Thompson-Lastad Ariana, Gardiner Paula
Osher Center for Integrative Medicine, UC San Francisco School of Medicine, San Francisco, California.
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts.
Glob Adv Health Med. 2020 Nov 18;9:2164956120973979. doi: 10.1177/2164956120973979. eCollection 2020.
There is strong evidence for clinical benefits of group medical visits (GMVs) (also known as shared medical appointments) for prenatal care, diabetes, chronic pain, and a wide range of other conditions. GMVs can increase access to integrative care while providing additional benefits including increased clinician-patient contact time, cost savings, and support with prevention and self-management of chronic conditions. During the COVID-19 pandemic, many clinical sites are experimenting with new models of care delivery including virtual GMVs using telehealth. Little research has focused on which clinicians offer this type of care, how the GMV approach affects the ways they practice, and their job satisfaction. Workplace-based interventions have been shown to decrease burnout in individual physicians. We argue that more research is needed to understand if GMVs should be considered among these workplace-based interventions, given their potential benefits to clinician wellbeing. GMVs can benefit clinician wellbeing in multiple ways, including: (1) Extended time with patients; (2) Increased ability to provide team-based care; (3) Understanding patients' social context and addressing social determinants of health. GMVs can be implemented in a variety of settings in many different ways depending on institutional context, patient needs and clinician preferences. We suggest that GMV programs with adequate institutional support may be beneficial for preventing burnout and improving retention among clinicians and health care teams more broadly, including in integrative health care. Just as group support benefits patients struggling with loneliness and social isolation, GMVs can help address these and other concerns in overwhelmed clinicians.
有充分证据表明,团体医疗就诊(GMV,也称为共享医疗预约)在产前护理、糖尿病、慢性疼痛以及许多其他病症方面具有临床益处。GMV可以增加综合护理的可及性,同时带来额外益处,包括增加临床医生与患者的接触时间、节省成本以及为慢性病的预防和自我管理提供支持。在新冠疫情期间,许多临床机构正在试验新的护理提供模式,包括使用远程医疗的虚拟GMV。很少有研究关注哪些临床医生提供这类护理、GMV方法如何影响他们的执业方式以及他们的工作满意度。基于工作场所的干预措施已被证明可以减少个体医生的职业倦怠。我们认为,鉴于GMV对临床医生健康可能带来的益处,需要更多研究来确定是否应将其纳入这些基于工作场所的干预措施之中。GMV可以通过多种方式使临床医生受益,包括:(1)与患者相处的时间延长;(2)提供团队式护理的能力增强;(3)了解患者的社会背景并解决健康的社会决定因素。GMV可以根据机构背景、患者需求和临床医生偏好,以多种不同方式在各种环境中实施。我们建议,获得充分机构支持的GMV项目可能有助于预防职业倦怠,并更广泛地提高临床医生和医疗团队(包括综合医疗保健领域)的留职率。正如团体支持对与孤独和社会隔离作斗争的患者有益一样,GMV可以帮助解决不堪重负的临床医生面临的这些及其他问题。