Elsevier

Surgery for Obesity and Related Diseases

Volume 2, Issue 5, September–October 2006, Pages 509-512
Surgery for Obesity and Related Diseases

Original article
Shared medical appointments: new concept for high-volume follow-up for bariatric patients

Presented as a Poster Presentation at the 23rd Annual Meeting of the American Society for Bariatric Surgery, June 26, 2006, San Francisco, California.
https://doi.org/10.1016/j.soard.2006.05.010Get rights and content

Abstract

Background

Shared medical appointments (SMAs) are a new model in patient care. This model was designed to improve patients’ access to their physicians and improve physician productivity. The aim of this study was to evaluate patient satisfaction with SMAs after bariatric surgery.

Methods

The medical records of consecutive patients who were followed up after bariatric surgery were retrospectively reviewed. The type of bariatric surgery and type of medical appointment were recorded, as were the patients’ replies to the evaluation questionnaires in the SMA group.

Results

From April 2004 to December 2004, 277 individual visits were conducted; 242 visits for patients who underwent Roux-en-Y gastric bypass and 35 visits for patients who underwent laparoscopic gastric banding. Thirty-three SMAs occurred during that period—28 SMAs for patients who underwent Roux-en-Y gastric bypass and 5 SMAs for patients who underwent laparoscopic gastric banding. Of the patients who initially participated in an SMA, 91% scheduled a subsequent SMA, and 96% indicated that they would recommend SMAs to others. On a scale of 1 to 5 (1, poor and 5, excellent), patients graded their overall experience with SMAs as 4.5. Other parameters in the questionnaire all ranked between 4 and 5. The average waiting period for an appointment before the implementation of SMAs was 57.7 days (range 50–65) for new patients and 50 days (range 20–72) for former patients. After the implementation of SMAs, the average waiting period was 25 days (range 8–42) for new patients (P = 0.0046) and 20.3 days (range 0–42) for former patients (P = 0.06).

Conclusion

The SMA offers the patient prompt access to medical care, enables high-volume follow-up, with high satisfaction rates.

Section snippets

SMA model

In our clinic, we adopted the follow-up SMA and physical examination SMA models. SMAs were offered to all consecutive patients who had undergone surgery at least 2 months previously. The first follow-up visit after surgery was always an individual one. Before and during the implementation of SMAs, all patients received a form explaining the SMA model, and the patients with upcoming individual appointments were interviewed by telephone and were offered the opportunity of changing their

Results

From April 2004 to December 2004, 277 individual visits were conducted—242 for patients who underwent RYGBP and 35 for patients who underwent LGB. During the same period, 33 SMAs (physical examination and follow-up) were conducted: 28 for patients who underwent RYGBP and 5 for patients who underwent LGB.

Of the patients who initially participated in an SMA, 91% scheduled a subsequent SMA and 96% indicated they would recommend SMAs to others. On a scale of 1 to 5 (1, poor and 5, excellent),

Discussion

The treatment of obesity is challenging and often disappointing, despite a variety of pharmacologic treatments, nutritional regimens, exercise, and behavioral therapy [7]. Although bariatric surgery offers patients an effective and sustained treatment for obesity, it is no panacea. Patients who undergo bariatric surgery also require intensive follow-up, including lifestyle and behavioral modifications. With the growing obese population and increasing demand for bariatric surgery, it is

Conclusion

SMAs can increase patient access and reduce backlog without increasing clinic time. This model can boost productivity and improve patient care, with high satisfaction rates.

References (9)

  • Managed Care Magazine. Available at http://www.managedcaremag.com/archives/0305/0305.sharedappointments.html. Accessed...
  • M. Wellington

    Stanford Health Partners: rationale and early experiences in establishing physician group visits and chronic disease self-management workshops

    J Ambul Care Manage

    (2001)
  • H.L. Thacker et al.

    Shared medical appointments: facilitating interdisciplinary care for midlife women

    J Womens Health (Larchmt)

    (2005)
  • D.L. Bronson et al.

    Shared medical appointments: increasing patient access without increasing physician hours

    Cleve Clin J Med

    (2004)
There are more references available in the full text version of this article.

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