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Ladies and Gentlemen, the Doctor Will See You Now

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No matter what they're called, group medical appointments usually share a certain structure. There's a socialization period, followed by an educational component. A question and answer session might follow, along with a check of vital signs. Patients can then get new prescriptions from the doctor, referrals, and perhaps minor tests done. And if necessary, they can have short, one-on-one, private consultations. Length of time for a group session varies, with Scott's running about two and a half hours.

Jill Antonides felt the group she attended, at about an hour and a half, with her 62-year-old mother wasn't long enough. The group focused on osteoporosis, a concern of Jill's mother, Sally. She did say, however, that questions asked by the patients in the group seemed to generate even more questions. "One thing I

noticed was the emphasis on self-care. That was impressive to me," says Antonides.

As far as concerns about confidentiality, Antonides says none of the patients seemed to mind the fact some of their previous study results were discussed publicly. She says her mother enjoyed the appointment and learned from it.

Marlene McKenzie, RN, MS, regional coordinator for senior programs at Kaiser, adds that most participants feel it's time well spent. She says they usually cite five main areas of satisfaction. "First, the relationship with their doctor. They feel they know their doctor a lot better, they feel their doctor knows them a lot better. They know him as a person and that's real special to them," she says. "Second, they value the opportunity of getting together with other people who are dealing with some of the same challenges of aging that they are. Third, they love the education component. Fourth, the opportunity to ask questions. They feel that in a routine doctor's office visit it's difficult to get the questions answered. They don't feel there's enough time or they forget to ask them. And fifth, the social component. They like getting together with people they know as friends."

The problem is, that friendly gathering is sponsored and supported by a managed care provider. Which raises a question: What's in it for the insurance companies? That has yet to be determined -- since group appointments are a relatively new concept and not yet widely available. And if up-front costs are an important consideration, they might stay that way: "It's more expensive to do group visits than individual office visits," Noffsinger says. "In addition to the physician, you have a behaviorist on hand, plus a nurse or other specialist." Throw in the clerical staffer to keep the records straight and a need for office space, and it starts to involve some serious cash.

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