Are shared medical appointments the key to solving global health care shortages?

New research from ESMT Berlin shows that shared medical appointments improve patient satisfaction, learning, and medication compliance, without compromising follow-up rates or clinical outcomes.

The researchers wanted to understand the impact of shared medical appointments on patient experience (knowledge gained and satisfaction) and behavior (follow-up rates and medication compliance rates). The findings are published in the journal PLOS Global Public Health.

In shared medical appointments (SMAs), patients with the same medical condition meet with the physician in a group, with each patient receiving attention in turn. The physician shares information customized to a patient's specific needs as well as standardized information relevant to other patients with the same condition.

SMAs have been touted as a potentially effective way to meet health care demand worldwide, especially in countries facing significant strain on their health care systems. However, the limited adoption of SMAs in the health care sector can be attributed to patient concerns regarding loss of privacy, which may impede open discussion of sensitive medical issues and dampen learning, satisfaction, and engagement.

This new research shows that SMAs significantly improved patient satisfaction, learning, and medication compliance, with no compromise of patient follow-up rates or measured clinical outcomes.

The researchers conducted a large-scale randomized controlled trial at the Aravind Eye Hospital in India. India has almost a fifth of the world's population but spends only 1.1% of GDP on health and faces a dire shortage of health care capacity. One thousand patients with primary glaucoma were randomly assigned to either attend one-on-one appointments or SMAs with five total patients in four successive routine follow-up visits scheduled four months apart.

At the end of each appointment, patients were surveyed to assess their satisfaction with the appointment, their knowledge about glaucoma, and their intention to return for a follow-up appointment. Patients were also tracked for their medication compliance rates.

This research was conducted by Nazlı Sönmez, ESMT Berlin; Kavitha Srinivasan and Rengaraj Venkatesh, Aravind Eye Hospital (India); Ryan W. Buell, Harvard Business School; and Kamalini Ramdas, London Business School.

"The demand for health care worldwide is soaring and exceeds supply," says Sönmez. "In underdeveloped countries, especially, the patient-to-doctor ratio is staggering, and patients face high barriers to receiving care. We must use innovative solutions, like shared medical appointments, to meet this demand. Failure to do so would deprive a huge number of people of their fundamental human right to health care access."

According to the researchers, SMAs could expand access to public health care, lower costs for private care, and significantly improve medical outcomes for various conditions, particularly for type 2 diabetes, in both primary and secondary care settings. The innovative utilization of SMAs could ensure that more patients receive access to health care faster, facilitating health care for all.