence – A New Way of Understanding Allergies and Autoimmune Diseases” a very detailed, interesting book.

  6. Liss says:

    I would do this! I think it would have helped me last year when I thought I was all alone. I am lucky that my doctor DOES give me good one-on-one time but I could see the benefit in this. I wouldn’t want it to be every appointment though. Perhaps 2x/year (as I see my neuro usually once every 2-3months). Sometimes I don’t want to spend 2 hours and ask a bunch of questions.

    For confidentiality sake, it may be that also certain things can’t be addressed in a group appointment, or that you may have to sign a waiver.

    I think patients at all different stages together might be good too. The more seasoned patients could be helpful to the new patients. However, the more seasoned patients may want an option to be with others like them

    The takeaway–I think it’s a great idea, in moderation.

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