Study: Shared medical appointments benefit women undergoing evaluation for macromastia

Participants laud group education and support, says study in plastic and reconstructive surgery

For women considering breast reduction surgery, initial evaluation at a shared medical appointment (SMA) provides excellent patient satisfaction in a more efficient clinic visit, reports a study in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Shared medical appointments have additional benefits, including "group learning, peer support, and a sense of solidarity and commonality" among women learning about breast reduction surgery, according to the study by Dr. Aviram M. Giladi of University of Michigan, Ann Arbor, and colleagues.

Shared Medical Appointment for Macromastia

The researchers offered shared medical appointments to women undergoing initial evaluation for symptomatic macromastia--pain and other symptoms related to large breasts. Patients were given the choice between an SMA and a traditional, one-on-one appointment with the plastic surgeon.

In addition to an individual, private examination and discussion of surgical options, the SMA approach included a group information and education session with the surgeon. On average, eight patients (each accompanied by one female guest) participated in the group session.

Patient satisfaction rates were compared for 26 women who chose an SMA against 26 who chose traditional appointments. Results demonstrated very high patient satisfaction rates--89 percent overall and 92 percent with regard to the thoroughness of care, in both the shared and individual appointment groups. More than 75 percent of patients who participated in the shared appointments said they would be likely to choose the same option in the future.

Concurrently, the SMA approach "more than doubled provider efficiency and clinic workflow," according to Dr. Giladi and colleagues. By combining some of the common informational aspects of the usual individual visit in the group portion of the visit, "The number of patients seen per hour substantially increased with the SMA model, as did each patient's total interaction with the surgeon." Including the educational session, SMA patients enjoyed four times longer total contact time with the surgeon.

For Patients, a Shared Medical Appointment Has Additional Benefits

Many women in the SMA group said they appreciated hearing the questions and concerns raised by other patients. One woman commented, "All the different questions asked and everyone having the same problem helped me not be shy and ask everything I needed to."

The concept of a group medical visit is not new--it was originally introduced for routine physical exams, and to improve long-term management of chronic diseases such as diabetes. Shared medical appointments have since expanded to a wide range of specialties and patient groups.

The SMA approach--combining traditional patient evaluation with a "community learning environment"-- also has benefits for women being evaluated for breast reduction surgery, the new study suggests. Dr Giladi and coauthors conclude, "We are able to provide this enhanced patient experience, built on camaraderie, peer support, and group education, while improving provider and clinic efficiency."

The study provides new evidence that patients find benefits in group consultation for breast reduction surgery, according to this month's introductory video by Rod J. Rohrich, MD, Editor-in-Chief, on the Plastic and Reconstructive Surgery website. "Macromastia patients liked shared medical appointments," says Dr. Rohrich. "It'll be exciting to see how patients with other conditions react to this unique practice as it continues to grow."