Patel Saxena Shilpa
SevaMed Institute, Lutz, Florida.
Am J Lifestyle Med. 2016 Jun 23;10(5):330-337. doi: 10.1177/1559827616638018. eCollection 2016 Sep-Oct.
Many challenges in reversing the chronic disease epidemic boil down to a lack of available time. Without time, implementing effective lifestyle medicine therapies and creating a therapeutic partnership between provider and patient is ineffectual. Although useful, the individual medical appointment model alone has not proved to "bend the cost curve" or improve morbidity. Lifestyle-based group visits (LBGVs) are extended clinical encounters that allow physicians and their patients to exchange valuable information regarding optimal chronic disease management within a supportive group format. Clinically, LBGVs improve patient knowledge scores and chronic disease outcome measures. Operationally, they reduce lobby wait times, increase available new and established patient appointment slots (ie, improving access), and improve provider and patient satisfaction measures. LBGVs simultaneously improve patient lives, disease management costs, and practice revenue when used in primary care and specialty practices. By providing personalized lifestyle education coupled with in-depth behavior modification support from a provider and a peer group with similar successes and struggles, group visits reduce symptomatology and reverse disease progression without expensive medications, procedures, and technologies. Despite perceived obstacles, the group medical appointment model is easy to implement and provides consistent benefits in settings ranging from residency programs to cash-based boutique practices.
扭转慢性病流行趋势面临的诸多挑战归根结底是时间不足。没有时间,实施有效的生活方式医学疗法以及在医疗服务提供者和患者之间建立治疗伙伴关系就毫无成效。虽然单独的个体医疗预约模式有一定作用,但尚未证明能“扭转成本曲线”或改善发病率。基于生活方式的小组就诊(LBGVs)是一种延长的临床诊疗形式,它使医生及其患者能够在支持性的小组环境中就最佳慢性病管理交流有价值的信息。在临床上,LBGVs提高了患者的知识得分和慢性病治疗效果指标。在运营方面,它们减少了候诊时间,增加了新患者和老患者的预约时段(即改善了就医机会),并提高了医疗服务提供者和患者的满意度指标。当在初级保健和专科诊疗中使用时,LBGVs能同时改善患者生活、疾病管理成本和诊疗收入。通过提供个性化的生活方式教育,再加上来自医疗服务提供者以及有着类似成功与困难经历的同伴群体的深入行为改变支持,小组就诊无需昂贵的药物、手术和技术就能减轻症状并逆转疾病进展。尽管存在一些可预见的障碍,但小组医疗预约模式易于实施,并且在从住院医师培训项目到现金支付的精品诊疗机构等各种环境中都能带来持续的益处。