July 2, 2012
Shared Medical Appointments Revisited
It does not seem possible that from May 2010 to now I have gone from being a total skeptic about this topic to an advocate. There are many types of diseases that could benefit from shared medical appointments. Why are they not as popular as they could be? This is a multifaceted situation that troubles many of those that have found success within SMAs.
I have recently talked with two physicians that have been using SMAs with good success. I am apologetic that neither will allow me to use their names and would only talk to me after affirming that I would not reveal their location or the type of practice. I can only say that other doctors are pressuring them to discontinue this part of their practice.
From my own observations, I can say that many doctors do not understand the benefits of SMAs and see no purpose to them. Other doctors view them as a threat and want to have them banned. Now a few doctors may well see them as a threat as they are the ones losing patients to these doctors. A couple of patients have expressed the satisfaction of finding others with the same disease and getting the communication going that they felt their former doctor was ignoring. They said that hope was restored and they felt that they were learning where before they were in a constant battle to have simple questions answered.
To this, I can only say that the medical community climate is changing and doctors that are unwilling to adjust, may be adjusted out of practice. Patients are starting to realize that they have rights and need communication with the doctor.
I have discovered the medical groups in some states are becoming entrenched and protective of their way of life; they are opposing anything new that happens to work. Those doctors that are hospital employees are strongly opposing concierge medicine and anything remotely resembling this. In many areas of this country, hospitals are hiring doctors away from private practice.
I need to get back to SMAs, as they can be a real benefit. Yes, they can benefit people with type 2 diabetes. However, this may be difficult for some doctors to use, as many people with type 2 diabetes want to keep it a secret. Their doctor and office staff can know, but not their neighbors or others in their community. SMAs may reveal this to those they do not wish to have known about their diabetes. Even our informal group has this happen when one of our members knows another person with type 2 diabetes and many of us have been asked not to talk about them with our friends.
One doctor has a small group with the same type of disease. He said that they really delve into different areas of the disease and contact each other outside the SMA. The doctor is now trying to get other types of diseases with four or more patients together for SMAs.
Just think of the information exchange that could take place for diabetes, multiple sclerosis, cancer, and other diseases. Granted, some people will not feel comfortable in SMAs because of their desire for secrecy, but others could really benefit. It is the open exchange of information that seems to help people in SMAs and points to the real benefits.
Other types of SMAs do exist that are more open and patients are encouraged to exchange ideas and information. This article from the Veterans Administration is also an excellent reference. I must apologize as two of the links I had here no longer exist as the American Association of Family Physicians has pulled the information because of opposition to SMAs. The VA reference is still valid, but you will need a PDF reader to view the file now.