December 7, 2008

• The doctor will see you now. and you. and you.

  Alcoholics do it. Addicts Do it. Widows do it. Would you care to join?

  http://www.boston.com/news/local/massachusetts/articles/2008/11/30/the_doctor_will_see_all_of_you_now/?page=2

  I am talking of course, about the idea of group therapy. An article in the boston something or other was recently written about how a harvard cardiologist see his patients in groups of 9 or 10. He then spends an hour examining all of them, answering their questions, and doing all the things that we are generally expected to do in a 15 minute appointment

  This idea of a shared medical appointment brings up some interesting pros and cons.

  Obviously the biggest con is that we can just go right ahead and throw HIPAA out the window at that point. If you are seeing people in a group, there is no way to keep each patients information private. And while YOU may be okay with the other people knowing your general health status, what if the doctor finds something you didnt expect…now its a bunch of stranger instead of family surrounding you. And while any part of the exam that requires disrobing or partial nudity is still done in a private room, do you really see a cardiologist for example taking each patient aside to auscultate on skin, or do you think its more likely they will just start listening to the heart and lungs through clothes? My money is on a decrease in clinical exam skills

  Then again, this does give the patient much more time to spend with the doc, provided they dont mind sharing it. And perhaps a question you may have been frightened to ask, or not known you should have could be brought up by another. Plus you in theory have an instant support group-people who are going through the same things you are, even if that happens to be the i eat too many cheetos and dont exercise at all support group. It would certainly ease our workload as physicians and if we could bill this as 9 patient visits all seen at the same time then yay, until the insurance companies catch on and find some other way to screw us…

  What do you think-would YOU go to a multiple appointment, or if from the physician side, would you want to run one?

  Medicine as a system has failed and has to change with the times…but is this the wave of the future?

  -Almost Dr J

  • 8:20 pm
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