Shared Medical Appointments (SMAs), or ‘Group Visits’, are “a series of consecutive individual medical consultations in a supportive group setting where all can listen, interact, and learn.”
As such, SMAs are both an individual consultation and an informal group education session, and:
- Increase clinical cost-efficiency
- Use peer support for better outcomes
- Mean not repeating yourself ad nauseum
- Improve clinical teamwork
- Increase patient/provider satisfaction
- Make clinical practice more fun!
The current SMA Protocol was adapted from overseas models by Professor Garry Egger and Professor John Stevens, and has since developed into an efficient and effective form of patient consultation and management with a robust protocol, a number of local research studies, and an abundance of real world application.
The structure of SMAs
The minimal ‘team’ for an SMA is a doctor and a trained facilitator. In an SMA, the doctor carries out his/her doctoring, but with other patients watching. The facilitator introduces the group, writes records and questions on a board, assists the doctor with information, controls the group dynamics, and in some cases writes the medical records.
Other personnel can include a documenter (to keep medical records), a Practice Nurse (for carrying out pre-group observations) or other allied health professionals according to the group needs and financial availability.
Watch an SMA in action:
The evidence for SMAs
Traditionally, medical consultations have been carried out in a 1:1 situation; an ‘expert’ (doctor) consulting with one patient. This has served us well, and still does with injuries and infectious diseases. But the rise in chronic and lifestyle-related diseases has dramatically altered the clinical landscape.
No longer is a short consultation with a doctor sufficient or necessarily appropriate to manage what can amount to complex, lifetime, metabolic, cardiovascular, respiratory and other disorders.
In the past, attempts have been made to address this by the development of education sessions (e.g. diabetes education), usually involving one health ‘expert’ and a patient group of say, 10-20 people. But the group education lacks medical input and the 1:1 consultation lacks an education component. Hence another model was still needed.
ASLM has partnered with the Monash Centre for Health Research and Implementation (MCHRI) to conduct further research into the cost effectiveness and outcomes of SMAs. MCHRI aims to research, implement and translate clinical, health services and public health knowledge, underpinned by cross sector end-user engagement, to improve health outcomes. We’re delighted to be part of this initiative and held our first joint workshop on 13 May 2017 at Monash Medical Centre.
- Shared Medical Appointments: An adjunct for chronic disease management in Australia?
- A user assessment of the potential for shared medical appointments in Australia
- Sharing care – Garry Egger and John Dixon
- Is there a SMArter way to manage chronic care?
- The Doctor will see you ALL now – Shared Medical Appointments
- Patients’ and providers’ satisfaction with shared medical appointments
- Shared Medical Appointments for Aboriginal and Torres Strait Islander Men
- Programmed shared medical appointments: A novel procedure for chronic disease management
- Diabetes threatens to overwhelm western Sydney hospitals as obesity epidemic rages
- Could shared medical appointments help the NHS and patients?
- Health gains of group visits – Medical Observer
- Shared Medical Appointments May Be Effective for Improving Clinical and Behavioral Outcomes in Type 2 Diabetes: A Narrative Review
SMA training and professional development
Interested in learning more about SMAs?
Watch this introductory webinar designed to answer common questions regarding Shared Medical Appointments, including what they are, the existing research, and derivatives of the SMA concept.
Interested in conducting SMAs?
Register for this workshop to learn how to conduct SMAs, and optionally complete followup assessment and peer review to become an ASLM Certified SMA Facilitator.